Background: The impact of a cancer diagnosis and cancer treatment on women is profound with psychological, psychosocial and psychosexual effects. As a result of earlier diagnosis and individualised and multi-modal treatments for cancer, more women are living longer after their diagnosis. However, according to many studies, they are also living with a poorer quality of life. A National Health and Medical Research Council (NHMRC) Partnerships Project was awarded for a national collaborative project to develop, trial and evaluate the clinical benefits and cost effectiveness of an e-health enabled structured health promotion intervention - The Women’s Wellness after Cancer Program (WWACP).
Methods
The WWACP is a 12-week web based, interactive, holistic, lifestyle, program. Primary outcomes for this project were to promote a positive change in health-related quality of life (HRQoL) and reduction in Body Mass Index (BMI) in the women undertaking WWACP compared to women who receive usual care. Secondary outcomes included managing other side effects of cancer treatment through evidence-based nutrition and exercise practices, dealing with stress, sleep, menopause and sexuality issues. The program was underpinned by a sound theoretical model that enabled positive self-efficacy and lifestyle changes. These included the online coaching with a registered nurse who undertook a specifically designed training to deliver the intervention, plus written educational and health promotional information. The program was delivered through the e-health enabled interfaces which enabled virtual delivery via desktop and mobile computing devices. Importantly this enabled accessibility for rural and regional women in Australia who are frequently geographically disadvantaged in terms of health care provision and support services.
Results
Following the 12-week lifestyle intervention, statistically significant improvements were observed in the intervention groups in health-related quality of life in emotional and physical components scores. In relation to anthropometric measures, the intervention group saw significant improvement in scores for body mass index and waist circumference when compared to the control group and in the domain of sexual health, significant improvements were reported for lubrication and sexual satisfaction.
Conclusions: Analysis so far indicates The WWACP is effective for improvements in HRQoL, anthropometric measures and sexual wellbeing in women previously treated for haematological, breast and gynaecological cancers. This demonstrates that the conclusion of active treatment is a key 'teachable moment' in which sustainable positive lifestyle change and reduction of risk of recurrence and other chronic disease may be achieved if patients receive education and psychological support which targets key treatment related health problems and known chronic disease risk factors.