Systematic Review of Behaviour Change Theories Implementation in Dietary Interventions for People Who Have Survived Cancer

Jana Sremanakova, Anne Marie Sowerbutts, Chris Todd, Richard Cooke, Sorrel Burden, Jana Sremanakova, Anne Marie Sowerbutts, Chris Todd, Richard Cooke, Sorrel Burden

Abstract

Background: An increasing number of dietary interventions for cancer survivors have been based on the behaviour change theory framework. The purpose of this study is to review the use and implementation of behaviour change theories in dietary interventions for people after cancer and assess their effects on the reported outcomes.

Methods: The search strategy from a Cochrane review on dietary interventions for cancer survivors was expanded to incorporate an additional criterion on the use of behaviour change theory and updated to September 2020. Randomised controlled trials (RCT) testing a dietary intervention compared to the control were included. Standard Cochrane methodological procedures were used.

Results: Nineteen RCTs, with 6261 participants (age range 44.6 to 73.1 years), were included in the review. The Social Cognitive Theory was the most frequently used theory (15 studies, 79%). Studies included between 4 to 17 behaviour change techniques. Due to limited information on the mediators of intervention and large heterogeneity between studies, no meta-analyses was conducted to assess which theoretical components of the interventions are effective.

Conclusions: Whilst researchers have incorporated behaviour change theories into dietary interventions for cancer survivors, due to inconsistencies in design, evaluation and reporting, the effect of theories on survivors' outcomes remains unclear.

Keywords: BCT(s); anthropometry; behaviour change; cancer; diet; survivorship.

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Preferred reporting items for systematic reviews and meta-analysis (PRISMA) flow diagram for the study selection.
Figure 2
Figure 2
Risk of bias summary for each included study. Note: green (+)—low risk of bias, red (-)—high risk of bias, yellow (?)—unclear risk of bias.

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