Center of Research on Psychological Disorders and Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.
Ann Behav Med. 2024 Jan 1;58(1):22-36. doi: 10.1093/abm/kaad049.
Optimal approaches to promote sustained adherence to lifestyle and bodyweight recommendations in postmenopausal breast cancer (PMBC) survivors are lacking.
This Delphi-study aims to identify and understand expert-opinion on potential barriers and facilitators for promoting adherence to these lifestyle and bodyweight recommendations in (clinical) care for PMBC survivors, and to determine potential effective intervention strategies.
The expert panel consisted of oncology Health Care Professionals (HCPs) (N = 57), patient advocates (N = 5), and PMBC survivors (N = 38). They completed three questionnaires: Q1-idea generation; Q2-validation and prioritization; Q3-ranking. The Behavior Change Wheel was used as theoretical framework for analysis. Thematic analysis was applied to identify key overarching themes based on the top-ranked facilitators and barriers. Potential Behavior Change Techniques (BCTs) and intervention strategies were identified using the Behavior Change Technique Taxonomy version 1 and the Behavior Change Wheel.
Eleven core categories of key barriers/facilitators for the promotion of adherence to recommendations for lifestyle and bodyweight among PMBC survivors were identified. For each core category, relevant BCTs and practical potential intervention strategies were selected based on suggestions from the expert panel. These included: increasing knowledge about the link between lifestyle and cancer; enabling self-monitoring of lifestyle behaviors followed by evaluation; offering group lifestyle counseling for PMBC survivors, enhancing social support for favorable lifestyle behaviors; and stimulating multidisciplinary collaboration among HCPs.
Findings provide valuable insight for the development of interventions changing behavior of PMBC survivors and HCPs toward increased healthy lifestyle (support) behavior.
缺乏促进绝经后乳腺癌（PMBC）幸存者坚持生活方式和体重建议的最佳方法。
本 Delphi 研究旨在确定和了解专家对促进 PMBC 幸存者临床护理中坚持这些生活方式和体重建议的潜在障碍和促进因素的意见，并确定潜在的有效干预策略。
专家小组由肿瘤学医疗保健专业人员（HCP）（N = 57）、患者权益倡导者（N = 5）和 PMBC 幸存者（N = 38）组成。他们完成了三份问卷：Q1-创意生成；Q2-验证和优先级排序；Q3-排名。行为改变车轮被用作分析的理论框架。主题分析用于根据排名最高的促进因素和障碍确定关键的总体主题。使用行为改变技术分类学 1 版和行为改变车轮确定潜在的行为改变技术（BCT）和干预策略。
确定了促进 PMBC 幸存者坚持生活方式和体重建议的 11 个核心类别的关键障碍/促进因素。对于每个核心类别，根据专家小组的建议选择了相关的 BCT 和实用的潜在干预策略。这些包括：提高对生活方式与癌症之间联系的认识；使 PMBC 幸存者能够自我监测生活方式行为，然后进行评估；为 PMBC 幸存者提供团体生活方式咨询，增强对有利生活方式行为的社会支持；并刺激 HCP 之间的多学科合作。
研究结果为制定干预措施提供了有价值的见解，这些干预措施旨在改变 PMBC 幸存者和 HCP 对增加健康生活方式（支持）行为的行为。
