DEUS: Diet and Physical Activity in Uterine Cancer Survivors

• Sponsor: University College, London (Other)
• Overall Status: Completed
• CT.gov ID: NCT02433080
• Collaborator: (none)
• Enrollment: 60
• Locations: 2
• Arms: 2
• Duration (Months): 14
• Patients Per Site: 30
• Patients Per Site Per Month: 2.1

Study Details

Study Description

Brief Summary

Endometrial cancer is the most common gynaecological cancer in developed countries with more than 75% of the patients surviving for at least five years. However, most endometrial cancer survivors are overweight and obese and do not meet the current nutrition and physical activity recommendations. This can lower their quality of life and increase their risk for chronic diseases. Behaviour change interventions can help them feel better about themselves and improve their quality of life. Applying them shortly after treatment seems ideal as cancer survivors feel motivated to make changes about their lifestyle at this time point.

This study is to see if the investigators can design a project to measure how well a psycho-educational healthy eating and physical activity programme tailored to the survivors' needs works. Sixty-four endometrial cancer survivors diagnosed during the previous three years, and are all clear will be put by chance into one of two groups. One will receive the program. The other will receive usual care until the end of the trial and, then, a discussion and a self-help guide about eating well and being active following cancer treatment. This will help us to see if the programme makes a difference compared with usual care. The results will inform a larger study to test if a lifestyle program can improve the quality of life of uterine cancer survivors compared with usual care. The investigators will change the programme materials in response to the investigators' findings, making them available to services. The results will inform practice and research.

Condition or Disease	Intervention/Treatment	Phase
Endometrial Neoplasms	Behavioral: Shape-Up following cancer treatment	N/A

Detailed Description

Low physical activity, poor diet and obesity are risk factors for the development of endometrial cancer. A growing body of evidence suggests that they may be linked with quality of life after cancer treatment. However, only about 1% of endometrial cancer survivors seem to meet the current fruit and vegetable, physical activity, and non-smoking recommendations; while 57% meets only the non-smoking recommendations, and 22% meet none of the recommendations,

These behaviours exist despite cancer diagnosis being perceived as a "teachable moment". Capitalising the "teachable moment" of cancer, behaviour change interventions in high-risk populations might be more effective than those targeting the general population.

Theory-based behaviour change interventions suggest that improving diet and physical activity is safe, acceptable, and feasible and can help cancer survivors improve their quality of life. In contrast, there are only limited studies to support these data in the United Kingdom to allow generalisability of these results. However, the majority of these interventions were long-term and resource intensive which may render them inappropriate for wide dissemination. Therefore, feasible and effective interventions are needed to promote implementation of the nutrition and physical activity guidelines.

The intervention is based on the Shape-Up eight-week weight management programme. This programme is based on "Social Cognitive Theory" and "Control Theory". A version of this program has been favourably evaluated in terms of acceptability, physical, and psychological outcomes. We have tailored this programme (Shape-Up following cancer treatment) to help endometrial cancer survivors improve their diet, and activity pattern. The focus of the programme lies on self-control, self-efficacy, and relapse prevention in terms of healthy eating and physical activity. Behavioural techniques will include self-monitoring of behaviour with the use of food and physical activity diaries, behavioural goal setting, action planning, graded tasks, problem solving, self-reward, and review of behavioural goals. It will also provide information about health consequences and emotional consequences, pros and cons, behavioural practice, habit formation, reducing exposure to cues for the behaviour, behaviour substitution, distraction, social support (unspecified), demonstration of behaviour (for resistance exercises), instructions on how to perform the behaviour (for resistance exercises), and reframing.

The DEUS pilot trial is an eight-week, two-arm, individually randomised, controlled pilot trial comparing the use of the "Shape-Up following cancer treatment" programme to usual care. According to Medical Research Council guidance for complex interventions, this is a Phase 2 feasibility study. Randomisation will be performed with minimisation using a 1:1 allocation.

Study Design

• Study Type: Interventional
• Actual Enrollment: 60 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Single (Outcomes Assessor)
• Primary Purpose: Supportive Care
• Official Title: Randomised, Controlled, Pilot Clinical Trial to Assess the Feasibility of a Healthy Eating and Physical Activity Program in Endometrial Cancer Survivors
• Study Start Date: Apr 1, 2015
• Actual Primary Completion Date: Dec 1, 2015
• Actual Study Completion Date: Jun 1, 2016

Arms and Interventions

Arm	Intervention/Treatment
Active Comparator: Shape-Up following cancer treatment In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group.	Behavioral: Shape-Up following cancer treatment; The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.; Other Names: Self-help healthy eating and physical activity programme
No Intervention: Control intervention Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.

Outcome Measures

Primary Outcome Measures

1. Recruitment Rate (Percentage of Potentially Eligible Participants Who Were Enrolled to the Study) [6 months]

   Achieving a 30% recruitment rate of the potentially eligible participants

Secondary Outcome Measures

1. Change From Baseline in Health-related Quality of Life Score [Baseline, 8weeks, 24weeks]

   European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 & European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer Module 24 Global quality of life scale ranging from 0-100 with higher scores indicating better quality of life

2. Change From Baseline in Dietary Quality (24-h Dietary Recall) [Baseline, 8weeks, 24weeks]

   One 24-h dietary recall for each timepoint. This is the combined total Alternate healthy eating index-2010 score ranging from 0-110 with higher scores indicating higher dietary quality.

3. Change From Baseline in Physical Activity (Physical Activity Recall) [Baseline, 8weeks, 24weeks]

   7-day physical activity recall

4. Change From Baseline in Hand-grip Strength [Baseline, 8weeks, 24weeks]

5. Change From Baseline in Weight [Baseline, 8weeks, 24weeks]

6. Change From Baseline in Fat Mass Index [Baseline, 8weeks, 24weeks]

   Using MC980 multi-frequency segmental body composition analyser. Fat mass index was calculated as kg of fat mass divided by squared height in meters.

7. Intervention Evaluation Questionnaire [8weeks, 24weeks]

   Change in the self-assessment of the gained skills (Shape-Up self-efficacy score). This is a total score 0-5 with higher scores indicating higher self-efficacy.

8. Health Care Services Use - Medication [24weeks]

   Number of currently prescribed medications over the 24 weeks of the trial (Self-reported)

9. Adherence Rate [8 weeks]

   The percentage of engaged participants attending at least one of the last three sessions of the intervention. Engaged participants are those who have attended at least two sessions of the intervention.

10. Retention Rate [Baseline to 24weeks]

    Rate of complete follow-up

11. Health Care Services Use - Number of General Practitioner Visits [24weeks]

    Number of visits to their general practitioner over the 24 weeks of the trial (Self-reported)

Eligibility Criteria

Criteria

• Ages Eligible for Study: 18 Years and Older
• Sexes Eligible for Study: Female
• Accepts Healthy Volunteers: No

Inclusion Criteria:

1. Women aged >18 years (no upper age limit)

2. Women diagnosed with endometrial cancer (C54.1) within the previous 36 months

3. Women who are able to understand spoken and written English

Exclusion Criteria:

1. Women with stage IVB (metastatic) endometrial cancer (any metastasis beyond the pelvis)

2. Women on active anti-cancer, and/or palliative treatment,

3. Women having second primary cancer

4. Women who lack mental capacity to decide to take part in the study and to participate in it (upon clinical team's judgement in accordance with the Mental Capacity Act 2005 Code of Practice 2007)

5. Women with severe depression (upon consultant's judgement based on the Diagnostic and Statistical Manual of Mental Disorders-IV criteria)

6. Women unavailable for longitudinal follow-up assessments

7. Women who participated in a professionally delivered weight loss or exercise program during the previous 6 months

8. Women with a World Health Organization performance score 3-4

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Barts Health NHS Trust	London	Greater London	United Kingdom	E1 1BB
2	University College London Hospital NHS Trust	London	Greater London	United Kingdom	NW1 3AD

Sponsors and Collaborators

• University College, London

Investigators

• Principal Investigator: Anne Lanceley, PhD, University College, London

Study Documents (Full-Text)

None provided.

More Information

Publications

• Chiuve SE, Fung TT, Rimm EB, Hu FB, McCullough ML, Wang M, Stampfer MJ, Willett WC. Alternative dietary indices both strongly predict risk of chronic disease. J Nutr. 2012 Jun;142(6):1009-18. doi: 10.3945/jn.111.157222. Epub 2012 Apr 18.
• Koutoukidis DA, Lopes S, Atkins L, Croker H, Knobf MT, Lanceley A, Beeken RJ. Use of intervention mapping to adapt a health behavior change intervention for endometrial cancer survivors: the shape-up following cancer treatment program. BMC Public Health. 2018 Mar 27;18(1):415. doi: 10.1186/s12889-018-5329-5.

• Responsible Party: University College, London
• ClinicalTrials.gov Identifier: NCT02433080
• Other Study ID Numbers: 14/0765
• First Posted: May 4, 2015
• Last Update Posted: May 19, 2020
• Last Verified: May 1, 2020

• Additional relevant MeSH terms: Endometrial Neoplasms

Study Results

Participant Flow

Pre-assignment Detail	Although 60 participants were enrolled, only 54 were included in the study analysis as the remaining 6 participants were deemed ineligible to participate and excluded from the analysis.

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Period Title: Overall Study
STARTED	26	28
8 Weeks	25	24
COMPLETED	25	24
NOT COMPLETED	1	4

Baseline Characteristics

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention	Total
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.	Total of all reporting groups
Overall Participants	25	24	49
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	62.6 (9)	61.5 (7.7)	62.1 (8.3)
Sex: Female, Male (Count of Participants)
Female	25 100%	24 100%	49 100%
Male	0 0%	0 0%	0 0%
Region of Enrollment (participants) [Number]
United Kingdom	25 100%	24 100%	49 100%

Outcome Measures

1. Primary Outcome

Title	Recruitment Rate (Percentage of Potentially Eligible Participants Who Were Enrolled to the Study)
Description	Achieving a 30% recruitment rate of the potentially eligible participants
Time Frame	6 months

Outcome Measure Data

Analysis Population Description

Of the 296 potentially eligible participants, 20.3% were enrolled in the study.

Arm/Group Title	Both Arms Combined
Arm/Group Description	Recruitment to the trial overall
Measure Participants	296
Number (95% Confidence Interval) [percentage of participants]	20.3 81.2%

2. Secondary Outcome

Title	Change From Baseline in Health-related Quality of Life Score
Description	European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 & European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Endometrial Cancer Module 24 Global quality of life scale ranging from 0-100 with higher scores indicating better quality of life
Time Frame	Baseline, 8weeks, 24weeks

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	25	24
8week change from baseline	3.0 (11.3)	8.7 (14.5)
24week change from baseline	8.7 (14.5)	-1.4 (14.7)

Statistical Analysis 1

Statistical Analysis Overview	Comparison Group Selection	Both Arms Combined, Control Intervention
	Comments	This statistical analysis applies for the outcomes 2-8.
	Type of Statistical Test	Other
	Comments
Statistical Test of Hypothesis	p-Value	0.05
	Comments
	Method	ANCOVA
	Comments
Method of Estimation	Estimation Parameter	Mean Difference (Net)
	Estimated Value	6.4
	Confidence Interval	(2-Sided) 95%; -3.6 to 16.5
	Parameter Dispersion	Type: Value:
	Estimation Comments

3. Secondary Outcome

Title	Change From Baseline in Dietary Quality (24-h Dietary Recall)
Description	One 24-h dietary recall for each timepoint. This is the combined total Alternate healthy eating index-2010 score ranging from 0-110 with higher scores indicating higher dietary quality.
Time Frame	Baseline, 8weeks, 24weeks

Outcome Measure Data

Analysis Population Description

The outcome measure values below refer to the change at 24weeks from baseline using an ANCOVA model

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	25	24
8week change from baseline	4.4 (15.3)	-2.9 (14.1)
24week change from baseline	3.0 (14.0)	2.2 (17.8)

4. Secondary Outcome

Title	Change From Baseline in Physical Activity (Physical Activity Recall)
Description	7-day physical activity recall
Time Frame	Baseline, 8weeks, 24weeks

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	25	24
8week change from baseline	-1.4 (2.2)	-1.8 (3.6)
24week change from baseline	0.2 (2.1)	0.4 (2.7)

5. Secondary Outcome

Title	Change From Baseline in Hand-grip Strength
Time Frame	Baseline, 8weeks, 24weeks

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	25	24
8week change from baseline	-0.3 (2.4)	-1.7 (3.1)
24week change from baseline	0.0 (2.4)	-1.3 (1.9)

6. Secondary Outcome

Title	Change From Baseline in Weight
Time Frame	Baseline, 8weeks, 24weeks

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	25	24
8week change from baseline	-0.9 (1.1)	0.3 (1.5)
24week change from baseline	-1.1 (2.6)	-0.2 (2.5)

7. Secondary Outcome

Title	Change From Baseline in Fat Mass Index
Description	Using MC980 multi-frequency segmental body composition analyser. Fat mass index was calculated as kg of fat mass divided by squared height in meters.
Time Frame	Baseline, 8weeks, 24weeks

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	25	24
8week change from baseline	-0.1 (0.8)	0.1 (0.5)
24week change from baseline	-0.4 (0.8)	-0.2 (0.8)

8. Secondary Outcome

Title	Intervention Evaluation Questionnaire
Description	Change in the self-assessment of the gained skills (Shape-Up self-efficacy score). This is a total score 0-5 with higher scores indicating higher self-efficacy.
Time Frame	8weeks, 24weeks

Outcome Measure Data

Analysis Population Description

Missing data for 2 people in the Shape-up group

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	25	24
8week change from baseline	0.2 (0.5)	-0.2 (0.7)
24week change from baseline	0.1 (0.5)	-0.1 (0.3)

9. Secondary Outcome

Title	Health Care Services Use - Medication
Description	Number of currently prescribed medications over the 24 weeks of the trial (Self-reported)
Time Frame	24weeks

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	25	24
Mean (Standard Deviation) [Prescribed medications]	1.4 (2.2)	1.5 (1.7)

10. Secondary Outcome

Title	Adherence Rate
Description	The percentage of engaged participants attending at least one of the last three sessions of the intervention. Engaged participants are those who have attended at least two sessions of the intervention.
Time Frame	8 weeks

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Shape-Up Following Cancer Treatment
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.
Measure Participants	26
Count of Participants [Participants]	20 80%

11. Secondary Outcome

Title	Retention Rate
Description	Rate of complete follow-up
Time Frame	Baseline to 24weeks

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	26	28
Count of Participants [Participants]	25 100%	24 100%

12. Secondary Outcome

Title	Health Care Services Use - Number of General Practitioner Visits
Description	Number of visits to their general practitioner over the 24 weeks of the trial (Self-reported)
Time Frame	24weeks

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Shape-Up Following Cancer Treatment	Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.	Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
Measure Participants	25	24
Mean (Standard Deviation) [Visits to the general practitioner]	1.2 (1.8)	1.5 (1.7)

Adverse Events

Time Frame	24 weeks
Adverse Event Reporting Description	Denominators in the adverse event rates below denote number of participants included in the study analysis excluding ineligible participants.
Arm/Group Title	Shape-Up Following Cancer Treatment		Control Intervention
Arm/Group Description	In addition to usual care, cancer survivors in the intervention group will participate in a behaviour change programme, called "Shape-Up following cancer treatment: a self-help programme on eating well and being active". Participants will be allocated to groups of eight to ten. These groups will meet every week for eight weeks and each session will last approximately 90 minutes. The programme focuses on strategies for improving diet and physical activity in a self-help and peer education format. Each week, one participant will volunteer to present a new concept (e.g. regular eating, being active, eating a balanced diet, keep an eye on portion sizes, and manage internal and external triggers, and understanding food labeling) to the rest of the group. Shape-Up following cancer treatment: The programme is based on "Social Cognitive Theory" and "Control Theory". The focus of the programme lies on self-control, self-efficacy, and relapse prevention.		Participants in the control group will be offered usual care until the 24-week follow-up. Quantifying usual care is challenging, but preliminary qualitative work suggested that most survivors do not received any unsolicited advice about healthy eating and physical activity from their health care professionals after treatment. During the course of their participation in the trial, participants will be contacted only for the assessments. After the completion of the 24-week follow-up, participants will receive the booklet "Healthy living after cancer"; a brief self-help manual produced by the World Cancer Research Fund. Providing only this information aims to match the currently offered usual care as accurately as possible but also meet ethical standards.
All Cause Mortality
	Shape-Up Following Cancer Treatment		Control Intervention
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/26 (0%)		0/28 (0%)
Serious Adverse Events
	Shape-Up Following Cancer Treatment		Control Intervention
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/26 (0%)		3/28 (10.7%)
Gastrointestinal disorders
Bowel obstruction	0/26 (0%)		1/28 (3.6%)
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Ovarian cancer diagnosis	0/26 (0%)		1/28 (3.6%)
Cancer recurrence	0/26 (0%)		1/28 (3.6%)
Other (Not Including Serious) Adverse Events
	Shape-Up Following Cancer Treatment		Control Intervention
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/26 (0%)		0/28 (0%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

All Principal Investigators ARE employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.