Supporting healthy behaviours in people living with and beyond cancer

Background: There is increasing evidence for the beneficial effects of positive health behaviours, such as regular physical activity (PA) and a healthy diet, on cancer outcomes. The World Cancer Research Fund (WCRF) therefore recommends those living with and beyond cancer (LWBC) follow their PA and dietary guidelines for cancer prevention. However, there is a lack of simple, effective behaviour change interventions to support adherence to these guidelines.

Methods: We carried out a programme of work with people LWBC and healthcare professionals to inform the development of a brief intervention to support improvements across nine target behaviours aligned to the WCRF recommendations. ‘Healthy Habits for Life’ is based on habit theory and incorporates printed materials with a personally tailored discussion. A survey including questions about current health behaviours was sent out to people living with and beyond breast, colorectal and prostate cancer from 10 hospital trusts. The survey included an option for participants to express their interest in a ‘lifestyle’ trial. The primary aim of this trial was to test the effect of ‘Healthy Habits for Life’ vs ‘usual care’ on a composite health behaviour risk index (CHBRI) based on meeting/partially meeting/ not meeting the WCRF recommendations at 3 months.

Results: 5835 people LWBC completed the initial questionnaire. Less than a third were engaged in the recommended amount of PA (31%), and adherence to most dietary guidelines was low (11-46%). Most (67-70%) had not received PA or diet advice post-diagnosis, but most (60-65%) were interested in diet and PA advice.  3354 (57.5%) were “interested” in the trial and provided their contact details. Of these, 1134 (34%) participants provided complete CHBRI data at baseline and were randomised to ‘Healthy Habits for Life’ (n=555) or ‘usual care’ (n=579). Preliminary trial results will be discussed.

Conclusions: UK adults LWBC are unlikely to adhere to WCRF recommendations, and few receive advice on these post-diagnosis. ‘Healthy Habits for Life’ was developed to address an unmet need for interventions to encourage adherence. If effective, this intervention has the potential to be implemented within the cancer care pathway and could improve long-term outcomes for people LWBC.