Iris Kanera

5 125 Lifestyle-related effects of the Kanker Nazorg Wijzer Effects of following module Diet on diet behavior As displayed in Table 5.3, users of the module Diet had a significantly higher increase in fruit ( B = .181, p = .031, p fdr = .120, d = -.12, f 2 = .016) and fish intake ( B = .542, p = .045, p fdr = .120 d = -.11, f 2 = -.002) after six months. A significant increase in vegetable consumption was found among participants who did not followmodule Diet ( B = 11.123, p = .048, p fdr = .384, d = -.23, f 2 = -.018). However, after controlling for multiple comparisons, these results did not remain significant (Table 5.3). Smoking behavior after six months At baseline, 27 (11.7%) respondents of the IC, and 32 (13.9%) respondents of the UC were current smokers (Table 5.1). After six months, respectively 18 (7.8%) and 28 (13.5%) respondents of IC and UC were current smokers. From the smokers at baseline, 18 (81.8%) were persistent smokers and four (18.8%) were quitters after six months in the IC. In the UC, 26 (92.9%) were persistent smokers and two (7.1%) were quitters after six months. No significant intervention effect was found between groups at follow-up (χ 2  = 1.42, p = .233, OR 2.89). ITT revealed comparable results (χ 2 = 1.18, p = .278, OR = 2.61; Chi-square tests are not displayed in Table 5.1). DISCUSSION The present RCT evaluated the effects of the web-based, computer tailored, multiple behavior KNW intervention on lifestyle outcomes, i.e., PA, diet (vegetable, fruit, whole grain bread and fish consumption), and smoking behavior after six months. The presented outcomes point in the direction that the KNWmay affect moderate PA and dietary behaviors. Cancer survivors who had access to the KNW showed larger increases in moderate PA and vegetable consumption, and using the specific modules resulted in a larger increase of moderate PA, and larger increases in fruit and fish consumption. These effects need to be interpreted with caution, however, since results did not remain significant after correction for multiple testing. The loss to follow-up after six months was low (11.5%) in comparison with the mean percentage of dropouts (19.7%) of web-based trials for cancer survivors (Kuijpers et al., 2013). This suggests a strong commitment that may be attributed to an evident need of cancer survivors for support after completion of primary cancer treatment (Willems et al., 2016). This period can be considered as a teachable moment. Additionally, low dropout in the UC after six months (Figure 5.2) suggests that allocation to the waiting list UC was well accepted by the participants.