Physical activity behaviour change : supporting cancer survivors to move more.

This thesis is presented in five chapters. Chapter one offers a review of the literature, divided into six sections. The first section of this chapter provides an understanding of cancer as a disease and a public health concern, including detail on its incidence and prevalence, the biology of cancer and its treatment. The second section of this chapter reviews the literature on physical activity and cancer across the cancer continuum, from prevention of cancer, through cancer treatment, living with or beyond cancer, advanced cancer, and detail on physical activity and cancer mortality and recurrence. The third section of this chapter discusses the determinants of physical activity in cancer survivors, framed within behavioural theories and models to support the identification of intervention opportunities. The identified intervention opportunities are covered in the fourth section. The fifth section of this chapter presents the scope and relevance of the research included in this thesis. The sixth section provides a summary of chapter one. Chapter two presents the first study included within this thesis, a service evaluation investigating the reach, adoption, and impact of a training intervention to influence UK healthcare professionals to give very brief advice on physical activity to cancer survivors. This study also includes an assessment of the predictive value of the behavioural theory upon which the intervention is based, the COM-B model of behaviour (Michie, van Stralen, & West, 2011). Chapter two includes four sections covering an introduction, the method, results, and discussion. Chapter three presents the second study within this thesis. The second study is a randomised waiting list control trial to investigate the impacts of a remote-print based intervention supported by Internet-based tools on the physical activity, self-efficacy, and health-related quality of life (HRQOL) of cancer survivors. The randomised waiting list control trial also includes a cost-consequence analysis. Chapter four presents the third study of this thesis, a process evaluation of the remote-print based intervention supported by Internet-based tools. This process evaluation aimed to contextualise use and perceived usefulness of the intervention, supporting the identification of what works and for whom. Chapter five then closes this thesis with a discussion on the theoretical and practical contributions of the body of research as a whole. This final chapter also includes discussion on how the interventions under assessment influence the identified determinants of physical activity in cancer survivors, and identification of future research possibilities