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A randomised controlled trial of the effect of providing online risk information and lifestyle advice for the most common preventable cancers: study protocol.

ABSTRACT: BACKGROUND:Cancer is a leading cause of mortality and morbidity worldwide. Prevention is recognised by many, including the World Health Organization, to offer the most cost-effective long-term strategy for the control of cancer. One approach that focuses on individuals is the provision of personalised risk information. However, whether such information motivates behaviour change and whether the effect is different with varying formats of risk presentation is unclear. We aim to assess the short-term effect of providing information about personalised risk of cancer in three different formats alongside lifestyle advice on health-related behaviours, risk perception and risk conviction. METHODS:In a parallel group, randomised controlled trial 1000 participants will be recruited through the online platform Prolific. Participants will be allocated to either a control group receiving cancer-specific lifestyle advice alone or one of three intervention groups receiving the same lifestyle advice alongside their estimated 10-year risk of developing one of the five most common preventable cancers, calculated from self-reported modifiable behavioural risk factors, in one of three different formats (bar chart, pictograph or qualitative scale). The primary outcome is change from baseline in computed risk relative to an individual with a recommended lifestyle at three months. Secondary outcomes include: perceived risk of cancer; anxiety; cancer-related worry; intention to change behaviour; and awareness of cancer risk factors. DISCUSSION:This study will provide evidence on the short-term effect of providing online information about personalised risk of cancer alongside lifestyle advice on risk perception and health-related behaviours and inform the development of interventions. TRIAL REGISTRATION:ISRCTN17450583. Registered 30 January 2018.

SUBMITTER: Usher-Smith JA

PROVIDER: S-EPMC6019532 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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A randomised controlled trial of the effect of providing online risk information and lifestyle advice for the most common preventable cancers: study protocol.

Usher-Smith Juliet A JA Masson Golnessa G Mills Katie K Sharp Stephen J SJ Sutton Stephen S Klein William M P WMP Griffin Simon J SJ

BMC public health 20180626 1

<h4>Background</h4>Cancer is a leading cause of mortality and morbidity worldwide. Prevention is recognised by many, including the World Health Organization, to offer the most cost-effective long-term strategy for the control of cancer. One approach that focuses on individuals is the provision of personalised risk information. However, whether such information motivates behaviour change and whether the effect is different with varying formats of risk presentation is unclear. We aim to assess the ...[more]

PMID: 29940914

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Project description:Background and study aims Previous research has shown that providing cancer risk information to people can improve their understanding of their risk of cancer, increase their intention to attend cancer screening, and increase their fruit and vegetable intake and physical activity. A risk calculator has been developed and tested based on modifiable behavioural risk factors, such as weight and smoking, which estimates the risk of an individual developing one of the five most common preventable cancers in the UK over a 10-year period. These cancers are lung, bowel, bladder, kidney and oesophageal cancer for men and breast, lung, bowel, endometrial and kidney cancer for women). Alongside 66 healthcare professionals who have taken part in focus groups and interviews, a web-based tool has been developed which allows people to enter details of their current lifestyle and then see their estimated risk of developing one of the cancers over the next 10 years, the effect changes in their lifestyle would make on that risk, and lifestyle advice. The aim of this study is to use that web-based tool to test whether people given their personalised cancer risk estimate in combination with lifestyle advice are more motivated to make changes in their behaviour than people given lifestyle advice alone. The study also compares different ways of presenting the risk information. Who can participate? Men and women aged 30-74 who do not have a past history of cancer What does the study involve? Participants answer a set of questions about their diet, lifestyle and beliefs about their risk of cancer. They are then randomly allocated to be presented with their personalised 10-year cancer risk and lifestyle advice, or go straight to the lifestyle advice without seeing their personalised risk. The cancer risk is presented in one of three formats. The first format is a bar chart, the second format is pictures of either 1000 or 100 faces depending on the individual's estimated risk, and the third format is a bar with a scale from below average to above average with arrows. Participants then answer a further set of questions about their thoughts about their risk of cancer and motivation to make lifestyle change. They are then asked if they agree to take part in a follow-up task 3 months later where they answer a similar set of questions to check how their lifestyle and ideas about cancer risk have changed with time. After completing that task, if they are one of the people who did not see their personalised risk in the first task, they are offered the opportunity to see it then.

Project description:Physical activity (PA) and fruit and vegetable intake (FVI) are two key modifiable risk factors for cardiovascular disease (CVD). Achieving change in these behaviours is challenging and affected by many variables including psychosocial factors. We aimed to investigate the association between social support, stress and mood, and change in PA and FVI following provision of CVD risk information and web-based lifestyle advice.Seven hundred sixteen blood donors (56% male; mean age 57 years) from the intervention arms of the Information and Risk Modification (INFORM) trial, a randomised controlled trial to assess the impact of providing CVD risk and web-based lifestyle information, were analysed as a prospective cohort. We used linear and logistic regression analyses to quantify the association between social support, stress and mood at baseline and behaviour change following the intervention. We modelled objective (average acceleration measured by Axivity AX3 wrist-worn accelerometers and plasma carotenoid levels) and subjective (self-reported recreational PA and FVI) outcomes as change between baseline and 12 weeks follow-up.There was no clear association between social support and change in objective or subjective PA. Higher levels of stress and, to a lesser extent, depression symptoms were associated with smaller improvement in self-reported PA (? -1.53 h/week vigorous PA, 95% confidence interval (CI) -2.30 to -0.75, p <?0.001 for stress; ? -1.64 h/week, 95% CI -3.50 to 0.21, p =?0.082 for little interest). Higher social support was associated with greater odds and higher stress was associated with lower odds of increasing self-reported FVI to five portions per day (odds ratio (OR) 1.33, 95% CI 1.05 to 1.69, p =?0.020 for social support; OR 0.57, 95% CI 0.43 to 0.76, p <?0.001 for stress). The associations between psychosocial factors and objective FVI were not statistically significant.High stress and low mood may reduce the likelihood and extent of reported change in PA and FVI following CVD risk information and advice. Greater social support may be associated with increased FVI. The role of psychosocial factors should be considered when developing, tailoring and evaluating future interventions.Current Controlled Trials ISRCTN17721237 . Registered 12 January 2015.

Project description:ObjectivesThe supermarket industry now services many customers through online food shopping over the Internet. The Internet shopping process offers a novel opportunity for the modification of dietary patterns. The aim of this study was to evaluate the effects on consumers' purchases of saturated fat of a fully automated computerised system that provided real-time advice tailored to the consumers' specific purchases recommending foods lower in saturated fat.DesignThis study was a blinded, randomised controlled trial.SettingThe study was conducted in Sydney, New South Wales, Australia.ParticipantsThe participants were consumers using a commercial online Internet shopping site between February and June 2004.InterventionsIndividuals assigned to intervention received fully automated advice that recommended specific switches from selected products higher in saturated fat to alternate similar products lower in saturated fat. Participants assigned to control received general non-specific advice about how to eat a diet lower in saturated fat.Outcome measuresThe outcome measure was the difference in saturated fat (grams per 100 g of food) in shopping baskets between the intervention and control groups.ResultsThere were 497 randomised participants, mean age 40 y, each shopping for an average of about three people. The amount of saturated fat in the foods purchased by the intervention group was 0.66% lower (95% confidence interval 0.48-0.84, p < 0.001) than in the control group. The effects of the intervention were sustained over consecutive shopping episodes, and there was no difference in the average cost of the food bought by each group.ConclusionsFully automated, purchase-specific dietary advice offered to customers during Internet shopping can bring about changes in food purchasing habits that are likely to have significant public health implications. Because implementation is simple to initiate and maintain, this strategy would likely be highly cost-effective.

Project description:INTRODUCTION:Obesity represents a significant health burden, and WHO recognises the importance of preventing weight gain and subsequent development of obesity among adults who are within the healthy weight range. Women of reproductive age have demonstrated high rates of weight gain during pregnancy placing them at risk of becoming overweight or obese. We will evaluate the effects of dietary and physical activity advice on maternal, fetal and infant health outcomes, among pregnant women of normal body mass index (BMI). METHODS AND ANALYSIS:We will conduct a randomised controlled trial, consenting and randomising women with a live singleton pregnancy between 10+0 and 20+0 weeks and BMI 18.5-24.9?kg/m2 at first antenatal visit, from a tertiary maternity hospital. Women randomised to the Lifestyle Advice Group will receive three face-to-face sessions (two with a research dietitian and one with a trained research assistant) and three telephone calls over pregnancy, in which they will be provided with dietary and lifestyle advice and encouraged to make change using a SMART goals approach. Women randomised to the Standard Care Group will receive routine antenatal care. The primary outcome is infant birth weight >4?kg. Secondary outcomes will include adverse infant and maternal outcomes, maternal weight change, maternal diet and physical activity changes, maternal quality of life and emotional well-being, fetal growth and costs of healthcare. We will recruit 624 women to detect a reduction from 8.72% to 3.87% (alpha 0.05 (two-tailed); power 70%) in infants with birth weight >4?kg. Analyses will be intention to treat with estimates reported as relative risks and 95% CIs. ETHICS AND DISSEMINATION:Ethical approval has been obtained from the Women's and Children's Hospital ethics committee. Findings will be disseminated widely via journal publication and conference presentation(s), and participants informed of results. TRIAL REGISTRATION NUMBER:ACTRN12614000583640.

Project description:BackgroundApproximately one-third of Japanese couples currently worry or previously worried about infertility. To develop strategies for the primary prevention of infertility as a population approach, it is important for the general population to be knowledgeable about fertility and infertility. The internet may contribute to the dissemination of information regarding infertility and fertility. However, few studies have examined online information about fertility.ObjectiveThis study aimed to quantitatively examine online Japanese-language information about lifestyle factors associated with reduced fertility.MethodsWe conducted online searches, using the 10 search terms with the highest numbers of searches that people hoping to conceive are likely to input in two major search engines in Japan (Google Japan and Yahoo! Japan). From the 2200 retrieved websites, 1181 duplicates and 500 websites unrelated to our objective were excluded, resulting in a final dataset of 519 websites. Coding guidelines were developed for the following lifestyle factors associated with reduced fertility: sexually transmitted diseases, psychological stress, cigarette smoking, alcohol use, nutrition and diet, physical activity and exercise, underweight, overweight and obesity, and environmental pollutants.ResultsIn terms of the website author's professional expertise, 69.6 % of the coding instances for the selected lifestyle factors were mentioned by hospitals, clinics, or the media, whereas only 1.7% were mentioned by laypersons. Psychological stress (20.1%) and sexually transmitted diseases (18.8%) were the most frequently mentioned lifestyle factors associated with reduced fertility. In contrast, cigarette smoking, alcohol use, nutrition and diet, physical activity and exercise, underweight, overweight and obesity, and environmental pollutants were mentioned relatively infrequently. The association between reduced fertility and sexually transmitted diseases was mentioned significantly more frequently by hospitals and clinics than by the media (P<.001). The association between reduced fertility and nutrition and diet was mentioned significantly more frequently by the media than by hospitals and clinics (P=.008). With regard to the sex of the target audience for the information, female-specific references to psychological stress, sexually transmitted diseases, nutrition and diet, underweight, physical activity and exercise, and overweight and obesity were significantly more frequent than were male-specific references to these lifestyle factors (psychological stress: P=.002, sexually transmitted diseases: P<.001, nutrition and diet: P<.001, underweight: P<.001, physical activity and exercise: P<.001, overweight and obesity: P<.001).ConclusionsOf the lifestyle factors known to be related to reduced fertility, cigarette smoking, alcohol use, and male-specific lifestyle factors are mentioned relatively infrequently in online information sources in Japan, and these factors should be discussed more in information published on websites.

Dataset Information

A randomised controlled trial of the effect of providing online risk information and lifestyle advice for the most common preventable cancers: study protocol.

Publications

A randomised controlled trial of the effect of providing online risk information and lifestyle advice for the most common preventable cancers: study protocol.

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