A randomised controlled trial of a tele-based lifestyle intervention for colorectal cancer survivors ('CanChange'): study protocol.

BACKGROUND: Colorectal cancer survivors may suffer from a range of ongoing psychosocial and physical problems that negatively impact on quality of life. This paper presents the study protocol for a novel telephone-delivered intervention to improve lifestyle factors and health outcomes for colorectal cancer survivors. METHODS/DESIGN: Approximately 350 recently diagnosed colorectal cancer survivors will be recruited through the Queensland Cancer Registry and randomised to the intervention or control condition. The intervention focuses on symptom management, lifestyle and psychosocial support to assist participants to make improvements in lifestyle factors (physical activity, healthy diet, weight management, and smoking cessation) and health outcomes. Participants will receive up to 11 telephone-delivered sessions over a 6 month period from a qualified health professional or 'health coach'. Data collection will occur at baseline (Time 1), post-intervention or six months follow-up (Time 2), and at 12 months follow-up for longer term effects (Time 3). Primary outcome measures will include physical activity, cancer-related fatigue and quality of life. A cost-effective analysis of the costs and outcomes for survivors in the intervention and control conditions will be conducted from the perspective of health care costs to the government. DISCUSSION: The study will provide valuable information about an innovative intervention to improve lifestyle factors and health outcomes for colorectal cancer survivors. TRIAL REGISTRATION: ACTRN12608000399392.

A telephone-delivered lifestyle intervention for colorectal cancer survivors 'CanChange': a pilot study.

OBJECTIVE: To investigate the feasibility and short-term effectiveness of a lifestyle intervention for colorectal cancer (CRC) survivors. METHODS: CanChange was telephone-delivered to 20 CRC survivors by health coaches over 6 weeks supported by an interactive participant handbook. We assessed program feasibility (program retention and satisfaction) and health outcomes [CRC-specific symptoms (fatigue, nausea, diarrhoea), quality of life (QOL), and lifestyle variables (physical activity, dietary intake, alcohol intake, smoking, body mass index (BMI))] at baseline and post-intervention. RESULTS: Post-intervention, 76% of participants rated the program as excellent, 100% rated the health coach as excellent, and 75% rated the handbook as excellent. In addition, 80% said that CanChange addressed their issues, 72% said that CanChange helped them deal more effectively with their problems, and 100% said that CanChange made them more motivated to make positive life changes. Finally, all participants said that they would recommend CanChange to other CRC survivors. From baseline to post-intervention we observed: non-significant improvements in all CRC-specific symptoms and QOL; a significant decrease in processed meat intake [median (interquartile range): 1.0 (3.0) vs 0.0 (1.0), p=0.01]; as well as non-significant improvements in sedentary behaviour, and the proportion of participants meeting the national guidelines for fruit and vegetable intake. We observed no change in smoking status, while the results for alcohol intake, physical activity, and BMI were variable. CONCLUSIONS: CanChange was a feasible and potentially effective lifestyle intervention to improve health outcomes for CRC survivors. A large randomised controlled trial will follow to test the longer-term effects of this approach.

Women's perceptions and beliefs about the use of complementary and alternative medicines during menopause.

INTRODUCTION: Studies of menopausal women are providing increasing evidence of the reasons for complementary and alternative medications (CAM) use during menopause, the types of CAM used and the prevalence of use; however, further insight into the experiences of women using CAM during menopause is required. The aim of this study was to put CAM use during menopause into context by identifying and describing the factors that influence menopausal women in their decision to use CAM. METHODS: Menopausal women participated in focus groups and telephone interviews and the following information were collected: symptoms experienced during menopause; therapies (other than hormones) used to cope with menopause, and the perceived benefits of these therapies, and how the women found out about these therapies. The data collected were analysed using thematic analysis. RESULTS: Fifteen women participated in the study; 13 in the focus groups and two in telephone interviews. The women reported using a diverse range of therapies, supplements and activities. Empowerment was a central theme throughout the study. The level of support from the women's general practitioners was reported to be a major influence in their decision to take CAM. The availability of information about CAM and individual determinants, such as symptoms and perceptions of menopause, were also identified as significant influences. CONCLUSION: The women in this study expressed a desire to have control over their symptoms and the way in which their menopause was treated. This study has highlighted a need for more information and education about menopause and, in particular, the range, safety and efficacy of CAM use during menopause. The study also shows there is a need for strong participatory relationships between women and their health professionals.

The use of complementary and alternative medications by menopausal women in South East Queensland.

This study aimed to identify the prevalence and types of complementary and alternative medications (CAMs) used by women during menopause and explore potential associations between CAM use and menopausal symptoms. Analysis was undertaken with 886 randomly selected menopausal women aged 47-67 years who participated in a postal questionnaire on the menopause experience. The prevalence of CAM use was relatively high (82.5%), with nutrition most commonly cited (67%), followed by phytoestrogens (56%), herbal therapies (41%), and CAM medications (25%). Multivariate analysis adjusted for confounders revealed that women who consumed CAM medications were 17-23% more likely to report anxiety (p = .019) or vasomotor symptoms (p = .013). Women who used herbal therapies (p = .009) or phytoestrogens (p = .030) were 13-16% more likely to experience vasomotor symptoms. Women who used nutrition were 18% more likely to experience anxiety (p = .049). These results highlight the importance for health professionals to incorporate CAMs into their practice to better inform menopausal women of their treatment choices.

Relationship between menopausal symptoms and menopausal status in Australian and Japanese women: preliminary analysis.

The main aim of the present study was to explore the midlife experience for women living in Australia and Japan. The specific objectives of the study included: (i) comparing menopausal symptoms between the two groups; and (ii) comparing the factor structure of symptoms and exploring their relationship to menopausal status. Postal questionnaires were distributed to two structured, random population based samples of midlife women aged 45-60 years; consisting of 712 women living in Australia and 1502 women living in Japan. Analysis showed significant differences in menopausal symptoms related to psychological symptoms (P < 0.001), including anxiety (P < 0.001) and depression (P < 0.001), somatic symptoms (P < 0.001), and vasomotor symptoms (P < 0.01). The analysis, which excluded hormone replacement therapy (HRT) users, found that there were significant differences seen across menopausal status in the following symptoms: difficulty in sleeping (P < 0.01), difficulty in concentrating (P < 0.01), feeling dizzy or faint (P < 0.001), loss of interest in most things (P < 0.01) and loss of feeling in hands or feet (P < 0.001). In the postmenopausal stage specifically, significant differences were seen in the areas of feeling tense or nervous (P < 0.01), feeling unhappy or depressed (P < 0.01), parts of body feeling numb or tingling (P < 0.05), headaches (P < 0.01), and sweating at night (P < 0.05). Our analysis revealed that the experience of menopause for women is different between Australian and Japanese women.