Feasibility, Acceptability, and Preliminary Efficacy of a Remotely-Delivered Health Coaching Intervention for Young and Middle-Aged Cancer Survivors: A Phase II Pilot Study

Cancer survivors living in rural areas have poorer health outcomes due in part to poorer access to survivorship programs. This study evaluated the feasibility, acceptability, and preliminary efficacy of a scalable, remotely-delivered health coaching lifestyle intervention for cancer survivors. In this phase II pilot study, we recruited young and middle-aged adult cancer survivors (18-64 years) to participate in a remotely-delivered eight-week lifestyle behavior change intervention that included remote health coaching sessions (administered by trained student health coaches), remote health education videos, and a wearable activity/sleep monitor. Feasibility was measured by enrollment, retention, and attrition rates, while acceptability was assessed via a post-intervention survey. Preliminary efficacy was evaluated by changes in psychosocial mechanisms, health behaviors, and cancer-related health outcomes. Our enrollment rate (49%) fell just short of our target (50%). Our retention rate (83%) exceeded our target rate of 75%. Adherence rates also exceeded targets (75%) with 99% of remote health coaching sessions attended, 84% of educational videos viewed, and activity monitors worn on 87% of all intervention days. Acceptability rates were also high with most participants reporting the program was beneficial (90%) and that they would recommend it to others (87%). We observed medium-large effects for several secondary/exploratory outcomes including behavioral regulation skills (Cohen's d = 2.04), fatigue (d = 0.86), and global health scores (d = 0.99). No pre-post changes were observed for physical activity, diet, or sleep behaviors. Findings suggest it is feasible to deliver an acceptable remote lifestyle intervention to young and middle-aged cancer survivors. Improvements in targeted psychosocial and cancer-related health markers are promising and support the need for a larger, controlled follow-up study. These findings support the feasibility of delivering a remote, lifestyle behavior change program to young and middle-aged cancer survivors.