Objectives: This study presents the 3-month follow-up clinical and qualitative outcomes of a randomised trial comparing Healthy Living after Cancer Online (HLaC Online) as self-guided versus with two coaching calls.
Methods: Fifty-two Australian post-treatment cancer survivors were randomised to receive the self-guided format (SG) or with two coaching calls (CC) over 12 weeks. Linear mixed models examined differences between groups over time from post-intervention to 3-month follow-up. The primary outcome was quality of life (QoL), and secondary outcomes were physical activity, nutrition, fatigue, distress, cancer symptom distress, and fear of cancer recurrence. Telephone semi-structured interviews gathered participant feedback on HLaC Online.
Results: Thirty-nine participants (SG n = 19; CC n = 20) completed post-intervention assessment and were included in the analysis. A significant interaction showed a decrease in symptom interference from post-intervention to 3-month follow-up for CC (Mchange = -1.16) and an increase for SG (Mchange = +0.38). Both groups improved over time in QoL (p = .02), fibre intake behaviours (p = .01), fatigue (p = .01), fear of cancer recurrence (p = .01) and symptom severity (p = .01). Feedback suggested guidance was a positive adaption, with benefits including high acceptability, practicality through program understanding, and maintenance of behaviour change. SG participants reported high demand for coaching calls and feeling less engaged.
Conclusion: While both formats demonstrated improvements at 3-month follow-up, the CC format demonstrated greater changes to symptom interference and supported cancer survivors to engage with the program more effectively. This study demonstrates that support does not have to be intensive to be impactful and future online interventions should consider including brief couching calls to support participant engagement in the program and health behaviours.