Abstract
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Endometrial
cancer survivors comprise a high-risk group for obesity-related
comorbidities. Healthy eating and physical activity can lead to better health
and well-being, but this population may experience difficulties adopting
healthy lifestyle practices. Personalised behaviour change programmes that
are feasible, acceptable, and cost-effective are needed. Using various
methodologies, this doctoral research aimed to develop and pilot a healthy
eating and physical activity program. Through a systematic literature review
and meta-analysis, study 1 demonstrated preliminary evidence that obesity is
positively associated with overall mortality. Expanding the review, study 2
indicated that a healthy lifestyle is positively associated with
health-related quality of life. Study 3 primarily piloted the instruments and
procedures for the trial. Study 4, using qualitative methodology, suggested
that interventions should incorporate recommendations on managing late-treatment
effects, and behaviour change techniques for cognitive, practical, and social
barriers to healthy lifestyle changes. Based on this feedback, an
evidence-based weight management programme was adapted using the intervention
mapping systematic framework in study 5. Subsequently, the programme was
piloted in a phase II, individually randomized, parallel, controlled,
two-site, pilot clinical trial in study 6. Adult endometrial cancer survivors
(n = 60)
who had been diagnosed with endometrial cancer within the previous 3 years
and were not on active treatment were assigned in a 1:1 ratio through
minimisation to either the 8-week, group-based, behaviour-change programme
with weekly 90-min sessions about healthy eating and physical activity or
usual care. Follow-up assessments were conducted at 8 and 24 weeks from the
baseline assessment. The intervention, which focused on self-monitoring, goal
setting, and self-incentives, was feasible in terms of recruitment,
adherence, and retention. It also showed promising effectiveness. The study
results will inform the development of a randomised controlled trial to test
if the programme can improve the health and quality of life of this
population.
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