title: Surviving and thriving with cancer using a Web-based health behavior change intervention: randomized controlled trial.
abstract: BACKGROUND
  Given the substantial improvements in cancer screening and cancer treatment in the United States, millions of adult cancer survivors live for years following their initial cancer diagnosis and treatment. However, latent side effects can occur and some symptoms can be alleviated or managed effectively via changes in lifestyle behaviors.
  
  
  OBJECTIVE
  The purpose of this study was to test the effectiveness of a six-week Web-based multiple health behavior change program for adult survivors.
  
  
  METHODS
  Participants (n=352) were recruited from oncology clinics, a tumor registry, as well as through online mechanisms, such as Facebook and the Association of Cancer Online Resources (ACOR). Cancer survivors were eligible if they had completed their primary cancer treatment from 4 weeks to 5 years before enrollment. Participants were randomly assigned to the Web-based program or a delayed-treatment control condition.
  
  
  RESULTS
  In total, 303 survivors completed the follow-up survey (six months after completion of the baseline survey) and participants in the Web-based intervention condition had significantly greater reductions in insomnia and greater increases in minutes per week of vigorous exercise and stretching compared to controls. There were no significant changes in fruit and vegetable consumption or other outcomes.
  
  
  CONCLUSIONS
  The Web-based intervention impacted insomnia and exercise; however, a majority of the sample met or exceeded national recommendations for health behaviors and were not suffering from depression or fatigue at baseline. Thus, the survivors were very healthy and well-adjusted upon entry and their ability to make substantial health behavior changes may have been limited. Future work is discussed, with emphasis placed on ways in which Web-based interventions can be more specifically analyzed for benefit, such as in regard to social networking.
  
  
  BACKGROUND
  Clinicaltrials.gov NCT00962494; http://www.clinicaltrials.gov/ct2/show/NCT00962494 (Archived by WebCite at http://www.webcitation.org/6NIv8Dc6Q).
authors.affiliation: University of Hawaii Cancer Center, Cancer Prevention & Control, Honolulu, HI, United States. ebantum@cc.hawaii.edu.
authors.forename: Erin O'Carrol
authors.initials: EO
authors.lastname: Bantum
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Albright
authors.forename: Kami K
authors.initials: KK
authors.lastname: White
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Berenberg
authors.forename: Gabriela
authors.initials: G
authors.lastname: Layi
authors.forename: Phillip L
authors.initials: PL
authors.lastname: Ritter
authors.forename: Diana
authors.initials: D
authors.lastname: Laurent
authors.forename: Katy
authors.initials: K
authors.lastname: Plant
authors.forename: Kate
authors.initials: K
authors.lastname: Lorig
mesh_terms: D000328:Adult; D003625:Data Collection; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D020407:Internet; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000534:rehabilitation*; D017741:Survivors; D017216:Telemedicine
keywords: cancer survivors; online interventions; social support