br Participant information was collected on date of
Participant information was collected on date of birth, gender, cancer type, time since diagnosis, treatment received, time since completion of treatment, response to treatment and ethnic group to assess baseline characteristics between arms. The structure of the questions used to obtain the
additional participant information followed that GSK1838705A used in a UK Department of Health survey.4
Procedures and assessment tools
Physical activity was assessed using the Godin Leisure-Time Exercise Questionnaire (GLTEQ)36 a four-item questionnaire used previously with cancer survivors.37 The GLTEQ provides a physical activity score to measure change and to categorise participants into insufficiently active (less than 14), moder-ately active (greater than 14 and less than 24) and active cat-egories (greater than 24). Participants were asked to complete the GLTEQ twice at baseline:
1. To consider physical activity in a standard week before cancer diagnosis, to allow for the tailoring of the e-news-letters and to assess the predictive value of prediagnosis physical activity on physical activity improvement and
2. To consider physical activity in a standard week after diagnosis, as a baseline measure.
The cancer-specific 7-item Functional Assessment of Cancer Therapy questionnaire (FACT-G7) was used to assess HRQOL, providing a score from 1 (low HRQOL) to 28 (high HRQOL).38
Self-efficacy was assessed using the single-item mea-sure ‘On a scale of onee10 (1 ¼ not at all confident and 10 ¼ very confident), how confident are you that you will be physically active in situations such as the following: feeling tired, bad mood, not having the time, on vacation, bad weather?’ based on a measure developed by Marcus et al.39 used previously with cancer survivors.40 Single-item assessment tools have been shown to perform just as well as multi-item assessment tools in measuring self-efficacy, as-well-as reducing burden on participant.41
The effectiveness of the Move More Pack at improving physical activity, self-efficacy and HRQOL was evaluated at 12 weeks and 24 weeks in both the intervention and control arms. The control arm received the Move More Pack at the 12-week time point. Participants in the control arm were asked, at 12 weeks, if Minichromosome had previously used the Move More Pack with the data omitted from the study for those who had. Participants in the intervention arm continued to have access to the Internet tools between 12 weeks and 24 weeks. Data were collected between March and October 2017 using Qual-trics™ software and processed in accordance with the Data Protection Act.42
The data were analysed using intention-to-treat analysis with the last observation carried forward for missing data. Analysis of covariance (ANCOVA) assessed physical activity, self-efficacy and HRQOL improvement at 12 weeks between arms, controlling for the baseline observation of the outcome assessed and for age and gender when assessing the outcome of physical activity. The paired t-test was used to assess within-group changes.
Small improvements in physical activity can bring health benefits;43 therefore, the impact of the Move More Pack on
physical activity improvement, or not, at 12 weeks was assessed using the two-proportion z-test. In addition, the number needed to treat was calculated. Binary logistic regression assessed the difference in the proportion of par-ticipants classified as active between groups at 12-weeks, controlling for baseline physical activity, age and gender.
The predictive value of prediagnosis physical activity and baseline self-efficacy resulting in physical activity improve-ment over 24 weeks in the intervention arm was assessed using regression analysis. All analyses were completed using SPSS™. A cost-consequence analysis was also conducted including only the costs for intervention delivery.