Iris Kanera

1 21 INTRODUCTION The final chapter, Chapter 7, summarizes and integrates the main results presented in the previous chapters, and relates them to previous conducted research. Furthermore, the main methodological considerations as well as suggestions for future research, proposals for improvement of the KNW intervention, and the implications for implementation of the KNW into clinical practice are discussed. Finally, some general conclusions are provided. An overview of the studies in this thesis is displayed in Table 1.1. Table 1.1 Overview of the studies in this thesis Chapter Objectives Design Sample size Part I. Intervention development 2 (1) To assess the prevalence of smoking, physical activity, alcohol, and fruit and vegetable consumption, and adherence to lifestyle recommendations (2) To examine the correlations between the different lifestyle behaviors (3) To explore the contribution of demographic, cancer-related, psychological and social cognitive factors to explain lifestyle behaviors and adherence to recommendations Cross- sectional survey N = 255 3 To describe the systematic development of the Kanker Nazorg Wijzer (Cancer Aftercare Guide, KNW) NA NA Part II. Intervention process evaluation 4 (1) To describe the use of the KNW modules and to identify predictors of a higher number of modules used (2) To investigate the adherence to the Module Referral Advice (3) To describe the appreciation of the KNW at its predictors, and to explore possible predictors of personal relevance RCT, longitudinal N = 231 Part III. Intervention effect evaluation 5 (1) To assess the effect of the KNW on physical activity outcomes, diet outcomes, and smoking, 6 months after baseline (2) To explore the effect of using the behavior-specific module on the outcome of the corresponding behavior RCT, longitudinal N = 462 6 (1) To examine the long-term effects of the KNW on moderate physical activity and vegetable consumption, 12 months after baseline (2) To explore the effect of using the behavior-specific module on the outcome of the corresponding behavior (3) To explore whether possible effects were moderated by gender, age, and educational level RCT, longitudinal N = 462 Note: NA = Not Applicable; RCT = randomized controlled trial; KNW = Kanker Nazorg Wijzer