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Self-management support in colorectal cancer care pilot study

ABSTRACT: Interventions: The intervention involves administration of The Flinders Program at the Wellington Blood & Cancer Centre. Approximately fifty eligible patients diagnosed with colorectal cancer will be randomised into intervention and control groups after completing an initial assessment. Those in the intervention group will be given three cancer coaching sessions with a trained coach over 3-months during regularly scheduled outpatient treatment appointments. The Flinders Program is a set of generic tools and processes enabling health professionals and health consumers to undertake a structured process that allows for assessment of self-management behaviours, collaborative identification of problems and goal setting leading to the development of individualised care plans (Flinders Human Behaviour & Health Research Unit, 2005). Each 30-60 minute cancer coaching session involves discussions centred around the person, not the disease. Support provided attempts to encourage collaboration and problem-solving; ideally resulting in increased resilience, information sharing, referral (if appropriate) and care planning. Primary outcome(s): Self-management competency as measured by the Flinders Partners in Health scale.[Pre- and post-intervention (4-months)] Study Design: Purpose: Educational / counselling / training; Allocation: Randomised controlled trial; Masking: Open (masking not used);Assignment: Parallel;Type of endpoint: Efficacy

DISEASE(S): Public Health-health Service Research,Colorectal Cancer,Cancer-bowel-back Passage (rectum) Or Large Bowel (colon),Co-morbidity

PROVIDER: 2458985 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: The general rehabilitation program will consist of a multidisciplinary education and exercise program, which will be provided as group sessions twice weekly for 8 weeks. The education component will include 1-hour nutritional advice and management provided by a dietitian; 1-hour exercise education regarding the importance of exercise to well-being, bladder and bowel advice, and adherence to exercise provided by a physiotherapist; 1-hour fatigue management and return to work strategies provided by an occupational therapist; and 5-hours health behavior change and self-management strategies provided by a psychologist. The exercise component will consist of a moderate intensity (Borg Rating of Perceived Exertion (RPE) Scale 12-14), physiotherapist-supervised, combined aerobic and resistance training program. The exercise program will be individualized based on the results from baseline outcome measures. Participants will be required to attend an one hour education session per week and an one hour exercise session per week over the 8-week intervention period. The home-based walking program requires participants to perform daily walking with duration and intensity individually prescribed based on the results of baseline walking tests. To encourage adherence to the home-based walking program, 6 telephone motivational coaching sessions (1 to 2 calls per month) will be provided from a physiotherapist, between data collection time-points 2 (immediately post-intervention) and 3 (6 months following baseline) . Daily feedback for participants regarding distance and number of steps taken will be encouraged with a simple pedometer. Primary outcome(s): Functional capacity as assessed using the six-minute walk test [At baseline, immediately post-intervention, and at 6 months following baseline];Feasibility as assessed by the recruitment rate, adherence, withdrawals, and adverse events. There are minimal risks associated with the rehabilitation and measurement tests. Participants may feel some general muscle discomfort after exercise, which is a normal response to exercise.[At baseline, immediately post-intervention, and at 6, 12, 24, and 60 months following baseline] Study Design: Purpose: Educational / counselling / training; Allocation: Non-randomised trial

Project description:Interventions: The intervention will include (I) providing a wearable tracker; (ii) up to six individual telephone or social media based sessions of health coaching. and (iii) a booklet with physical activity information and motivational tools to support behaviour change. The wearable tracker will be a wrist worn Fitbit Charge 2. Participants will be encouraged to wear the Fitbit during all waking hours, except for showering or swimming. However, it is not mandatory to wear the Fitbit during all waking hours. Participants will choose mode of delivery according to their preferences from a choice of telephone, Skype, zoom, or messenger etc. This is a distance-based intervention. Therefore the wearable tracker will be mailed to participants. Four sessions of health coaching are fixed (at wk 1, 2, 4 and 8) for all participants and will last up to 45 minutes each. However, the intervention includes a patient-centred and stepped-care approach by providing additional health coaching sessions (i.e., at wk 6, and 10) to those who may need them in order to achieve meaningful sustained physical activity change. A Health coach will be employed to deliver the intervention and will be required to have a background in Psychology or allied health discipline (at least to degree level), and previous experience of interviewing or working with patients. There is no specific exercise prescription but participants will be encouraged to meet the physical activity guidelines for cancer survivors, which is at least 150 minutes of moderate-intensity physical activity per week. They will also be informed that 3-5 hours of moderate-intensity physical activity will bring maximum benefits and will be encouraged to reach this goal once achieve the minimum guidelines of 150-minutes per week. The purpose of the health coaching is to motivate and support increased physical activity through supporting self-efficacy, action planning, and coping planning. The first session will cover technical issues and featu Primary outcome(s): The primary outcome is Minutes of Moderate to vigorous physical activity per week assessed using an accelerometer (the Actigraph GT9 X). At each assessment point, participants will be mailed the Actigraph and asked to wear the device on their hip or waist for a period of 7 consecutive days during all waking hours.[week 12 post baseline assessment];Change in minutes of sedentary behaviour per week, also assessed using the Actigraph GT9X . Sedentary behaviour will be defined by accelerometer activity counts of <100 counts per minute, for 20 consecutive minutes or more.[week24 post baseline assessment] Study Design: Purpose: Prevention; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Parallel;Type of endpoint: Efficacy

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Self-management support in colorectal cancer care pilot study

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