Long-term efficacy of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors:A randomized controlled trial

Background Physical activity(PA)can improve the physical and psychological health of prostate and colorectal cancer survivors,but PA behavior change maintenance is necessary for long-term health benefits.OncoActive is a print-and web-based intervention in which prostate and colorectal cancer patients and survivors receive automatically generated,personalized feedback aimed at integrating PA into daily life to increase and maintain PA.We evaluated the long-term outcomes of OncoActive by examining the 12-month follow-up differences between OncoActive and a control group,and we explored whether PA was maintained during a 6-month non-intervention follow-up period.Methods Prostate or colorectal cancer patients were randomly assigned to an OncoActive(n=249)or a usual care waitlist control group(n=229).OncoActive participants received PA advice and a pedometer.PA outcomes(i.e.,ActiGraph and self-report moderate-to-vigorous intensity PA(MVPA)min/week and days with≥30 min PA)and health-related outcomes(i.e.,fatigue,depression,physical functioning)were assessed at baseline,6 months,and 12 months.Differences between groups and changes over time were assessed with multilevel linear regressions for the primary outcome(ActiGraph MVPA min/week)and all additional outcomes.Results At 12 months,OncoActive participants did not perform better than control group participants at ActiGraph MVPA min/week,self-report MVPA min/week,or ActiGraph days with PA.Only self-report days with PA were significantly higher in OncoActive compared to the control group.For health-related outcomes only long-term fatigue was significantly lower in OncoActive.When exploratively examining PA within OncoActive,the previously found PA effects at the end of the intervention(6 months follow-up)were maintained at 12 months.Furthermore,all PA outcomes improved significantly from baseline to 12 months.The control group showed small but non-significant improvements from 6 months to 12 months(and from baseline to 12 months),resulting in a decline of differences between groups.Conclusion The majority of previously reported significant between-group differences at 6 months follow-up were no longer present at long-term follow-up,possibly because of natural improvement in the control group.At long-term follow-up,fatigue was significantly lower in OncoActive compared to control group participants.Computer-tailored PA advice may give participants an early start toward recovery and potentially contributes to improving long-term health.