No change in health behavior, BMI or self-rated health after a psychosocial cancer rehabilitation: Results of a randomized trial

Figures & data

Figure 1. Randomization and follow-up of cancer patients eligible for participation in the randomized controlled trial of psychosocial cancer rehabilitation in Denmark, 2004–2008. ¹Baseline assessment before randomization, ²Includes illness in family, lack of energy to participate or emigration, ³One participant attended six-month follow-up, ⁴Six participants attended six-month follow-up.

Table I. Baseline characteristics of 507 participants with breast, prostate or colorectal cancer, by allocated intervention status.

	Intervention (n=259) n (%)		Usual care (n=248)^1 n (%)
Characteristic	Received allocation (n=208)	Did not receive allocation (n = 51)^2	Received allocation (n=244)^2
Cancer site
Breast	122 (59)	20 (39) p = 0.01	116 (48) p = 0.04
Prostate	32 (15)	9 (18)	58 (24) p = 0.04
Colorectal	54 (26)	22 (43) p = 0.01	70 (29)
Gender
Male	62 (30)	17 (33)	100 (41)
Female	146 (70)	34 (67)	144 (59)
Age (years)
Mean (5 – 95%)	60 (41 – 75)	61 (39 – 82)	61 (41 – 79)
Education
Basic	18 (9)	8 (16)	27 (11)
Youth	82 (39)	17 (33)	91 (37)
Higher	99 (48)	24 (47)	118 (48)
Unknown	9 (4)	2 (4)	8 (3)
Time since diagnosis (months)
Mean (5 – 95%)	13.8 (2.5 – 26.2)	16.1 (4.0 – 28.1)	14.7 (3.4 – 26.6)
Cancer stage
Low risk	64 (31)	19 (37)	91 (37)
High risk	134 (64)	23 (45)	147 (60)
Unknown	10 (5)	9 (18)	6 (2)
Surgery
Yes	179 (86)	36 (71)	196 (80)
No	11 (5)	5 (10)	21 (9)
Unknown	18 (9)	10 (20)	27 (11)
Chemotherapy
Yes	46 (22)	8 (35)	61 (25)
No	99 (48)	18 (35)	104 (43)
Unknown	63 (30)	25 (49)	79 (32)
Radiotherapy
Yes	48 (23)	6 (12)	38 (16)
No	127 (61)	28 (55)	169 (69)
Unknown	33 (16)	17 (33)	37 (15)
Hormone treatment^3
Yes	61 (40)	7 (24)	61 (34)
No	30 (19)	9 (31)	50 (28)
Unknown	63 (41)	13 (45)	63 (36)
Smoking (g/week)
Mean (min–max)	2.9 (0–55)	3.1 (0–50)	2.4 (0 – 80)
Yes	44 (22.0)	10 (20.0)	34 (14.4) p=0.05
No/former	156 (78.0)	40 (80.0)	202 (85.6)
Alcohol (units/week)
Mean (min–max)	8.8 (1–35)	7.9 (1–35)	8.8 (1–35)
0 units	35 (17.4)	16 (32.7)	48 (20.3)
< 14/21^4	148 (73.6)	27 (55.1)	167 (70.8)
> 14/21^4	18 (9.0)	6 (12.2)	21 (8.9)
Physical activity (h/week)
Mean (min–max)	18.9 (0.7–48)	17.1 (0–44)	18.4 (0–48)
0–3.5	4 (2.1)	4 (8.0)	10 (4.4)
3.5–21	118 (62.1)	32 (64.0)	138 (61.3)
> 21	68 (35.8)	14 (28.0)	77 (34.2)
Sport (h/week)
Mean (min–max)	1.3 (0–14)	1.07 (0–4)	1.4 (0–20)
0–1	135 (67.2)	31 (62.0)	160 (67.8)
> 1	66 (32.8)	19 (38.0)	76 (32.2)
BMI (kg/m^2)
Mean (min–max)	26.2 (18.8–47.8)	25.9 (19.2–36.5)	25.9 (18.5–40.6)
< 18.5	2 (1.0)	0 (0)	0 (0.0)
18.5–25	86 (43.9)	24 (49.0)	114 (49.1)
25–30	86 (43.9)	17 (34.7)	81 (34.9)
> 30	22 (11.2)	8 (16.3)	37 (16.0)
Self rated health (score)
Mean (min–max)	3.0 (1–5)	3.2 (1–5)10	3.1 (1–5)
Excellent/very good	54 (27.0)	(20.0)	74 (31.9)
Good	89 (44.5)	22 (44.0)	112 (48.3)
Fair/poor	57 (28.5)	18 (36.0)	46 (19.8)

¹Owing to the small number, no analyses were performed for the four participants in the usual care group who did not receive the allocated usual care condition.

²p-values are provided were proportions are significantly different from proportions in intervention receiver group.

³Only breast and prostate cancer patients, as colorectal cancer patients did not receive hormonal treatment.

⁴National alcohol recommendations: maximum, 14 units for women and 21 units for men per week at the time participants were asked.

Table II. Changes in health behavior, BMI and self-rated health: mean differences between baseline and follow-up.

	Mean baseline level (SD) (n)		Mean difference between baseline and follow-up at 1 month (n)			Mean difference between baseline and follow-up at 6 months (n)
Outcome	Intervention group	Usual care group	Intervention group	Usual care group	p-value in adjusted model^1	Intervention group	Usual care group	p-value in adjusted model^1
Smoking (g/day)	2.9	2.4	−0.43	0.25	0.42	−0.42	0.41	0.47
	(7.6)	(2.4)	(167)	(184)		(161)	(187)
	(200)	(234)
Alcohol (units/week)	8.8	8.8	0.01	0.52	0.33	0.22	0.83	0.47
	(6.8)	(7.0)	(144)	(149)		(137)	(150)
	(165)	(185)
Physical activity	18.9	18.4	−0.51	−1.89	0.13	0.12	−1.74	0.07
(h/week)	(11.0)	(10.8)	(157)	(175)		(151)	(178)
	(190)	(225)
Sport (h/week)	1.3	1.4	0.42	0.01	0.24	0.28	0.15	0.63
	(2.1)	(2.7)	(168)	(191)		(165)	(194)
	(201)	(236)
BMI (kg/m^2)	26.2	25.9	0.13	0.09	0.53	0.03	0.15	0.34
	(4.3)	(4.1)	(154)	(178)		(153)	(184)
	(193)	(231)
Self-rated health^2	3.0	3.1	0.02	0.01	0.62	0.06	−0.01	0.67
	(0.9)	(0.8)	(168)	(188)		(163)	(187)
	(200)	(232)

¹Adjusted for baseline score of the outcome variable, cancer site, time since diagnosis, gender, age at baseline and education.

²On a scale from 1 (poor) to 5 (excellent).

Table III. Changes in health behavior, BMI and self-rated health: proportions with positive change between baseline and follow-up.

	Percentage positive change between baseline and follow-up at one month (n)			Percentage positive change between baseline and follow-up at six months (n)
Outcome^1	Intervention group	Usual care group	p-value in adjusted model^2	Intervention group	Usual care group	p-value in adjusted model^2
Smoking	1.2%	1.6%	–^3	1.9%	1.1%	–^3
	(2)	(3)		(3)	(2)
Alcohol	19.9%	15.6%	0.21	18.0%	15.0%	0.59
	(32)	(27)		(28)	(26)
Physical activity	33.1%	27.4%	0.19	35.8%	27.0%	0.09
	(52)	(48)		(54)	(48)
Sport	16.7%	15.7%	0.99	18.8%	19.7%	0.46
	(28)	(30)		(29)	(36)
BMI	16.2%	11.2%	0.22	20.9%	15.8%	0.31
	(25)	(20)		(32)	(29)
Self-rated health	17.3%	14.8%	0.83	24.5%	20.3%	0.69
	(36)	(36)		(40)	(38)

¹Proportion of people who changed their health behavior, BMI or self-rated health in a positive direction, defined as:

Smoking: changed from being smoker to non-smoker

Alcohol: decreased their intake by more than 2 units/week

Physical activity: increased their total physical activity by more than 3.5 h/week

Sport: increased sports activities by more than 1 h/week

BMI: decreased their BMI (kg/m²) by more than 2.5%

Self-rated health: any increase on a scale from 1 (poor) to 5 (excellent).

²Adjusted for baseline score of the outcome variable, cancer site, time since diagnosis, gender, age at baseline and education.

³P-values not calculated due to the low number of persons.

Table IV. Changes in health behavior, BMI and self-rated health: mean differences between baseline and follow-up in subgroups with positive change.

	Mean difference between baseline and follow-up at one month (n)			Mean difference between baseline and follow-up at six months (n)
Outcome^1	Intervention group	Usual care group	p-value in adjusted model^2	Intervention group	Usual care group	p-value in adjusted model^2
Smoking	−7.5	−26.2	–^3	−9.2	−35.8	–^3
	(2)	(3)		(3)	(3)
Alcohol	−5.6	−4.4	0.04	−7.0	−6.7	0.79
	(32)	(27)		(28)	(26)
Physical activity	11.0	10.4	0.75	10.2	10.5	0.54
	(52)	(48)		(54)	(48)
Sport	4.0	4.3	0.99	4.1	3.3	0.40
	(28)	(30)		(29)	(39)
BMI	−1.2	−1.1	0.16	−1.9	−1.3	0.04
	(25)	(20)		(32)	(29)
Self-rated health	1.1	1.2	0.59	1.1	1.2	0.59
	(36)	(36)		(40)	(38)

¹Subgroups of people who changed their health behavior, BMI and self-rated health in a positive direction, defined as:

Smoking: changed from being a smoker to a non-smoker

Alcohol: decreased their intake by more than 2 units/week

Physical activity: increased their total physical activity by more than 3.5 h/week

Sport: increased sports activities by more than 1 h/week

BMI: decreased their BMI (kg/m²) by more than 2.5%

Self-rated health: had any increase on a scale from 1 (poor) to 5 (excellent).

²Adjusted for baseline score of the outcome variable, cancer site, time since diagnosis, gender, age at baseline and education.

³P-values not calculated due to the low number of persons.