Enhancing behavioral change among lung cancer survivors participating in a lifestyle risk reduction intervention: a qualitative study

Publication Date


UMMS Affiliation

Graduate School of Nursing; Department of Quantitative Health Sciences

Document Type



Behavioral Medicine | Behavior and Behavior Mechanisms | Counseling | Health Psychology | Health Services Administration | Neoplasms | Nursing | Respiratory Tract Diseases


PURPOSE: Early detection and improved treatment have increased lung cancer survival. Lung cancer survivors have more symptom distress and lower function compared with other cancer survivors; however, few interventions are available to improve health-related quality of life (HR-QOL). Lifestyle risk reduction interventions have improved HR-QOL in other cancer survivors. The purpose of this study was to explore lung cancer survivor perspectives on making behavioral changes in the context of a lifestyle risk reduction intervention.

METHODS: Twenty-two lung cancer survivors participated in interviews after completing the Healthy Directions (HD) intervention. Interviews were audiotaped, transcribed, and analyzed using inductive content analysis. Demographic and clinical characteristics were gathered through a survey and analyzed using descriptive statistics.

RESULTS: Five main themes were identified: (1) the diagnosis was a motivator for behavior change, (2) participants had to deal with disease consequences, (3) the coach provided guidance, (4) strategies for change were initiated, and (5) social support sustained behavioral changes. Other important subthemes were the coach helped interpret symptoms, which supported self-efficacy and goal setting, and survivors employed self-monitoring behaviors. Several participants found the recommended goals for physical activity were difficult and were discouraged if unable to attain the goal. Findings underscore the need for individualized prescriptions of physical activity, especially for sedentary survivors.

CONCLUSIONS: Lung cancer survivors described the benefits of coaching to enhance their engagement in behavioral change. Additional research is needed to validate the benefit of the HD intervention to improve HR-QOL among this vulnerable and understudied group of cancer survivors.


Coaching, Health goals, Health-related quality of life, Lifestyle risk reduction, Lung cancer, Multiple health behavior change

DOI of Published Version



Support Care Cancer. 2019 Apr;27(4):1299-1308. doi: 10.1007/s00520-018-4631-1. Epub 2019 Jan 14. Link to article on publisher's site

Journal/Book/Conference Title

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer

Related Resources

Link to Article in PubMed

PubMed ID