Abstract
Cancer survivors living in rural areas have poorer health outcomes due in part to poorer access to survivorship programs. This study evaluated the feasibility, acceptability, and preliminary efficacy of a scalable, remotely-delivered health coaching lifestyle intervention for cancer survivors. In this phase II pilot study, we recruited young and middle-aged adult cancer survivors (18–64 years) to participate in a remotely-delivered eight-week lifestyle behavior change intervention that included remote health coaching sessions (administered by trained student health coaches), remote health education videos, and a wearable activity/sleep monitor. Feasibility was measured by enrollment, retention, and attrition rates, while acceptability was assessed via a post-intervention survey. Preliminary efficacy was evaluated by changes in psychosocial mechanisms, health behaviors, and cancer-related health outcomes. Our enrollment rate (49%) fell just short of our target (50%). Our retention rate (83%) exceeded our target rate of 75%. Adherence rates also exceeded targets (75%) with 99% of remote health coaching sessions attended, 84% of educational videos viewed, and activity monitors worn on 87% of all intervention days. Acceptability rates were also high with most participants reporting the program was beneficial (90%) and that they would recommend it to others (87%). We observed medium-large effects for several secondary/exploratory outcomes including behavioral regulation skills (Cohen’s d = 2.04), fatigue (d = 0.86), and global health scores (d = 0.99). No pre-post changes were observed for physical activity, diet, or sleep behaviors. Findings suggest it is feasible to deliver an acceptable remote lifestyle intervention to young and middle-aged cancer survivors. Improvements in targeted psychosocial and cancer-related health markers are promising and support the need for a larger, controlled follow-up study. These findings support the feasibility of delivering a remote, lifestyle behavior change program to young and middle-aged cancer survivors.