Development, implementation and evaluation of a behaviour change intervention targetting physical activity after treatments for cervical cancer

Treatments for cervical cancer can result in several compromising after-effects, including the early onset of menopause, lymphadenectomy complications, fatigue and psychological sequelae which can contribute to poor quality of life (QOL). Cancer survivorship presents a period where physical activity participation is generally low, as treated women experience numerous barriers to physical activity. This is despite physical activity participation after cancer being a well-established and safe avenue to improve physical function and QOL. Due to a previous lack of research, it is not known how best to promote and implement physical activity after cervical cancer, particularly regarding what modes, intensities, duration, and frequencies of physical activity are preferable in this population. The overall aim of this thesis is to address this gap in knowledge through the development, implementation and evaluation of a behaviour change intervention targeting physical activity in women treated for cervical cancer.

This thesis is comprised of four empirical studies, adopting a mixed methods approach. The first study aimed to achieve complementarity in the research process by understanding the personal experiences of women treated for cervical cancer. It was found that unmet physical, social, and emotional needs contributed to compromised QOL after cervical cancer. To improve QOL, an ‘exercise is medicine’ approach was taken whereby physical activity was chosen as a mechanism to improve wellbeing. Thus, the other three studies followed a systematic process of intervention development, implementation, and evaluation to trial a multi-component physical activity programme after cervical cancer. The programme was named ACCEPTANCE (Acceptability in Cervical Cancer of an Exercise-based Programme delivered Through An oNline Community Environment). The intervention was implemented within a feasibility trial and process evaluation measures were conducted alongside its delivery. Several intervention aspects were deemed ‘feasible as is’ or ‘feasible with close monitoring’, whilst it was demonstrated that participants increased both their volume of physical activity and moderate to vigorous physical activity from baseline to follow-up.

In conclusion, the developed programme was generally well accepted by participants. Only minor modifications are needed before the ACCEPTANCE trial can be delivered as a definitive randomised control trial. Findings from this thesis will have real world and practical implications for those treated for cervical cancer and healthcare practitioners.