Healthy Living after Cancer
Despite considerable evidence, lifestyle interventions are not incorporated into the routine care of cancer survivors. Healthy Living after Cancer (HLaC) is a NHMRC-funded Partnership Project (2015 – 2019) evaluating the implementation of an evidence-based, telephone-delivered lifestyle program by four Cancer Councils (NSW, VIC, SA, WA) via their 13 11 20 service. Cancer survivors, following treatment with curative intent, are eligible for the free, six-month program of behaviourally-based support to achieve internationally-agreed recommendations for physical activity, healthy eating and healthy weight. In this phase IV dissemination study (single-group, pre-post design; baseline, 6, 12-month assessment), primary outcomes relate to program implementation: adoption (referral sources); reach (# of participants) and retention; participant and staff satisfaction; fixed and recurrent costs of program delivery. Secondary outcomes are patient-reported and validated measures of: physical activity and dietary intake/behaviour, weight, quality of life, cancer-related side-effects, and fear of recurrence. Program completers are offered the option of a further 6-months of tailored text messages to support maintenance of behaviour change. To date, 500+ participants have enrolled: 89% female; mean age 57 (SD = 11); average BMI = 29 kg/m2 (SD = 6); with a wide range of cancers; retention rate = 59%. Among the first 203 program completers, significant (p<.05) and clinically-meaningful improvements have been seen in all secondary, patient-reported outcomes. This University-Cancer Council collaboration provides an opportunity for national dissemination of an evidence-based intervention to support healthy living among cancer survivors. Rigorous evaluation of service-level and patient-reported outcomes will provide the practice-based evidence needed to inform decisions about sustained delivery.
QCCS Team Members
Prof Elizabeth Eakin
Associate Dean (Research), Faculty of Medicine, University of Queensland
Professor Elizabeth Eakin has built a program of research around behavioural approaches to chronic disease prevention and management focusing on telephone-delivered lifestyle interventions. This program emphasises physical activity (newer work on too much sitting) and dietary behaviour/weight loss interventions in a wide range of population subgroups, including office-based workers, and those with type 2 diabetes and breast cancer.
Elizabeth Eakin is Director of the Cancer Prevention Research Centre, Professor of Health Behaviour Interventions and NHMRC Senior Research Fellow within the School of Population Health at the University of Queensland. She holds an NHMRC Senior Research Fellowship (2008 – 2012, 2013 – 2017), is Chair of the Scientific Advisory Committee of the Psycho-oncology Cooperative Research Group, and is a past president of the Australasian Society for Behavioural Health & Medicine. As a behavioural scientist working in the field of population health, she has developed an internationally recognised program of research in health behaviour interventions in chronic disease prevention and management. Her research emphasises CONSORT-designed, pragmatic randomised controlled trials (RCTs) of physical activity, dietary behaviour and weight loss interventions, using broad-reach delivery modalities (telephone and text messaging) to maximise population reach. Attention is given to rigorous measurement of health behaviours and biomarkers of disease risk; development of intervention protocols guided by and contributing to the science of behaviour change and maintenance; and systematic evaluation of outcomes important to informing translation into practice, including cost-effectiveness. She has conducted numerous such RCTs involving over 2000 trial participants in health-service and community settings, with examples of the uptake of this work into population health practice across community and state-wide translational initiatives.
Professor Elizabeth Eakin has built a program of research around behavioural approaches to chronic disease prevention and management, focusing on telephone-delivered lifestyle interventions. This program emphasises physical activity (newer work on too much sitting) and dietary behaviour/weight loss interventions in a wide range of population subgroups, including office-based workers, and those with type 2 diabetes and cancer.
- PhD, University of California
- BA, University of Oregon
Prof Sandi Hayes
Principal Research Fellow, School of Public Health and Social Work, Queensland University of Technology
PhD (Queensland University of Technology)
- Cancer recovery
- Cancer rehabilitation
- Breast cancer
- Exercise interventions
Past and current projects
- Newman B, Davies P, Cornish B, Parker T, Hayes S, Hirst C, Green A, Aitken J. Limitations in upper-body function among Breast Cancer Survivors: A longitudinal study (Pulling Through Study PTS), NBCF Project Grant; $212,000 (10%) 2001-04. This was a population-based, longitudinal study that assessed the prevalence and trajectory of physical and psychosocial concerns experienced by women following breast cancer treatment.
- Turner J, Reul-Hirche H, Hayes S. Exercise and breast cancer, RBWH Research Institute; $13,000 (50%) 2003-04. This intervention pilot study aimed to improve our understanding of exercise prescription for women with breast cancer.
- Hayes S. Physical activity and breast cancer recovery: Research to reality, NBCF Postdoctoral Training Fellowship, $240,000 (100%) 2005-08. The objective of this fellowship was (i) to investigate the role of physical activity in enhancing functional capacity and quality of life among breast cancer survivors; (ii) to determine optimal exercise prescription guidelines for this population; and (iii) to investigate the most effective mechanisms to deliver exercise interventions to enhance quality-of-life throughout the breast cancer care continuum. In addition, the work has also incorporated a second primary focus, understanding the epidemiology, measurement, prevention and treatment of lymphoedema following breast cancer.
- Hayes S, Turner J, Reul-Hirch H. Randomised controlled trial of exercise in breast cancer patients with upper limb lymphoedema, Cancer and Bowel Research Trust; $20,000 (70%) 2005-06.The objective of this work was to improve our understanding of the safety and benefits of exercise for women with breast cancer-related lymphoedema.
- Hayes S, Newman B, Yates P, Eakin E, Battistutta D. Randomised controlled trial of exercise intervention for women with breast cancer, NBCF Project Grant; $310,000 (70%) 2006-08. This project involves evaluating an evidence-based exercise intervention, delivered via two different modes, designed to reduce physical symptoms and improve quality-of-life, among women during and following breast cancer treatment. Ultimately, completion of the project will enable a better understanding of the physical and psychosocial benefits attained and sustained through participation in supervised (exercise delivered face-to-face) versus unsupervised (delivered over the telephone) exercise interventions in comparison to those attained from current standard care. It will also provide valuable information in relation to the feasibility of integrating these interventions into clinical practice. If one or both of the interventions prove successful, this translational research is positioned to influence the standard of care provided to women with breast cancer.
- Eakin E, Hayes S, Lawler S. Using the telephone to promote exercise-based rehabilitation in rural/regional/remote (RRR) Australian breast cancer survivors, NBCF Pilot Grant; $85,000 (50%) 2006-08. This pilot study will evaluate the feasibility of a telephone-delivered exercise-based rehabilitation support program (used in P7) for women newly diagnosed with breast cancer living in regional, rural and remote areas of Queensland. Feasibility and effect size data from the pilot study will be used to refine the intervention and to inform a subsequent application for a fully powered RCT.
- Newman B, Kedda M, Janda M, Yates P, Hayes S, Ward L. Genetic polymorphisms and risk of secondary lymphoedema after breast cancer: a nested case-control study, Cancer Australia/NBCF; $215,000 (25%) 2008-09. This is a follow-up study to P1, however the focus is on lymphoedema rather than upper body function. The objectives of this work are to improve our understanding of the incidence of lymphoedema, as well as the genetic contribution towards risk.
- Hayes S, Millikan R. Integrating the PTS into Phase III of the Carolina Breast Cancer Study; (80%) 2008-10. This work involves integrating previous research hypothesis and methods utlised in P1 into a U. S. government-funded project, involving over 2000 women with breast cancer and 2000 controls.
- Obermair A, Janda M, Hayes S, Reul Hirch H, Ward L. Prospective evaluation of lymphoedema among patients with gynaecological cancer, Cancer Australia; $600,000 (50%) 2008-10. This project uses the experience gained from the P1 project. Results from the work will significantly advance our understanding of the measurement, incidence and aetiology of lymphoedema following gynaecological cancer.
- Breast cancer recovery
- Cancer rehabilitation
- Exercise science
Prof Monika Janda
Professor in Behavioural Science, Centre for Health Services Research, Faculty of Medicine, University of Queensland
Ph.d (University of Vienna), Master of Philosophy (University of Vienna)
Prof Monika Janda is a behavioural scientist with 15 years of experience in cancer research. She has over 180 publications in peer-reviewed journals and has presented her work at national and international conferences. Monika is currently involved in epidemiological and behavioural research to address the public health impact of
- breast cancer
- endometrial cancer
- ovarian cancer
- brain tumours.
Awards NHMRC Career Development Award level 2 2013-2016 NHMRC Career Development Award level 1 2009-2012 VC Award of Research excellence 2013
- Epidemiological and behavioural oncology research to address the public health impact of cancer
- Quality of Life Research
Professional memberships and associations
- Member – Prevention Committee, International Psycho-Oncology Society
- Member – Scientific Advisory Committee Psycho-Oncology Co-operative Research Group http://www.pocog.org.au (past chair 2013-16)
- Past member – National Working Group for Gynaecological Cancer/Cancer Australia
- Past member – Scientific Advisory Committee Cooperative Trial Group for Neuro-oncology (COGNO)
- Australian Society for Medical Research (ASMR)
- Australian Psychological Society (College of Health Psychologists)
Monika’s publications are available on:
A/Prof Marina Reeves
School of Public Health, University of Queensland
Marina Reeves is an Associate Professor in Nutrition in the Cancer Prevention Research Centre, School of Public Health. She is also an Advanced Accredited Practising Dietitian and Heads the Nutrition Unit within the School. Her program of research is focused on the role of weight management, diet and physical activity in improving outcomes for women diagnosed with breast cancer. Her research has been funded by multiple grants from the National Health and Medical Research Council (NHMRC) and National Breast Cancer Foundation (NBCF). A/Prof Reeves is currenlty leading a pilot study evaluating an exercise and diet intervention for women diagnosed with metastatic breast cancer. Marina has a particular interest in the use of broad-reach delivered interventions (e.g. delivered via telephone, SMS) to achieve and maintain weight loss and behaviour change in adults.
A/Prof Reeves has over 70 peer-reviewed publications, has presented at a number of national and international conferences, and has secured over $4.8 million in competitive research funding as a chief investigator (>$2 million as CIA).
- Doctor of Philosophy, Queensland University of Technology
- Bachelor of Health Science (Nutrition & Dietetics), Queensland University of Technology
(2017–2019) Pilot Study Grant
(2016–2017) Bond University
(2014–2018) NHMRC Partnership Projects