JMIR Publications

ABSTRACT

Background:

Benefits of physical activity (PA) as supportive care in oncology have been widely demonstrated by the scientific community. However, survivors who have completed chemo-radio-immunotherapy treatments don’t achieve PA recommendations. This reinforces the need to identify factors influencing PA level, and to propose a multilevel model (macro-, meso-, micro-level) to better understand what facilitates the adoption and maintenance of active behavior and what hinders it. To date, there is no socio-ecological model explaining this behavior in the post-treatment phase of breast, colorectal, prostate, and lung cancers.

Objective:

The objective is to identify factors influencing active behavior in cancer survivorship, and to assess the feasibility of an individualized program targeting the adoption and maintenance of the active lifestyle. Objectives were addressed in three stages. Stage 1 aims to identify factors influencing active lifestyle in cancer survivorship. Stage 2 aims to develop an explanatory model of the factors identified previously to build an individualized health education program targeting the adoption and maintenance of active lifestyle. Stage 3 aims to assess the feasibility and to identify the effects of an individualized health education program.

Methods:

First, the exploration of factors influencing PA (Stage 1) will be based on a mixed-methods research, using an explanatory sequential design, supported by a multi-level analysis. The quantitative phase consists in the completion of a questionnaire from a socio-ecological perspective. Then, a subsample of patients will participate in semi-structured interviews to assist in the interpretation of the quantitative results. From this phase, we seek to build a model of the factors influencing active lifestyle and to create an individualized 12-week program in accordance with our previous results (Stage 2). In phase 3, we will implement our multicenter program for 150 physically inactive cancers survivors throughout Metropolitan France. Program feasibility and transferability will be evaluated. Measured PA level by connected device, and multidimensional variables such as declared PA and sedentary behaviors, PA readiness, motivation, PA preferences, PA knowledge and skills, and barriers and facilitators will be assessed before, during the program, and 52 weeks post-intervention.

Results:

The institutional review board approved the mixed-methods study (Phase 1) in April 2020. The intervention (Phase 3) was approved in March 2022. Recruitment and data collection began in April 2022. The implementation of the intervention was concluded in March 2023, data collection and full data analysis are expected to be completed by March 2024.

Conclusions:

DEFACTO study aims to better understand, within our socio-ecological model, what facilitates active lifestyle of cancer survivors, and if a tailored intervention based on the model can support an active lifestyle. Clinical Trial: ClinicalTrials.gov NCT05354882; https://www.clinicaltrials.gov/study/NCT05354882