Aims: Nutrition and physical activity interventions form an important component of cancer care. The global rising incidence of cancer is placing increased pressure on health systems to deliver these services, prompting a need to consider alternative and novel models of care that reduce the demand for clinician resources through flexible, tailored, easily accessible services, whilst maintaining optimal health outcomes. This systematic review describes and appraises the literature regarding the efficacy of technology supported self-guided nutrition and physical activity interventions for people with cancer.
Methods: A systematic search of Medline, Scopus, CINAHL, EMBASE, Cochrane library and SPORTDiscus was conducted through to July 2018 for randomised or non-randomised controlled trials investigating technology supported self-guided nutrition and physical activity interventions. Risk of bias was assessed using the Cochrane Risk of Bias tool. Outcomes of interest were measures of behavioural, health-related, clinical, health service or financial outcomes.
Results: Sixteen randomised controlled trials representing 2,684 participants were included. The majority of studies used a web-based intervention (n=9). Seven studies assessed dietary behaviour with two reporting a significant benefit on diet quality or fruit and vegetable intake. Fifteen studies measured physical activity behaviour with eight finding significant improvements in muscle strength and moderate to vigorous physical activity levels. Four of nine studies assessing health-related quality of life (HRQoL) reported a significant improvement in global HRQoL or a HRQoL domain. A significant improvement in fatigue was found in four of six studies. Overall, the risk of bias was moderate. Interpretation of findings is influenced by inadequate reporting of both the intervention description and compliance.
Conclusion: This review identified a benefit of technology supported self-guided interventions on physical activity behaviour and fatigue, and some benefit on dietary behaviour and HRQoL in people with cancer. There is lack of evidence investigating the long-term benefit and cost effectiveness.