Towards OPtimal TIming and Method for promoting sUstained adherence to lifestyle and body weight recommendations in postMenopausal breast cancer survivors (the OPTIMUM-study): Protocol for a longitudinal mixed-method study

Sandra J. M. Van Cappellen-van Maldegem, Floortje Mols, Nicole Horevoorts, Anja De Kruif, Laurien M. Buffart, Dounya Schoormans, Hester Trompetter, Sandra Beijer, Nicole P. M. Ezendam, Michiel De Boer, Renate Winkels, Ellen Kampman, Jantine Schuit, Lonneke Van De Poll-franse, Jacob C. Seidell, Meeke Hoedjes

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Abstract

Background
The majority of postmenopausal breast cancer (PMBC) survivors do not adhere to lifestyle recommendations and have excess body weight. In this group, this is associated with poorer health-related quality of life and an increased risk of type II diabetes mellitus, cardiovascular disease, second primary cancers, cancer recurrences, and mortality. Gaining and maintaining a healthy lifestyle and body composition is therefore important. It is unknown when and how sustained adherence to these recommendations can be promoted optimally in PMBC survivors. Therefore, the OPTIMUM study aims to identify the optimal timing and method for promoting sustained adherence to lifestyle and body weight recommendations in PMBC survivors.

Methods
The OPTIMUM-study has a mixed-methods design. To assess optimal timing, a longitudinal observational study will be conducted among approximately 1000 PMBC survivors. The primary outcomes are adherence to lifestyle and body weight recommendations, readiness for change, and need for support. Questionnaires will be administered at 4–6 months after cancer diagnosis (wave 1: during treatment and retrospectively before diagnosis), 1 year after diagnosis (wave 2: after completion of initial treatment), and 1.5 years after diagnosis (wave 3: during follow-up). Wave 2 and 3 include blood sampling, and either wearing an accelerometer for 7 days or completing a 3-day online food diary (randomly assigned at hospital level). To assess the optimal method, behavioural determinants of the primary outcomes will be matched with Behavior Change Techniques using the Behaviour Change Technique Taxonomy. Qualitative research methods will be used to explore perceptions, needs and preferences of PMBC survivors (semi-structured interviews, focus groups) and health care providers (Delphi study). Topics include perceptions on optimal timing to promote adherence; facilitators and motivators of, and barriers towards (sustained) adherence to recommendations; and acceptability of the selected methods.

Discussion
The OPTIMUM study aims to gain scientific knowledge on when and how to promote sustained adherence to lifestyle and body weight recommendations among PBMC survivors. This knowledge can be incorporated into guidelines for tailored promotion in clinical practice to improve health outcomes.
Original languageEnglish
Article number268
JournalBMC Women's Health
Volume21
Issue number1
DOIs
Publication statusPublished - 2021

Keywords

  • Body Weight
  • Breast Neoplasms/therapy
  • Cancer Survivors
  • Diabetes Mellitus, Type 2
  • Exercise
  • Female
  • Humans
  • Leukocytes, Mononuclear
  • Life Style
  • Neoplasm Recurrence, Local
  • Observational Studies as Topic
  • Postmenopause
  • Quality of Life
  • Retrospective Studies
  • Survivors

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