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A randomised control trial and cost-consequence analysis to examine the effects of a print-based intervention supported by internet tools on the physical activity of UK cancer survivors
b University of Surrey, School of Psychology, Faculty of Health and Medical Sciences, Guildford Surrey, GU2 7XH, UK
Objective: The objective of this AMG-176 study was to evaluate the effectiveness of a print-based intervention supported by Internet tools at improving physical activity in cancer survi-vors compared with a standard letter recommendation. Prediagnosis physical activity and self-efficacy were hypothesised to predict physical activity improvement.
Study design: Waiting list randomised control trial and cost-consequence analysis. Methods: Adult cancer survivors who could become physically active without prior medical approval were randomised to receive either a print-based intervention supported by Internet tools (intervention, n ¼ 104) or a standard letter recommendation (control, n ¼ 103). Physical activity was assessed at 12 weeks with maintenance assessed at 24 weeks in the intervention arm. The number needed to treat was calculated, and a cost-consequence analysis completed.
Results: Participants in receipt of a print-based intervention supported by Internet tools improved their physical activity by 36.9% over 12 weeks compared with 9.1% in the control arm. Physical activity was maintained at 24 weeks in the intervention arm. A total of 6.29 cancer survivors needed to receive the intervention for one cancer survivor to improve their physical activity over a standard letter recommendation. Intervention delivery cost £8.19 per person. Prediagnosis physical activity and self-efficacy did not predict physical activity improvement.
Conclusion: A print-based intervention supported by Internet tools offers a promising low-cost means to intervene to improve physical activity in cancer survivors.
The study was registered with the International Standard Randomised Controlled Trials Number registry (registration number: 66418871), and ethical approval was received from the University of Surrey (reference: UEC/2017/023/FHMS).
© 2019 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
E-mail addresses: [email protected] (J. Webb), [email protected] (C. Fife-Schaw), [email protected] (J. Ogden).
0033-3506/© 2019 The Authors. Published by Elsevier Ltd on behalf of The Royal Society for Public Health. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
The benefits of physical activity for cancer survivors are well documented.1 A recent systematic review of systematic re-views concludes aorta physical activity significantly improves clinical and functional outcomes in cancer survivors before treatment, during active treatment and after treatment regardless of cancer type.1 Physical activity is safe1,2 and should be recommended to all cancer survivors but with appropriate screening in place to identify those requiring medical support or guidance before increasing physical ac-tivity.1 Despite the benefits of being active, physical activity typically decreases after a cancer diagnosis and may not increase without intervention.3 Only 23% of cancer survivors in England are active to the aerobic physical activity guidelines.4