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. 2021 May 31;2021(5):CD012932. doi: 10.1002/14651858.CD012932.pub2

Bantum 2014.

Study characteristics
Methods RCT
Participants Participants: cancer survivors,(n = 352)
Age range: 18 years of age or older
Recruitment: from oncology clinics, a tumour registry, as well as through online mechanisms, such as Facebook and the Association of Cancer Online Resources (ACOR).
Eligibility: cancer survivors were eligible if they had completed their primary cancer treatment from 4 weeks to 5 years before enrolment, diagnosis with only one cancer and no recurrence, access to the Internet and ability to read English.
Country: USA
Interventions Intervention: social media only (n = 176)
Six weeks online program (Examples include improving diet by making healthier food choices, increasing exercise, stress management via relaxation training, improving communication with healthcare providers) etc. patient education course adopting the underlying principle that people with similar health conditions can help each other improve their health behaviours.
Control: non‐social media (n = 176)
No access to the intervention.
Outcomes Fatigue, insomnia, minutes per week of physical activity (categorised as strenuous plus moderate aerobic, strenuous aerobic, moderate aerobic, mild aerobic, and stretching), servings of fruits and vegetables eaten per week, and depression, website use.
Equity High‐income country
Notes Health behaviours: exercise and weekly fruit/vegetable intake were both stated as primary outcomes and were both selected for this category as per our outcome selection criteria. Several exercise outcomes were reported ‐ minutes per week of strenuous or moderate aerobic exercise was selected for this category as it was considered the most patient‐important.
Body function: insomnia was the only physical health outcome reported and was classified as such because the questions in the Women’s Health Initiative Insomnia Rating Score were related to falling in staying asleep.
Psychological health: depression was the only psychological health outcome reported and was measured using a validated tool.
Well‐being: not applicable.
Mortality: not applicable.
Adverse effects: not applicable.
Secondary outcomes: not applicable.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Low risk Once 40 to 50 participants had completed their baseline questionnaire, they were numbered in the order of completion and then randomised, using a random number table, half to treatment and half to wait‐list control.
Allocation concealment (selection bias) Unclear risk Not reported
Blinding of personnel Unclear risk Not reported
Blinding of participants Unclear risk Not reported
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk Not reported ‐ all measures are self‐report related to exercise and diet behaviours
Incomplete outcome data (attrition bias)
All outcomes Low risk Attrition low, predictors for dropout provided and there were no differences between groups.
Selective reporting (reporting bias) High risk Protocol has additional outcomes not discussed in this paper including health care utilisation, quality of life, and interaction with oncologists
Baseline characteristics similar Low risk With the exception of age, no significant differences were found among the two groups. Double the number of non‐Hodgkins lymphoma patients in control group.
Baseline outcome measurements similar Low risk Additionally, there were no significant differences between the control and treatment groups on all outcomes measures at baseline Depression scores higher in control group at baseline, Minutes per week of strenuous exercise and stretching higher among intervention group, but absolute changes reported
Protection against contamination Low risk Not reported but participants are cancer survivors across multiple sites and recruited via tumour registries, Facebook etc.