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Systematic review and meta-analysis of maintenance of physical activity behaviour change in cancer survivors

Systematic review and meta-analysis of maintenance of physical activity behaviour change in cancer survivors
Systematic review and meta-analysis of maintenance of physical activity behaviour change in cancer survivors
Background

Physical activity can improve health and wellbeing after cancer and may reduce cancer recurrence and mortality. To achieve such long-term benefits cancer survivors must be habitually active. This review evaluates the effectiveness of interventions in supporting maintenance of physical activity behaviour change among adults diagnosed with cancer and explores which intervention components and contextual features are associated with effectiveness.

Methods

Relevant randomised controlled trials (RCTs) were identified by a search of Ovid Medline, Ovid Embase and PsychINFO. Trials including adults diagnosed with cancer, assessed an intervention targeting physical activity and reported physical activity behaviour at baseline and ≥ 3 months post-intervention were included. The behaviour change technique (BCT) taxonomy was used to identify intervention components and the Template for Intervention Description and Replication to capture contextual features. Random effect meta-analysis explored between and within group differences in physical activity behaviour. Standardised mean differences (SMD) describe effect size.

Results

Twenty seven RCTs were included, 19 were pooled in meta-analyses. Interventions were effective at changing long-term behaviour; SMD in moderate to vigorous physical activity (MVPA) between groups 0.25; 95% CI = 0.16–0.35. Within-group pre-post intervention analysis yielded a mean increase of 27.48 (95% CI = 11.48-43.49) mins/wk. of MVPA in control groups and 65.30 (95% CI = 45.59–85.01) mins/wk. of MVPA in intervention groups. Ineffective interventions tended to include older populations with existing physical limitations, had fewer contacts with participants, were less likely to include a supervised element or the BCTs of ‘action planning’, ‘graded tasks’ and ‘social support (unspecified)’. Included studies were biased towards inclusion of younger, female, well-educated and white populations who were already engaging in some physical activity.

Conclusions

Existing interventions are effective in achieving modest increases in physical activity at least 3 months post-intervention completion. Small improvements were also evident in control groups suggesting low-intensity interventions may be sufficient in promoting small changes in behaviour that last beyond intervention completion. However, study samples are not representative of typical cancer populations. Interventions should consider a stepped-care approach, providing more intensive support for older people with physical limitations and others less likely to engage in these interventions.
1479-5868
1-20
Grimmett, Chloe
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Corbett, Teresa
bce81837-17ae-46c3-a6b1-43a7e1f07f9c
Brunet, Jennifer
557c25b8-af75-44c8-b916-f042e2a00333
Shepherd, Jonathan
dfbca97a-9307-4eee-bdf7-e27bcb02bc67
Pinto, Bernardine M.
0c949cc8-f305-4913-a4ff-17e2b4b807e1
May, Carl R.
ef3787f2-f6cf-4e96-954a-4012f6879c89
Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73
Grimmett, Chloe
7f27e85b-2850-481d-a7dd-2835e1a925cd
Corbett, Teresa
bce81837-17ae-46c3-a6b1-43a7e1f07f9c
Brunet, Jennifer
557c25b8-af75-44c8-b916-f042e2a00333
Shepherd, Jonathan
dfbca97a-9307-4eee-bdf7-e27bcb02bc67
Pinto, Bernardine M.
0c949cc8-f305-4913-a4ff-17e2b4b807e1
May, Carl R.
ef3787f2-f6cf-4e96-954a-4012f6879c89
Foster, Claire
00786ac1-bd47-4aeb-a0e2-40e058695b73

Grimmett, Chloe, Corbett, Teresa, Brunet, Jennifer, Shepherd, Jonathan, Pinto, Bernardine M., May, Carl R. and Foster, Claire (2019) Systematic review and meta-analysis of maintenance of physical activity behaviour change in cancer survivors. International Journal of Behavioral Nutrition and Physical Activity, 16 (1), 1-20. (doi:10.1186/s12966-019-0787-4).

Record type: Article

Abstract

Background

Physical activity can improve health and wellbeing after cancer and may reduce cancer recurrence and mortality. To achieve such long-term benefits cancer survivors must be habitually active. This review evaluates the effectiveness of interventions in supporting maintenance of physical activity behaviour change among adults diagnosed with cancer and explores which intervention components and contextual features are associated with effectiveness.

Methods

Relevant randomised controlled trials (RCTs) were identified by a search of Ovid Medline, Ovid Embase and PsychINFO. Trials including adults diagnosed with cancer, assessed an intervention targeting physical activity and reported physical activity behaviour at baseline and ≥ 3 months post-intervention were included. The behaviour change technique (BCT) taxonomy was used to identify intervention components and the Template for Intervention Description and Replication to capture contextual features. Random effect meta-analysis explored between and within group differences in physical activity behaviour. Standardised mean differences (SMD) describe effect size.

Results

Twenty seven RCTs were included, 19 were pooled in meta-analyses. Interventions were effective at changing long-term behaviour; SMD in moderate to vigorous physical activity (MVPA) between groups 0.25; 95% CI = 0.16–0.35. Within-group pre-post intervention analysis yielded a mean increase of 27.48 (95% CI = 11.48-43.49) mins/wk. of MVPA in control groups and 65.30 (95% CI = 45.59–85.01) mins/wk. of MVPA in intervention groups. Ineffective interventions tended to include older populations with existing physical limitations, had fewer contacts with participants, were less likely to include a supervised element or the BCTs of ‘action planning’, ‘graded tasks’ and ‘social support (unspecified)’. Included studies were biased towards inclusion of younger, female, well-educated and white populations who were already engaging in some physical activity.

Conclusions

Existing interventions are effective in achieving modest increases in physical activity at least 3 months post-intervention completion. Small improvements were also evident in control groups suggesting low-intensity interventions may be sufficient in promoting small changes in behaviour that last beyond intervention completion. However, study samples are not representative of typical cancer populations. Interventions should consider a stepped-care approach, providing more intensive support for older people with physical limitations and others less likely to engage in these interventions.

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Systematic review and meta-analysis of maintenance of physical activity behaviour change in cancer survivors - Accepted Manuscript
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More information

Accepted/In Press date: 1 March 2019
Published date: 27 April 2019

Identifiers

Local EPrints ID: 429877
URI: https://eprints.soton.ac.uk/id/eprint/429877
ISSN: 1479-5868
PURE UUID: 69056c15-2628-46a0-bcd1-d3941f1311a7
ORCID for Chloe Grimmett: ORCID iD orcid.org/0000-0002-7540-7206
ORCID for Teresa Corbett: ORCID iD orcid.org/0000-0002-5620-5377
ORCID for Jonathan Shepherd: ORCID iD orcid.org/0000-0003-1682-4330
ORCID for Claire Foster: ORCID iD orcid.org/0000-0002-4703-8378

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Date deposited: 08 Apr 2019 16:30
Last modified: 15 Jul 2019 16:36

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