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      Feasibility study to assess the impact of a lifestyle intervention (‘LivingWELL’) in people having an assessment of their family history of colorectal or breast cancer

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          Abstract

          Objectives

          To assess the feasibility of delivering and evaluating a weight management (WM) programme for overweight patients with a family history (FH) of breast cancer (BC) or colorectal cancer (CRC).

          Study design

          A two-arm (intervention vs usual care) randomised controlled trial.

          Setting

          National Health Service (NHS) Tayside and NHS Grampian.

          Participants

          People with a FH of BC or CRC aged≥18 years and body mass index of ≥25 kg/m 2 referred to NHS genetic services.

          Intervention

          Participants were randomised to a control (lifestyle booklet) or 12-week intervention arm where they were given one face-to-face counselling session, four telephone consultations and web-based support. A goal of 5% reduction in body weight was set, and a personalised diet and physical activity (PA) programme was provided. Behavioural change techniques (motivational interviewing, action and coping plans and implementation intentions) were used.

          Primary outcome

          Feasibility measures: recruitment, programme implementation, fidelity measures, achieved measurements and retention, participant satisfaction assessed by questionnaire and qualitative interviews.

          Secondary outcomes

          Measured changes in weight and PA and reported diet and psychosocial measures between baseline and 12-week follow-up.

          Results

          Of 480 patients approached, 196 (41%) expressed interest in the study, and of those, 78 (40%) patients were randomised. Implementation of the programme was challenging within the time allotted and fidelity to the intervention modest (62%). Qualitative findings indicated the programme was well received. Questionnaires and anthropometric data were completed by >98%. Accelerometer data were attained by 84% and 54% at baseline and follow-up, respectively. Retention at 12 weeks was 76%. Overall, 36% of the intervention group (vs 0% in control) achieved 5% weight loss. Favourable increases in PA and reduction in dietary fat were also reported.

          Conclusions

          A lifestyle programme for people with a family history of cancer is feasible to conduct and acceptable to participants, and indicative results suggest favourable outcomes.

          Trial registration number

          ISRCTN13123470; Pre-results.

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          Most cited references36

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          International physical activity questionnaire: 12-country reliability and validity.

          Physical inactivity is a global concern, but diverse physical activity measures in use prevent international comparisons. The International Physical Activity Questionnaire (IPAQ) was developed as an instrument for cross-national monitoring of physical activity and inactivity. Between 1997 and 1998, an International Consensus Group developed four long and four short forms of the IPAQ instruments (administered by telephone interview or self-administration, with two alternate reference periods, either the "last 7 d" or a "usual week" of recalled physical activity). During 2000, 14 centers from 12 countries collected reliability and/or validity data on at least two of the eight IPAQ instruments. Test-retest repeatability was assessed within the same week. Concurrent (inter-method) validity was assessed at the same administration, and criterion IPAQ validity was assessed against the CSA (now MTI) accelerometer. Spearman's correlation coefficients are reported, based on the total reported physical activity. Overall, the IPAQ questionnaires produced repeatable data (Spearman's rho clustered around 0.8), with comparable data from short and long forms. Criterion validity had a median rho of about 0.30, which was comparable to most other self-report validation studies. The "usual week" and "last 7 d" reference periods performed similarly, and the reliability of telephone administration was similar to the self-administered mode. The IPAQ instruments have acceptable measurement properties, at least as good as other established self-reports. Considering the diverse samples in this study, IPAQ has reasonable measurement properties for monitoring population levels of physical activity among 18- to 65-yr-old adults in diverse settings. The short IPAQ form "last 7 d recall" is recommended for national monitoring and the long form for research requiring more detailed assessment.
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            The behavior change technique taxonomy (v1) of 93 hierarchically clustered techniques: building an international consensus for the reporting of behavior change interventions.

            CONSORT guidelines call for precise reporting of behavior change interventions: we need rigorous methods of characterizing active content of interventions with precision and specificity. The objective of this study is to develop an extensive, consensually agreed hierarchically structured taxonomy of techniques [behavior change techniques (BCTs)] used in behavior change interventions. In a Delphi-type exercise, 14 experts rated labels and definitions of 124 BCTs from six published classification systems. Another 18 experts grouped BCTs according to similarity of active ingredients in an open-sort task. Inter-rater agreement amongst six researchers coding 85 intervention descriptions by BCTs was assessed. This resulted in 93 BCTs clustered into 16 groups. Of the 26 BCTs occurring at least five times, 23 had adjusted kappas of 0.60 or above. "BCT taxonomy v1," an extensive taxonomy of 93 consensually agreed, distinct BCTs, offers a step change as a method for specifying interventions, but we anticipate further development and evaluation based on international, interdisciplinary consensus.
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              Social Foundations of Thought and Action : A Social Cognitive Theory

              Presents a comprehensive theory of human motivation and action from a social-cognitive perspective. This insightful text addresses the prominent roles played by cognitive, vicarious, self-regulatory, and self-reflective processes in psychosocial functioning; emphasizes reciprocal causation through the interplay of cognitive, behavioral, and environmental factors; and systematically applies the basic principles of this theory to personal and social change.
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                Author and article information

                Journal
                BMJ Open
                BMJ Open
                bmjopen
                bmjopen
                BMJ Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2044-6055
                2018
                1 February 2018
                : 8
                : 2
                : e019410
                Affiliations
                [1 ] departmentCentre for Research into Cancer Prevention and Screening / Tayside Cancer Centre, Division of Cancer Research , University of Dundee, Ninewells Hospital & Medical School , Dundee, UK
                [2 ] departmentDepartment of Clinical Genetics , Ninewells Hospital and Medical School , Dundee, UK
                [3 ] departmentClinical Genetics Service , Ashgrove House, Foresterhill , Aberdeen, UK
                [4 ] departmentPhysical Activity for Health Research Centre, Institute for Sport, Physical Education and Health Sciences , University of Edinburgh , Edinburgh, UK
                [5 ] departmentDivision of Psychology, School of Natural Sciences , University of Stirling , Stirling, UK
                [6 ] departmentInstitute for Social Marketing , Institute for Social Marketing, University of Stirling , Stirling, UK
                [7 ] Institute of Health Research, University of Exeter Medical School , Exeter, UK
                [8 ] departmentDepartment of Genetic Medicine , Ninewells Hospital and Medical School , Dundee, UK
                Author notes
                [Correspondence to ] Professor Annie S Anderson; a.s.anderson@ 123456dundee.ac.uk
                Article
                bmjopen-2017-019410
                10.1136/bmjopen-2017-019410
                5879797
                29391383
                bbb33380-27f4-42b0-82b1-6ff5ff8f4b03
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 31 August 2017
                : 14 November 2017
                : 07 December 2017
                Funding
                Funded by: Chief Scientist Office for Scotland;
                Categories
                Patient-Centred Medicine
                Research
                1506
                1722
                1359
                Custom metadata
                unlocked

                Medicine
                cancer genetics,nutritional support,preventive medicine,public health
                Medicine
                cancer genetics, nutritional support, preventive medicine, public health

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