Abstract
Purpose
Broad-reach (non-face-to-face) modalities offer an accessible and cost-effective means to provide behavior change programs in diverse and growing cancer survivor populations. The purpose of this systematic review is to evaluate the efficacy of physical activity, dietary, and/or weight control interventions for cancer survivors in which telephone, short-message service, print, and/or Web is the primary method of delivery.
Methods
A structured search of PubMed, Embase, Web of Science, CINAHL, and CENTRAL (May 2013) was conducted. Included studies focused and reported on physical activity (PA) and dietary change and/or weight control in adult cancer survivors, delivered at least 50 % of intervention contacts by broad-reach modality and included a control group. Study design, intervention features, and behavioral/weight outcomes were extracted, tabulated, and summarized.
Results
Twenty-seven studies were included; 22 telephone, three Web, and two print. Sixteen studies targeted PA, two diet, and nine targeted multiple behaviors. Most studies (18/27) targeted a single survivor group, namely breast cancer (n = 12). Nineteen of 27 studies found evidence for initiation of behavior change, with only eight reporting on maintenance and one on cost-effectiveness.
Conclusions
This review provides support for broad-reach modalities, particularly the telephone, in the delivery of lifestyle interventions to cancer survivors. Future research should evaluate (1) newer technologies (i.e., SMS and mobile phone applications), (2) interventions for diverse cancer survivors and those targeting multiple behaviors, (3) long-term outcomes, and 4) cost-effectiveness.
Implications for Cancer Survivors
Broad-reach lifestyle interventions are effective, with further research needed to evaluate their generalizability and integration into cancer care.
Similar content being viewed by others
References
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. International Agency for Research on Cancer, Lyon, France. 2013. http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Accessed 17/06/2014.
Carver JR, Shapiro CL, Ng A, Jacobs L, Schwartz C, Virgo KS, et al. American Society of Clinical Oncology clinical evidence review on the ongoing care of adult cancer survivors: cardiac and pulmonary late effects. J Clin Oncol. 2007;25(25):3991–4008.
Baade PD, Fritschi L, Eakin EG. Non-cancer mortality among people diagnosed with cancer. Cancer Causes Control. 2006;17(3):287–97.
Brown BW, Brauner C, Minnotte MC. Noncancer deaths in white adult cancer patients. J Natl Cancer Inst. 1993;85(12):979–87.
Eakin EG, Youlden DR, Baade PD, Lawler SP, Reeves MM, Heyworth JS, et al. Health status of long-term cancer survivors: results from an Australian population-based sample. Cancer Epidemiol Biomarkers Prev. 2006;15(10):1969–76.
Travis LB, Rabkin CS, Brown LM, Allan JM, Alter BP, Ambrosone CB, et al. Cancer survivorship–genetic susceptibility and second primary cancers: research strategies and recommendations. J Natl Cancer Inst. 2006;98(1):15–25. doi:10.1093/jnci/djj001.
Demark-Wahnefried W, Rock CL, Patrick K, Byers T. Lifestyle interventions to reduce cancer risk and improve outcomes. Am Fam Physician. 2008;77(11):1573–8.
Fong DY, Ho JW, Hui BP, Lee AM, Macfarlane DJ, Leung SS, et al. Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ. 2012;344:e70.
Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):243–74.
World Cancer Research Fund/American Institute for Cancer Research. Food, nutrition, physical activity, and the prevention of cancer: a global perspective. Washington: AICR; 2007.
Blanchard CM, Courneya KS, Stein K, American Cancer Society’s SCS-II. Cancer survivors’ adherence to lifestyle behavior recommendations and associations with health-related quality of life: results from the American Cancer Society’s SCS-II. J Clin Oncol. 2008;26(13):2198–204.
Eakin E, Youlden DR, Baade PD, Lawler SP, Reeves MM, Heyworth JS, et al. Health behaviors of cancer survivors: data from an Australian population-based survey. Cancer Causes Control. 2007;18:881–94.
Bourke L, Homer KE, Thaha MA, Steed L, Rosario DJ, Robb KA, et al. Interventions for promoting habitual exercise in people living with and beyond cancer. Cochrane Database Syst Rev. 2013;9, CD010192. doi:10.1002/14651858.CD010192.pub2.
Davies NJ, Batehup L, Thomas R. The role of diet and physical activity in breast, colorectal, and prostate cancer survivorship: a review of the literature. Br J Cancer. 2011;105 Suppl 1:S52–73. doi:10.1038/bjc.2011.423.
Schmitz KH, Holtzman J, Courneya KS, Masse LC, Duval S, Kane R. Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2005;14(7):1588–95. doi:10.1158/1055-9965.epi-04-0703.
Reeves MM, Terranova CO, Eakin EG, Demark-Wahnefried W. Weight loss intervention trials in women with breast cancer: a systematic review. Obes Rev. 2014;15(9):749–68. doi:10.1111/obr.12190.
Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100. doi:10.1007/s11764-009-0110-5.
McNeely ML, Campbell KL, Rowe BH, Klassen TP, Mackey JR, Courneya KS. Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ. 2006;175(1):34–41. doi:10.1503/cmaj.051073.
Pekmezi DW, Demark-Wahnefried W. Updated evidence in support of diet and exercise interventions in cancer survivors. Acta Oncol. 2011;50(2):167–78. doi:10.3109/0284186x.2010.529822.
Elena JW, Travis LB, Simonds NI, Ambrosone CB, Ballard-Barbash R, Bhatia S, et al. Leveraging epidemiology and clinical studies of cancer outcomes: recommendations and opportunities for translational research. J Natl Cancer Inst. 2013;105(2):85–94. doi:10.1093/jnci/djs473.
Phillips SM, Alfano CM, Perna FM, Glasgow RE. Accelerating translation of physical activity and cancer survivorship research into practice: recommendations for a more integrated and collaborative approach. Cancer Epidemiol Biomarkers Prev. 2014;23(5):687–99. doi:10.1158/1055-9965.EPI-13-1355.
Glasgow RE, Goldstein MG, Ockene JK, Pronk NP. Translating what we have learned into practice: principles and hypotheses for interventions addressing multiple behaviors in primary care. Am J Prev Med. 2004;27(2S):88–101.
van der Bij AK, Laurant MG, Wensing M. Effectiveness of physical activity interventions for older adults: a review. Am J Prev Med. 2002;22(2):120–33.
Stull VB, Snyder DC, Demark-Wahnefried W. Lifestyle interventions in cancer survivors: designing programs that meet the needs of this vulnerable and growing population. J Nutr. 2007;137(1 Suppl):243S–8.
Fjeldsoe B, Neuhaus M, Winkler E, Eakin E. Systematic review of maintenance of behavior change following physical activity and dietary interventions. Health Psychol. 2011;30(1):99–109. doi:10.1037/a0021974.
Eakin EG, Lawler SP, Vandelanotte C, Owen N. Telephone interventions for physical activity and dietary behavior change: a systematic review. Am J Prev Med. 2007;32(5):419–34.
Goode AD, Reeves MM, Eakin EG. Telephone-delivered interventions for physical activity and dietary behavior change: an updated systematic review. Am J Prev Med. 2012;42(1):81–8. doi:10.1016/j.amepre.2011.08.025.
Glasgow RE, Nelson CC, Strycker LA, King DK. Using RE-AIM metrics to evaluate diabetes self-management support interventions. Am J Prev Med. 2006;30(1):67–73.
Glasgow RE, Vogt TM, Boles SM. Evaluating the public health impact of health promotion interventions: the RE-AIM Framework. Am J Public Health. 1999;89:1322–7.
Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097. doi:10.1371/journal.pmed.1000097.
Valle CG, Tate DF, Mayer DK, Allicock M, Cai J. A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors. J Cancer Surviv. 2013;7(3):355–68. doi:10.1007/s11764-013-0279-5.
Cohen J. Statistical power analysis for the behavioral sciences. New York: Academic Press; 1977.
Morris SB. Estimating effect sizes from pretest-posttest-control group designs. Organ Res Methods. 2008;11(2):364–86.
Spark LC, Reeves MM, Fjeldsoe BS, Eakin EG. Physical activity and/or dietary interventions in breast cancer survivors: a systematic review of the maintenance of outcomes. J Cancer Surviv. 2013;7(1):74–82. doi:10.1007/s11764-012-0246-6.
Schulz KF, Altman DG, Moher D. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010;340:c332. doi:10.1136/bmj.c332.
Young MD, Morgan PJ, Plotnikoff RC, Callister R, Collins CE. Effectiveness of male-only weight loss and weight loss maintenance interventions: a systematic review with meta-analysis. Obes Rev. 2012;13(5):393–408. doi:10.1111/j.1467-789X.2011.00967.x.
Donnelly CM, Blaney JM, Lowe-Strong A, Rankin JP, Campbell A, McCrum-Gardner E, et al. A randomised controlled trial testing the feasibility and efficacy of a physical activity behavioural change intervention in managing fatigue with gynaecological cancer survivors. Gynecol Oncol. 2011;122(3):618–24. doi:10.1016/j.ygyno.2011.05.029.
Hawkes AL, Chambers SK, Pakenham KI, Patrao TA, Baade PD, Lynch BM, et al. Effects of a telephone-delivered multiple health behavior change intervention (CanChange) on health and behavioral outcomes in survivors of colorectal cancer: a randomized controlled trial. J Clin Oncol. 2013;31(18):2313–21. doi:10.1200/jco.2012.45.5873.
Pinto BM, Papandonatos GD, Goldstein MG. A randomized trial to promote physical activity among breast cancer patients. Health Psychol. 2013;32(6):616–26. doi:10.1037/a0029886.
Campbell MK, Carr C, DeVellis B, Switzer B, Biddle A, Amamoo MA, et al. A randomized trial of tailoring and motivational interviewing to promote fruit and vegetable consumption for cancer prevention and control. Ann Behav Med. 2009;38(2):71–85. doi:10.1007/s12160-009-9140-5.
Demark-Wahnefried W, Case LD, Blackwell K, Marcom PK, Kraus W, Aziz N, et al. Results of a diet/exercise feasibility trial to prevent adverse body composition change in breast cancer patients on adjuvant chemotherapy. Clin Breast Cancer. 2008;8(1):70–9.
Djuric Z, DiLaura NM, Jenkins I, Darga L, Jen CKL, Mood D, et al. Combining weight-loss counseling with the weight watchers plan for obese breast cancer survivors. Obes Res. 2002;10(7):657–65. doi:10.1038/oby.2002.89.
Rabin C, Dunsiger S, Ness KK, Marcus BH. Internet-based physical activity intervention targeting young adult cancer survivors. J Adolesc Young Adult Oncol. 2011;1(4):188–94.
Hatchett A, Hallam JS, Ford MA. Evaluation of a social cognitive theory-based email intervention designed to influence the physical activity of survivors of breast cancer. Psycho-Oncology. 2013;22(4):829–36. doi:10.1002/pon.3082.
Vallance JKH, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR. Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007;25(17):2352–9. doi:10.1200/jco.2006.07.9988.
Demark-Wahnefried W, Clipp EC, Lipkus IM, Lobach D, Snyder DC, Sloane R, et al. Main outcomes of the fresh start trial: a sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. J Clin Oncol. 2007;25(19):2709–18.
Jen KL, Djuric Z, DiLaura NM, Buison A, Redd JN, Maranci V, et al. Improvement of metabolism among obese breast cancer survivors in differing weight loss regimens. Obes Res. 2004;12(2):306–12. doi:10.1038/oby.2004.38.
Courneya KS, Friedenreich CM, Quinney HA, Fields ALA, Jones LW, Fairey AS. A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care. 2003;12(4):347–57.
Thorsen L, Skovlund E, Stromme SB, Hornslien K, Dahl AA, Fossa SD. Effectiveness of physical activity on cardiorespiratory fitness and health-related quality of life in young and middle-aged cancer patients shortly after chemotherapy. J Clin Oncol. 2005;23(10):2378–88. doi:10.1200/jco.2005.04.106.
Thorsen L, Dahl AA, Skovlund E, Hornslien K, Fossa SD. Effectiveness after 1 year of a short-term physical activity intervention on cardiorespiratory fitness in cancer patients. J Clin Oncol. 2007;25(10):1301–2. doi:10.1200/jco.2007.10.6682.
Demark-Wahnefried W, Clipp EC, Morey MC, Pieper CF, Sloane R, Snyder DC, et al. Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from Project LEAD. J Clin Oncol. 2006;24(21):3465–73.
Demark-Wahnefried W, Morey MC, Clipp EC, Pieper CF, Snyder DC, Sloane R, et al. Leading the way in exercise and diet (project LEAD): intervening to improve function among older breast and prostate cancer survivors. Control Clin Trials. 2003;24(2):206–23.
Bennett JA, Lyons KS, Winters-Stone K, Nail LM, Scherer J. Motivational interviewing to increase physical activity in long-term cancer survivors: a randomized controlled trial. Nurs Res. 2007;56(1):18–27. doi:10.1097/00006199-200701000-00003.
Christy SM, Mosher CE, Sloane R, Snyder DC, Lobach DF, Demark-Wahnefried W. Long-term dietary outcomes of the fresh start intervention for breast and prostate cancer survivors. J Am Diet Assoc. 2011;111(12):1844-51. doi:10.1016/j.jada.2011.09.013.
Ottenbacher AJ, Day RS, Taylor WC, Sharma SV, Sloane R, Snyder DC, et al. Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors. Support Care Cancer. 2012;20(10):2483–9. doi:10.1007/s00520-011-1370-y.
Matthews CE, Wilcox S, Hanby CL, Der Ananian C, Heiney SP, Gebretsadik T, et al. Evaluation of a 12-week home-based walking intervention for breast cancer survivors. Support Care Cancer. 2007;15(2):203–11.
Pierce JP, Natarajan L, Caan BJ, Parker BA, Greenberg ER, Flatt SW, et al. Influence of a diet very high in vegetables, fruit, and fiber and low in fat on prognosis following treatment for breast cancer - The Women’s Healthy Eating and Living (WHEL) Randomized Trial. JAMA. 2007;298(3):289–98. doi:10.1001/jama.298.3.289.
Pierce JP, Newman VA, Natarajan L, Flatt SW, Al-Delaimy WK, Caan BJ, et al. Telephone counseling helps maintain long-term adherence to a high-vegetable dietary pattern. J Nutr. 2007;137(10):2291–6.
Pierce JP, Faerber S, Wright FA, Rock CL, Newman V, Flatt SW, et al. A randomized trial of the effect of a plant-based dietary pattern on additional breast cancer events and survival: the Women’s Healthy Eating and Living (WHEL) study. Control Clin Trials. 2002;23(6):728–56.
Vallance JK, Courneya KS, Plotnikoff RC, Dinu I, Mackey JR. Maintenance of physical activity in breast cancer survivors after a randomized trial. Med Sci Sports Exerc. 2008;40(1):173–80.
Parsons JK, Newman V, Mohler JL, Pierce JP, Paskett E, Marshall J. The Men’s Eating and Living (MEAL) Study: a Cancer and Leukemia Group B pilot trial of dietary intervention for the treatment of prostate cancer. Urology. 2008;72(3):633-7.
Pinto BM, Rabin C, Papandonatos GD, Frierson GM, Trunzo JJ, Marcus BH. Maintenance of effects of a home-based physical activity program among breast cancer survivors. Support Care Cancer. 2008;33(2):235–254.
Pinto BM, Frierson GM, Rabin C, Trunzo JJ, Marcus BH. Home-based physical activity intervention for breast cancer patients. J Clin Oncol. 2005;23(15):3577–87. doi:10.1200/jco.2005.03.080.
Griffith K, Wenzel J, Shang JJ, Thompson C, Stewart K, Mock V. Impact of a walking intervention on cardiorespiratory fitness, self-reported physical function, and pain in patients undergoing treatment for solid tumors. Cancer. 2009;115(20):4874–84. doi:10.1002/cncr.24551.
Shang J, Wenzel J, Krumm S, Griffith K, Stewart K. Who will drop out and who will drop in: exercise adherence in a randomized clinical trial among patients receiving active cancer treatment. Cancer Nurs. 2012;35(4):312–22. doi:10.1097/NCC.0b013e318236a3b3.
Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, Hartman TJ, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA. 2009;301(18):1883–91. doi:10.1001/jama.2009.643.
Djuric Z, Ellsworth JS, Weldon AL, Ren J, Richardson CR, Resnicow K, et al. A diet and exercise intervention during chemotherapy for breast cancer. Open Obes J. 2011;3:87–97.
Kim SH, Shin MS, Lee HS, Lee ES, Ro JS, Kang HS, et al. Randomized pilot test of a simultaneous stage-matched exercise and diet intervention for breast cancer survivors. Oncol Nurs Forum. 2011;38(2):E97–e106. doi:10.1188/11.ONF.E97-E106.
Eakin EG, Lawler SP, Winkler EAH, Hayes SC. A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer: exercise for health. Ann Behav Med. 2012;43(2):229–38. doi:10.1007/s12160-011-9324-7.
Ligibel JA, Meyerhardt J, Pierce JP, Najita J, Shockro L, Campbell N, et al. Impact of a telephone-based physical activity intervention upon exercise behaviors and fitness in cancer survivors enrolled in a cooperative group setting. Breast Cancer Res Treat. 2012. doi:10.1007/s10549-011-1882-7.
Hawkes AL, Pakenham KI, Courneya KS, Gollschewski S, Baade P, Gordon LG, et al. A randomised controlled trial of a tele-based lifestyle intervention for colorectal cancer survivors (‘CanChange’): study protocol. BMC Cancer. 2009;9:286. doi:10.1186/1471-2407-9-.
Hayes SC, Rye S, DiSipio T, Yates P, Bashford J, Pyke C, et al. Exercise for health: a randomized, controlled trial evaluating the impact of a pragmatic, translational exercise intervention on the quality of life, function and treatment-related side effects following breast cancer. Breast Cancer Res Treat. 2013;137(1):175–86. doi:10.1007/s10549-012-2331-y.
Pinto BM, Papandonatos GD, Goldstein MG, Marcus BH, Farrell N. Home-based physical activity intervention for colorectal cancer survivors. Psycho-Oncology. 2013;22(1):54–64. doi:10.1002/pon.2047.
Cole-Lewis H, Kershaw T. Text messaging as a tool for behavior change in disease prevention and management. Epidemiol Rev. 2010;32(1):56–69. doi:10.1093/epirev/mxq004.
Wei J, Hollin I, Kachnowski S. A review of the use of mobile phone text messaging in clinical and healthy behaviour interventions. J Telemed Telecare. 2011;17(1):41–8. doi:10.1258/jtt.2010.100322.
Fjeldsoe BS, Marshall AL, Miller YD. Behavior change interventions delivered by mobile telephone short-message service. Am J Prev Med. 2009;36(2):165–73. doi:10.1016/j.amepre.2008.09.040.
Eakin E, Demark-Wahnefried W. Changing health behaviors after treatment. In: Holland JC, editor. Psycho-oncology. England: Oxford University Press; 2015.
Demark-Wahnefried W, Pinto BM, Gritz ER. Promoting health and physical function among cancer survivors: potential for prevention and questions that remain. J Clin Oncol. 2006;24(32):5125–31. doi:10.1200/jco.2006.06.6175.
Pinto BM, Waldemore M, Rosen R. A community-based partnership to promote exercise among cancer survivors: lessons learned. Int J Behav Med. 2014. doi:10.1007/s12529-014-9395-5.
Glasgow RE, Lichtenstein E, Marcus AC. Why don’t we see more translation of health promotion research to practice? Rethinking the efficacy-to-effectiveness transition. Am J Public Health. 2003;93(8):1261–7.
Green LW. Making research relevant: if it is an evidence-based practice, where’s the practice-based evidence? Fam Pract. 2008;25 Suppl 1:i20–4. doi:10.1093/fampra/cmn055.
Acknowledgments
CLB is supported by an Australian Postgraduate Award and a UQ School of Public Health Top-Up Scholarship. EGE is supported by a National Health and Medical Research Council Senior Research Fellowship. MMR is supported by a National Breast Cancer Foundation Early Career Fellowship.
Conflict of interest
ADG, SPL, CLB, MMR, and EGE declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
ESM 1
(DOCX 14 kb)
Rights and permissions
About this article
Cite this article
Goode, A.D., Lawler, S.P., Brakenridge, C.L. et al. Telephone, print, and Web-based interventions for physical activity, diet, and weight control among cancer survivors: a systematic review. J Cancer Surviv 9, 660–682 (2015). https://doi.org/10.1007/s11764-015-0442-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11764-015-0442-2