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Type: Journal article
Title: Translating research into practice: outcomes from the Healthy Living after Cancer partnership project
Author: Eakin, E.G.
Reeves, M.M.
Goode, A.D.
Winkler, E.A.H.
Vardy, J.L.
Boyle, F.
Haas, M.R.
Hiller, J.
Mishra, G.D.
Jefford, M.
Koczwara, B.
Saunders, C.M.
Chapman, K.
Hing, L.
Boltong, A.G.
Lane, K.
Baldwin, P.
Millar, L.
McKiernan, S.
Demark-Wahnefried, W.
et al.
Citation: BMC Cancer, 2020; 20(1):963-1-963-13
Publisher: Springer Nature; BioMed Central
Issue Date: 2020
ISSN: 1471-2407
Statement of
Elizabeth G. Eakin, Marina M. Reeves, Ana D. Goode, Elisabeth A.H. Winkler, Janette L. Vardy, Frances Boyle, Marion R. Haas, Janet E. Hiller, Gita D. Mishra, Michael Jefford, Bogda Koczwara, Christobel M. Saunders, Kathy Chapman, Liz Hing, Anna G. Boltong, Katherine Lane, Polly Baldwin, Lesley Millar, Sandy McKiernan, Wendy Demark-Wahnefried, Kerry S. Courneya, Jennifer Job, Natasha Reid, Erin Robson, Nicole Moretto, Louisa Gordon, and Sandra C. Hayes
Abstract: Background: 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 6 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.
Keywords: Lifestyle intervention; cancer survivors; dissemination and implementation study; physical activity; nutrition; healthy weight
Rights: © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.
DOI: 10.1186/s12885-020-07454-4
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