Oral Presentation COSA-IPOS Joint Scientific Meeting 2012

A randomised trial of the effects of a multiple health behaviour intervention for colorectal cancer survivors on quality of life and psychosocial outcomes (‘CanChange’). (#57)

Anna L Hawkes 1 , Kenneth Pakenham 2 , Kerry S Courneya 3 , Tania A Patrao 1
  1. Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia
  2. School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia
  3. Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada

Aims: To investigate the effect of a novel six month telephone-delivered multiple health behaviour intervention for colorectal cancer (CRC) survivors on health-related quality of life (HRQoL), and psychosocial outcomes including post-traumatic growth, spirituality, acceptance and distress.
Methods: 410 CRC survivors [mean(SD) age=66(10.1), 54% male] were recruited from the Queensland population-based cancer registry and randomised to the intervention or usual care (UC). The intervention included 11 acceptance commitment therapy (ACT) based telephone-delivered sessions over 6 months from a study-trained ‘Health Coach’. Health coaches used ACT strategies (e.g. mindfulness and acceptance) to enhance positive health behaviours (e.g. physical activity and diet) consistent with national recommendations for cancer survivors. Data were collected at baseline and post-intervention or 6 months. We report HRQoL (primary outcome) using the SF-36 physical component (PCS) and mental component summary scores (MCS), and psychosocial outcomes (secondary outcomes) including post-traumatic growth (PTGI), spirituality (FACT-sp), acceptance (AAQ-II) and distress (BSI-18). Intervention effects and within group improvements are presented as mean difference (95% CI), p value from baseline to 6 months using linear mixed models.
Results: Study retention was 84.6% and did not differ among groups. Intervention effects were observed for post-traumatic growth [7.5(3.7,11.2),p<0.001], spirituality [1.8(0.4,3.3),p=0.011] and acceptance [0.2(0.1,0.3),p=0.005)]. Within group improvements (intervention vs UC) in HRQoL {PCS [3.4(2.1,4.6),p<0.001 vs 3.4(2.1,4.6),p<0.001]; MCS [1.9(0.6,3.2),p=0.003 vs 1.2(-0.0,2.5),p=0.057]} and distress [-2.3(-3.4,-1.2),p<0.001 vs -2.4(-3.5,1.3), p<0.001)] were observed in both groups, and the differences between treatment groups were not significant (p>0.05).
Conclusions: The CanChange intervention had significant effects on post-traumatic growth, spirituality and acceptance. Improvements in HRQoL and distress were not significantly different between treatment groups. The CanChange intervention has clinical application as it improved psychosocial outcomes. Importantly, being telephone-delivered, it could increase program reach and has the potential to be adopted by the growing number of organisations that operate telephone information, support and triage centres.