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Institute of Epidemiology & Health Care

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Energy Balance & Cancer

energy-balance-cancer

Our research aims to establish the roles of health behaviours (predominantly physical activity and diet) across the cancer continuum, from primary prevention of cancer to improving outcomes after a cancer diagnosis. The programme of research we conduct involves both large epidemiological surveys, randomised controlled trials and pilot/feasibility studies. 


Contact

This group is led by Dr Abi Fisher (abigail.fisher@ucl.ac.uk)


Group Members 

Research staff: 

Dr Abi Fisher
Dr Phillippa Lally
Joanna Land
Dr Anna Roberts
Victoria Ireland
Sara Esser
Rana Conway

Zeynep Nas - Postdoctoral research fellow
I’m a postdoctoral research fellow working with Dr Clare Llewellyn and the wider Gemini study team. My research focus will be on appetite, eating behaviours as well as parental feeding practices using twin model fitting as well as molecular genetic approaches.

PhD students: 

Verity Hailey
I am a PhD student with the Soc-B programme, and my project is looking at ‘The role of social factors in physical activity during COVID-19 pandemic’. My main supervisor is Dr Abi Fisher.

Laetitia Firmenich
I am a first year PhD student in the Department of Behavioural Science and Health at UCL. During my PhD I aim to investigate the impacts of weight and diet on cancer survivorship through both qualitative and quantitative studies.

Orla McCourt
Project title: Exercise during haematological cancer treatment- exploring the feasibility of embedding exercise within a clinical pathway in multiple myeloma.
I am supervised by Prof Kwee Yong (UCL Cancer Institute), Dr Abi Fisher and Dr Gita Ramdharry (UCL Centre for Neuromuscular Diseases). My PhD is funded by a Health Education England (HEE)/National Institute for Health Research (NIHR) Integrated Clinical Doctoral Research Fellowship.

Caroline Buck
I am working at Department of Behaviour Science and Health, supervised by Dr Abi Fisher, as part of a doctoral programme at Liverpool John Moores University. I have a background in qualitative research, and am currently involved in the ASCOT study. I have just completed a qualitative project on the impact of the pandemic on the health behaviours of people living with and beyond breast, colorectal and prostate cancer. I am also working on the APPROACH trial, delivering an intervention that examines whether an app encouraging more physical activity improves the physical and psychosocial wellbeing of people living with cancer. Next year I plan to conduct a mixed methods study on the impact of perimenopause/menopause on the health behaviours of women.

Alex Rhodes 
Project title: Developing an app-based intervention to encourage and support expectant parents to develop healthier dietary and physical activity habits.
Pregnancy is a significant life change which can prompt the re-evaluation of health behaviours. A healthy eating and physical activity intervention targeting expectant couples could help to reduce rates of excessive gestational weight gain and build better lifestyle behaviours for family life. The intervention will draw on habit theory and the COM-B model of behaviour change and use a person-based approach in its development. It will sit within Baby Buddy, the free, NHS-approved pregnancy and parenting app from UK charity Best Beginnings.

Francesca Bentivegna 
Project title: Appetite, self-regulation, and the development of binge-eating behaviours: nature via nurture
I have recently started as a PhD student in the Energy Balance and Obesity research group, and my primary supervisor is Dr Clare Llewellyn. The aim of my project is to identify if food approach appetitive traits and self-regulation are risk factors for the onset of binge-eating symptoms using large population-based samples. Also, I aim to understand the genetic contributions to (and their interactions in) this relationship and to compare the findings across multiple population cohorts, including the Gemini twin study.
 


Research

Ongoing projects

Completed PhD projects

  • Gemma Pugh: Health behaviour change among teenage and young adult (TYA) cancer survivor
    There is growing recognition that teenage and young adult (TYA) cancer survivors should adopt a healthy lifestyle in order to reduce the impact a cancer diagnosis has upon growth and development as well as long-term health. There is a need for effective, inexpensive, and scalable health behaviour change interventions to be developed for TYA cancer survivors’ in the UK. The aim of this thesis was to develop a health behaviour intervention specifically for TYA cancer survivors. This thesis includes: a systematic review of existing interventions targeting health behaviour change among TYA cancer survivors; data on the proportion of TYA cancer survivors meeting current health behaviour recommendations in comparison to TYAs within the general population (Study 1); and quantitative and qualitative data on TYA cancer survivors’ interest in receiving health behaviour information and preference regarding the format, delivery, and timing of such information (Study 2 and Study 3). The results of the literature review and of studies 1-3 were combined with data on health professionals’ views of health behaviour intervention delivery to young people with cancer (Study 4) to inform the development of health behaviour change intervention resources containing comprehensive lifestyle information and behaviour change support tools. These resources were formatively evaluated by TYA cancer survivors and TYA health professionals for relevance, appeal and usability (Study 5). Results demonstrate TYA cancer survivors have a high level of interest in receiving health behaviour change support and would be open to engaging with the proposed intervention materials. The findings from this thesis contribute towards the development of a best practice health behaviour intervention for TYA cancer survivors. Such an intervention could be widely disseminated leading to an improvement in TYA cancer survivorship.
     
  • Anna Roberts: Development of a smartphone app-based intervention to promote physical activity among people living with and beyond cancer
    Cancer diagnoses are increasing, and people are living for increasing numbers of years after diagnosis, so it is important that cancer survivors are supported to live well, for as long as possible. Physical activity improves quality of life, cancer treatment side effects, and reduces risk of other comorbidities. Many cancer survivors do not meet recommended levels of physical activity and evidence-based interventions that are accessible and scalable are needed. Digital interventions could reach large proportions of the population in a cost-effective and scalable way. This thesis used mixed-methods to conduct a series of studies with the aim of developing a smartphone-app based intervention to promote physical activity in breast, prostate and colorectal cancer survivors. Study 1 showed that digital interventions have the potential to increase cancer survivors’ moderate-vigorous physical activity by 41 minutes per week, however high-quality studies are lacking. Study 2 found that up to 38% of cancer survivors are interested in internet-based and app-based health behaviour interventions. Interest is related to several sociodemographic and participant characteristics. Study 3 found that physical activity apps must acknowledge the varying needs and physical activity preferences of cancer survivors. Apps that promote walking and are recommended by members of their clinical team are favoured. Study 4 provided insight into Clinical Nurse Specialists’ perceptions of their role in physical activity promotion and showed that they are generally positive about the use of apps to complement existing physical activity promotion in cancer care. Together, these studies led to the development of an app-based physical activity intervention for cancer survivors.
  • Claire Stevens: Cancer Screening as a Teachable Moment for Risk Reduction Behaviour
    This thesis explored whether cancer screening participation (breast, bowel, cervical, lung) could be a prompt for spontaneous behaviour change, or an opportunity to deliver behavioural cancer prevention interventions. A systematic review found limited support for breast, bowel, cervical and lung screening as a prompt for spontaneous behaviour change (Study 1). Study 2, in a sample (n=774) of screening-naïve men from the English Longitudinal Study of Ageing, found data indicating that Faecal Occult Blood Testing (FOBT) participation might prompt small positive changes to vigorous physical activity. Study 3A (n=1,037) found most breast, bowel and cervical screening intenders were willing to receive lifestyle advice in a hypothetical screening scenario, even if results require further investigations. Two-thirds of were willing to receive advice about diet, weight and physical activity (Study 3B; n=1,221). Interest in advice about smoking and alcohol consumption was lower.  In a hypothetical lung screening scenario, most screening intenders were willing to receive lifestyle advice, more so if results require further investigations (Study 4; n=459). Half were interested in advice about smoking cessation. There was also some interest in advice about diet, weight, physical activity and alcohol consumption. A qualitative exploration of openness to receiving lifestyle advice alongside cancer screening was conducted among 30 breast, bowel and cervical screening attendees (Study 5). Receptivity was influenced by individuals’ affective response to cancer screening and how advice would be delivered. Four distinct types of receptivity to advice were identified. This study does not support a ‘one-size-fits-all’ approach to intervention delivery in this setting.

    Together, findings from this thesis suggest that in the absence of spontaneous behaviour change, targeted interventions and advice may be welcome in the context of cancer screening. 

Completed projects


Publications - Abi Fisher

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