Using the Behavior Change Wheel to Identify and Understand Key Facilitators and Barriers for Lifestyle Care for Postmenopausal Breast Cancer Survivors: A Delphi-Study

Sandra J.M. Van Cappellen-Van Maldegem*, Floortje Mols, Jacob C. Seidell, Anja De Kruif, Lonneke V. Van De Poll-Franse, Meeke Hoedjes

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: Optimal approaches to promote sustained adherence to lifestyle and bodyweight recommendations in postmenopausal breast cancer (PMBC) survivors are lacking. Purpose: This Delphi-study aims to identify and understand expert-opinion on potential barriers and facilitators for promoting adherence to these lifestyle and bodyweight recommendations in (clinical) care for PMBC survivors, and to determine potential effective intervention strategies. Methods: The expert panel consisted of oncology Health Care Professionals (HCPs) (N = 57), patient advocates (N = 5), and PMBC survivors (N = 38). They completed three questionnaires: Q1 - idea generation; Q2 - validation and prioritization; Q3 - ranking. The Behavior Change Wheel was used as theoretical framework for analysis. Thematic analysis was applied to identify key overarching themes based on the top-ranked facilitators and barriers. Potential Behavior Change Techniques (BCTs) and intervention strategies were identified using the Behavior Change Technique Taxonomy version 1 and the Behavior Change Wheel. Results: Eleven core categories of key barriers/facilitators for the promotion of adherence to recommendations for lifestyle and bodyweight among PMBC survivors were identified. For each core category, relevant BCTs and practical potential intervention strategies were selected based on suggestions from the expert panel. These included: increasing knowledge about the link between lifestyle and cancer; enabling self-monitoring of lifestyle behaviors followed by evaluation; offering group lifestyle counseling for PMBC survivors, enhancing social support for favorable lifestyle behaviors; and stimulating multidisciplinary collaboration among HCPs. Conclusions: Findings provide valuable insight for the development of interventions changing behavior of PMBC survivors and HCPs toward increased healthy lifestyle (support) behavior.

Original languageEnglish
Pages (from-to)22-36
Number of pages15
JournalAnnals of Behavioral Medicine
Volume58
Issue number1
DOIs
Publication statusPublished - 1 Jan 2024

Bibliographical note

Funding Information:
The research leading to these results received funding from the Dutch Cancer Society under grant agreement number 10960. The funder played no role in the design, conduct, or reporting of this study.

Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press on behalf of the Society of Behavioral Medicine.

Keywords

  • Barriers
  • Behavior Change Wheel
  • Breast cancer
  • Delphi method
  • Facilitators
  • Lifestyle

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