Goode Ana D, Lawler Sheleigh P, Brakenridge Charlotte L, Reeves Marina M, Eakin Elizabeth G
School of Public Health, Cancer Prevention Research Centre, The University of Queensland, Level 4 Public Health Building, Herston Rd, Herston, Brisbane, QLD, Australia.
J Cancer Surviv. 2015 Dec;9(4):660-82. doi: 10.1007/s11764-015-0442-2. Epub 2015 Mar 11.
Broad-reach (non-face-to-face) modalities offer an accessible and cost-effective means to provide behavior change programs in diverse and growing cancer survivor populations. The purpose of this systematic review is to evaluate the efficacy of physical activity, dietary, and/or weight control interventions for cancer survivors in which telephone, short-message service, print, and/or Web is the primary method of delivery.
A structured search of PubMed, Embase, Web of Science, CINAHL, and CENTRAL (May 2013) was conducted. Included studies focused and reported on physical activity (PA) and dietary change and/or weight control in adult cancer survivors, delivered at least 50% of intervention contacts by broad-reach modality and included a control group. Study design, intervention features, and behavioral/weight outcomes were extracted, tabulated, and summarized.
Twenty-seven studies were included; 22 telephone, three Web, and two print. Sixteen studies targeted PA, two diet, and nine targeted multiple behaviors. Most studies (18/27) targeted a single survivor group, namely breast cancer (n = 12). Nineteen of 27 studies found evidence for initiation of behavior change, with only eight reporting on maintenance and one on cost-effectiveness.
This review provides support for broad-reach modalities, particularly the telephone, in the delivery of lifestyle interventions to cancer survivors. Future research should evaluate (1) newer technologies (i.e., SMS and mobile phone applications), (2) interventions for diverse cancer survivors and those targeting multiple behaviors, (3) long-term outcomes, and 4) cost-effectiveness.
Broad-reach lifestyle interventions are effective, with further research needed to evaluate their generalizability and integration into cancer care.
广泛传播（非面对面）模式提供了一种可及且具成本效益的方式，以便在日益增多的多样化癌症幸存者群体中开展行为改变项目。本系统评价的目的是评估以电话、短信服务、印刷品和/或网络为主要传播方式的体育活动、饮食和/或体重控制干预措施对癌症幸存者的疗效。
对PubMed、Embase、科学引文索引、护理学与健康领域数据库和考克兰系统评价数据库（2013年5月）进行了结构化检索。纳入的研究聚焦于并报告了成年癌症幸存者的体育活动（PA）、饮食变化和/或体重控制情况，通过广泛传播模式提供至少50%的干预接触，并设有对照组。提取、制表并总结了研究设计、干预特征以及行为/体重结果。
纳入27项研究；22项为电话干预，3项为网络干预，2项为印刷品干预。16项研究针对体育活动，2项针对饮食，9项针对多种行为。大多数研究（27项中的18项）针对单一幸存者群体，即乳腺癌患者（n = 12）。27项研究中有19项发现了行为改变启动的证据，只有8项报告了维持情况，1项报告了成本效益。
本评价为广泛传播模式，尤其是电话模式在向癌症幸存者提供生活方式干预方面提供了支持。未来的研究应评估：（1）更新的技术（即短信和手机应用程序）；（2）针对不同癌症幸存者以及针对多种行为的干预措施；（3）长期结果；以及（4）成本效益。
广泛传播的生活方式干预是有效的，需要进一步研究以评估其普遍性以及纳入癌症护理的情况。
