Live Virtual Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Translating research into practice: outcomes from the healthy living after cancer partnership project  (#133)

Elizabeth Eakin 1 , Marina M Reeves 1 , Ana D Goode 1 , Elisabeth A H Winkler 1 , Janette L Vardy 1 , Frances Boyle 1 , Marion R Haas 1 , Janet E Hiller 1 , Gita D Mishra 1 , Michael Jefford 1 , Bogda Koczwara 1 , Christobel M Saunders 1 , Kathy Chapman 1 , Liz Hing 1 , Anna G Boltong 1 , Katherine Lane 1 , Polly Baldwin 1 , Lesley Millar 1 , Sandy McKiernan 1 , Wendy Demark-Wahnefried 1 , Kerry S Courneys 1 , Jennifer Job 1 , Natasha Reid 1 , Erin Robson 1 , Nicole Moretto 1 , Louisa Gordon 1 , Sandra C Hayes 1
  1. School of Population Health, Cancer Prevention Research Centre, The University of Queensland, Herston, QLD, Australia

Aims: Healthy Living after Cancer (HLaC) was a national dissemination and implementation study of an evidence-based lifestyle intervention for cancer survivors. The program was imbedded into existing telephone cancer information and support services delivered by Australian state-based Cancer Councils (CC). We report here the reach, effectiveness, adoption, implementation, and maintenance of the program.

Methods: In this phase IV study (single-group, pre-post design) participants - survivors of any type of cancer, following treatment with curative intent - received up to 12 nurse/allied health professional-led telephone health coaching calls over six months. Intervention delivery was grounded in motivational interviewing, with emphasis on evidence-based behaviour change strategies. Using the RE-AIM evaluation framework, primary outcomes were reach, indicators of program adoption, implementation, costs and maintenance. Secondary (effectiveness) outcomes were participant-reported anthropometric, behavioural and psychosocial variables including: weight; physical activity; dietary intake; quality-of-life; treatment side-effects; distress; and fear of cancer recurrence and participant satisfaction. Changes were evaluated using linear mixed models, including terms for timepoint (0/6 months), strata (Cancer Council), and timepoint x strata.

Results: Four of 5 CCs approached participated in the study. In total, 1183 cancer survivors were referred (mostly via calls to the Cancer Council telephone information service). Of these, 90.4% were eligible and 88.7% (n=791) of those eligible consented to participate. Retention rate was 63.4%. Participants were mostly female (88%), aged 57 years and were overweight (BMI = 28.8±6.5 kg/m2). Improvements in all participant-reported outcomes (standardised effect sizes of 0.1 to 0.6) were observed (p<0.001). The program delivery costs were on average AU$427 (US$296) per referred cancer survivor.

Conclusions: This telephone-delivered lifestyle intervention, which was feasibly implemented by Cancer Councils, led to meaningful and statistically significant improvements in cancer survivors’ health and quality-of-life at a relatively low cost.