- Title
- Multiple health behaviours in cancer survivors: does a cancer diagnosis provide a teachable moment for health behaviour change?
- Creator
- Tollosa, Daniel
- Relation
- University of Newcastle Research Higher Degree Thesis
- Resource Type
- thesis
- Date
- 2021
- Description
- Research Doctorate - Doctor of Philosophy (PhD)
- Description
- Healthy lifestyle behaviours (not smoking, minimal alcohol consumption, healthy diet, and regular physical activity) and maintaining a healthy weight could reduce various aspects of cancer burden, and thus cancer diagnosis may be a cue for health behaviour change (known as a ‘teachable moment’); however, compelling evidence in support of this hypothesis is limited. This PhD will help to fill this gap by presenting evidence whether a cancer diagnosis a trigger for adherence to multiple health behaviours recommendation. This program of work comprises four studies: one systematic review and meta-analysis summarising evidence regarding adherence to multiple lifestyle recommendations; and three empirical studies (one cross-sectional and two longitudinal) examining whether a cancer diagnosis provides a teachable moment for health behaviour change. The empirical studies utilised data from the 1946-51 cohort (n=13,714 at baseline in 1996) of the Australian Longitudinal Study of Women’s Health. The systematic review and meta-analysis (n=51 included studies, n=2,620,566 participants) found that adherence to health behaviour recommendations among cancer survivors was low (95% CI: 17%, 30%, I2=99.2%), with relative adherence lower among long-term survivors (95% CI: 14%, 36%, I2=99.0%) compared to more recently diagnosed survivors (95% CI: 27%, 35%, I2=83.2%). Similarly, the cross-sectional study (using the 2013 and 2016 [n=2,613, 63-70 years] ALSWH surveys) showed adherence to multiple health lifestyle recommendations was low among female cancer survivors in Australia, although adherence was significantly higher compared to women without a cancer history. The first longitudinal study utilised a repeated cross-sectional design (n=8,340 at baseline, aged 50-55 years), and showed that compared to the period pre-diagnosis, adherence to multiple health behaviour recommendations improved during the period immediately following diagnosis, but these initial improvements were not sustained in the longer term. The second longitudinal study utilised 15 years of follow-up data in women diagnosed with breast cancer (n=153 at baseline, mean age = 52.38 years), and demonstrated disparate results for different health behaviours, with a cancer diagnosis having a greater positive impact on physical activity and fruit intake compared to smoking and alcohol consumption, and no changes in intake of whole vegetables or other nutrient recommendations. Being in a healthy weight range was significantly reduced following diagnosis and continued to decline over the survivorship period. Overall, this program of work concluded that a cancer diagnosis may offer a teachable moment for improving health behaviours, although there was variation across different behaviours, and the early positive changes are not sustained. There is a need to increase the availability and uptake of multiple health behaviour change interventions for cancer survivors over the survivorship period.
- Subject
- health behaviours; teachable moment; cancer survivors; adherence; thesis by publication
- Identifier
- http://hdl.handle.net/1959.13/1468588
- Identifier
- uon:48066
- Rights
- Copyright 2021 Daniel Tollosa
- Language
- eng
- Full Text
- Hits: 489
- Visitors: 666
- Downloads: 216
| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | ATTACHMENT01 | Thesis | 6 MB | Adobe Acrobat PDF | View Details Download | ||
| View Details Download | ATTACHMENT02 | Abstract | 250 KB | Adobe Acrobat PDF | View Details Download |