Iris Kanera

6 137 Long-term effects of the Kanker Nazorg Wijzer of overcoming anticipated barriers to action (Sniehotta et al., 2005b). Participants were encouraged to gradually building up PA by setting achievable goals that fit with their capacities, to keep a record of the specified exercises, and to evaluate their activities. Videos of fellow cancer survivors and of specialized health professionals were enclosed to provide appropriate role models and information concerning different ways to be more active, how to cope with (physical) difficulties, how to overcome barriers, and how to attribute and cope with possible failures. For example, interpreting previous failures in terms of unstable attributions, and encouraging participants to resume engaging in their plan. This helps in maintaining behavior changes in the long term. The intervention mainly aimed at adopting and/or increasing moderate intensive activities (e.g. brisk walking, cycling, moderate sports activities, and household activities); however, if participants were interested, more vigorous sports activities were also encouraged, given that medical contraindications were excluded. Although respondents were encouraged to follow the PA recommendations, no specific prescriptions were provided concerning frequency, intensity, duration, andmode of specific exercises. The advice focused on sustainable behavior change by stimulating activities that fit optimally to individuals’ capabilities and preferences. Within the module Diet, additional questions explored cancer treatment-specific residual problems that might influence participants’ dietary behavior, such as changes in taste and smell, problems with chewing and swallowing, indigestion, and undesirable weight change, pain and fatigue. Moreover, the attitude toward a healthy dietary pattern (pros and cons), perceived barriers, self-efficacy, and social support concerning a more healthy diet were measured, in order to add this information to the subsequent tailoring process. Although generic information on the comprehensive diet guidelines was provided, the module Diet focused on improving and maintaining healthy eating, particularly fruit, vegetable, whole grains, and fish consumption. After receiving personalized feedback on these dietary behaviors, participants could choose one or two pre-formulated goals concerning these four dietary behaviors, for example, “I want to eat sufficient vegetables (on average 200 g a day)”. The personalized advice included relevant dietary information and support concerning coping with specific physical problems, possible difficult situations, and failure. Videos of fellow cancer survivors and specialized health professionals complemented the written advice, which was in line with the design of the PA module. Four weeks after completing a module, participants were invited for a brief online, personalized evaluation session. After assessing whether participants (partly) succeeded or failed at changing the desired behavior, personalized feedback included advice on how to cope with success and failure aimed at increasing the level of coping self-efficacy in order to increase behavioral maintenance (Kwasnicka, Dombrowski, White, & Sniehotta, 2016). Additionally, participants were encouraged to review or adapt their action- and coping plans, in order to resume or maintain their behavior change to achieve their goals.