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Characterization and efficacy of lifestyle behavior change interventions among adult rural cancer survivors: a systematic review

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Abstract

Purpose

Little is known about the intersection between age and rurality as characteristics that impact lifestyle behavior change for cancer survivors. This review aims to summarize the current literature on lifestyle behavior change interventions conducted among rural survivors of cancer, with an emphasis on older survivors.

Methods

A systematic search of five databases identified randomized controlled trials and controlled clinical trials that targeted diet, physical activity, alcohol consumption, or tobacco use change in adult cancer survivors living in rural areas of the world.

Results

Eight studies met the inclusion criteria. Most studies were conducted in either Australia or the USA, included survivors at least 6 weeks post-treatment, and half included only breast cancer survivors, while the other four included a mix of cancer types. All but one had a physical activity component. No articles addressed changes in alcohol or tobacco behavior. Seven (87.5%) had a fully remote or hybrid delivery model. Most of the physical activity interventions showed significant changes in physical activity outcomes, while the dietary interventions showed changes of clinical but not statistical significance.

Conclusions

Few studies have been conducted to implement and evaluate the effectiveness of lifestyle behavior change interventions among older rural survivors of cancer. Future research should evaluate the acceptability and relevancy of adapted, evidence-based intervention with this population.

Implications for Cancer Survivors

Effective diet and physical activity interventions exist, albeit limited in terms of effective lifestyle behavior change intervention tailored to older, rural survivors of cancer, particularly in relation to alcohol and tobacco behaviors.

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Acknowledgements

The authors would like to thank Dr. Amanda Sokan and Dr. Zhao Chen for their topic expertise and feedback on early drafts of this manuscript.

Funding

This research was supported by the University of Arizona Cancer Center Support Grant (P30 CA023074).

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Authors and Affiliations

  1. Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA

    Samantha J. Werts, Jennifer W. Bea & Cynthia A. Thomson

  2. University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA

    Samantha J. Werts, Rogelio Robles-Morales, Jennifer W. Bea & Cynthia A. Thomson

  3. Department of Clinical Translational Sciences, College of Medicine, University of Arizona, Tucson, AZ, USA

    Rogelio Robles-Morales

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  1. Samantha J. Werts
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Contributions

Study conception and design was completed by SJW with guidance from CAT and RR-M. Material preparation, data collection and analysis were performed by SJW and RR-M. The first draft of the manuscript was written by SJW and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Samantha J. Werts.

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Werts, S.J., Robles-Morales, R., Bea, J.W. et al. Characterization and efficacy of lifestyle behavior change interventions among adult rural cancer survivors: a systematic review. J Cancer Surviv (2023). https://doi.org/10.1007/s11764-023-01464-4

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