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Meta-Analysis
. 2017 Dec;11(6):704-719.
doi: 10.1007/s11764-017-0632-1. Epub 2017 Aug 4.

Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis

Anna L Roberts  1 , Abigail Fisher  2 , Lee Smith  3 , Malgorzata Heinrich  4 , Henry W W Potts  5
Affiliations
Meta-Analysis

Digital health behaviour change interventions targeting physical activity and diet in cancer survivors: a systematic review and meta-analysis

Anna L Roberts et al. J Cancer Surviv. 2017 Dec.

Abstract

Purpose: The number of cancer survivors has risen substantially due to improvements in early diagnosis and treatment. Health behaviours such as physical activity (PA) and diet can reduce recurrence and mortality, and alleviate negative consequences of cancer and treatments. Digital behaviour change interventions (DBCIs) have the potential to reach large numbers of cancer survivors.

Methods: We conducted a systematic review and meta-analyses of relevant studies identified by a search of Medline, EMBASE, PubMed and CINAHL. Studies which assessed a DBCI with measures of PA, diet and/or sedentary behaviour were included.

Results: Fifteen studies were identified. Random effects meta-analyses showed significant improvements in moderate-vigorous PA (seven studies; mean difference (MD) = 41 min per week; 95% CI 12, 71) and body mass index (BMI)/weight (standardised mean difference (SMD) = -0.23; 95% CI -0.41, -0.05). There was a trend towards significance for reduced fatigue and no significant change in cancer-specific measures of quality of life (QoL). Narrative synthesis revealed mixed evidence for effects on diet, generic QoL measures and self-efficacy and no evidence of an effect on mental health. Two studies suggested improved sleep quality.

Conclusions: DBCIs may improve PA and BMI among cancer survivors, and there is mixed evidence for diet. The number of included studies is small, and risk of bias and heterogeneity was high. Future research should address these limitations with large, high-quality RCTs, with objective measures of PA and sedentary time.

Implications for cancer survivors: Digital technologies offer a promising approach to encourage health behaviour change among cancer survivors.

Keywords: Behaviour change; Cancer survivors; Diet; Digital interventions; Physical activity; Sedentary behaviour.

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Conflict of interest statement

Conflict of interest

HP has previously received consultancy from myownteam. AR, AF, LS and MH declare that they have no conflict of interest.

Funding

AR is funded by a Medical Research Council PhD studentship. AF, HP and LS are funded by the Higher Education Funding Council for England. MH is funded by Cancer Research UK (grant number C1418/A14133).

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. The current study was a review/meta-analysis of existing studies that did not involve collection of new data.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram illustrating article selection strategy
Fig. 2
Fig. 2
Meta-analysis of DBCIs on MVPA
Fig. 3
Fig. 3
Risk of bias in included studies
See this image and copyright information in PMC

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