Associations between lifestyle factors and breast cancer in healthy women and breast cancer survivors and need for ehealth support


  • Simone Doreleijers



Breast cancer is the leading cause of cancer-related mortality amongst women and its’ incidence is highest in Western-Europe. Contributing factors are higher levels of obesity and alcohol consumption, and lower levels of physical activity. Literature suggests a poor compliance to health recommendations in both breast cancer survivors and women without history of breast cancer. In the light of breast cancer prevention it is of great importance to improve this adherence and to integrate health education. Ehealth counselling might be a useful medium to obtain this goal. To gain an insight in women’s needs and requirements regarding an eHealth programme, this study used a qualitative research design based on the iChange Model.


Youlden DR, Cramb SM, Dunn NA, Muller JM, Pyke CM, Baade PD. The descriptive epidemiology of female breast cancer: an international comparison of screening, incidence, survival and mortality. Cancer epidemiology. 2012;36(3):237-48

Demark-Wahnefried W, Platz EA, Ligibel JA, Blair CK, Courneya KS, Meyerhardt JA, et al. The role of obesity in cancer survival and recurrence. Cancer Epidemiology Biomarkers & Prevention. 2012;21(8):1244-59.

Holm M, Olsen A, Christensen J, Kroman NT, Bidstrup PE, Johansen C, et al. Pre‐diagnostic alcohol consumption and breast cancer recurrence and mortality: Results from a prospective cohort with a wide range of variation in alcohol intake. International Journal of Cancer. 2013;132(3):686-94.

Sanchis-Gomar F, Lucia A, Yvert T, Ruiz-Casado A, Pareja-Galeano H, Santos-Lozano A, et al. Physical Inactivity And Low Fitness Deserve More Attention To Alter Cancer Risk And Prognosis. Cancer Prevention Research. 2014:canprevres. 0320.2014.

Ligibel J. Lifestyle factors in cancer survivorship. Journal of Clinical Oncology. 2012;30(30):3697-704

Kwan ML, Kushi LH, Weltzien E, Tam EK, Castillo A, Sweeney C, et al. Alcohol consumption and breast cancer recurrence and survival among women with early-stage breast cancer: the life after cancer epidemiology study. Journal of clinical Oncology. 2010;28(29):4410-6.

Zhao G, Li C, Okoro CA, Li J, Wen XJ, White A, et al. Trends in modifiable lifestyle-related risk factors following diagnosis in breast cancer survivors. Journal of Cancer Survivorship. 2013;7(4):563-9.

Ollberding NJ, Maskarinec G, Wilkens LR, Henderson BE, Kolonel LN. Comparison of modifiable health behaviours between persons with and without cancer: the Multiethnic Cohort. Public health nutrition. 2011;14(10):1796-804.

Marcus BH, Lewis BA, Williams DM, Dunsiger S, Jakicic JM, Whiteley JA, et al. A comparison of Internet and print-based physical activity interventions. Archives of Internal Medicine. 2007;167(9):944-9.

Samoocha D, Bruinvels DJ, Elbers NA, Anema JR, van der Beek AJ. Effectiveness of web-based interventions on patient empowerment: a systematic review and meta-analysis. Journal of medical Internet research. 2010;12(2).

Lu H-Y, Shaw BR, Gustafson DH. Online health consultation: Examining uses of an interactive cancer communication tool by low-income women with breast cancer. International journal of medical informatics. 2011;80(7):518-28

I-change Model: Maastricht University; 2013 [cited 2015 15-6-2015]. Available from:

de Vries H, Mesters I, Van de Steeg H, Honing C. The general public’s information needs and perceptions regarding hereditary cancer: an application of the Integrated Change Model. Patient education and counseling. 2005;56(2):154-65.

Schüz B, Wurm S, Warner LM, Wolff JK, Schwarzer R. Health motives and health behaviour self-regulation in older adults. Journal of behavioral medicine. 2014;37(3):491-500.

Bandura A. Health promotion by social cognitive means. Health education & behavior. 2004;31(2):143-64.

Mann T, de Ridder D, Fujita K. Self-regulation of health behavior: social psychological approaches to goal setting and goal striving. Health Psychology. 2013;32(5):487.

Rutten LJF, Agunwamba AA, Wilson P, Chawla N, Vieux S, Blanch-Hartigan D, et al. Cancer-Related Information Seeking Among Cancer Survivors: Trends Over a Decade (2003–2013). Journal of Cancer Education. 2015:1-10.

Arora NK, Johnson P, Gustafson DH, McTavish F, Hawkins RP, Pingree S. Barriers to information access, perceived health competence, and psychosocial health outcomes: test of a mediation model in a breast cancer sample. Patient education and counseling. 2002;47(1):37-46.

Ajzen I. The theory of planned behavior. Organizational behavior and human decision processes. 1991;50(2):179-211.

Madden TJ, Ellen PS, Ajzen I. A comparison of the theory of planned behavior and the theory of reasoned action. Personality and social psychology Bulletin. 1992;18(1):3-9.

Thøgersen-Ntoumani C, Ntoumanis N. The role of self-determined motivation in the understanding of exercise-related behaviours, cognitions and physical self-evaluations. Journal of sports sciences. 2006;24(4):393-404.

Middelweerd A, Mollee JS, van der Wal C, Brug J, Te Velde SJ. Apps to promote physical activity among adults: a review and content analysis. Int J Behav Nutr Phys Act. 2014;11(1):97.

Breton ER, Fuemmeler BF, Abroms LC. Weight loss—there is an app for that! But does it adhere to evidence-informed practices? Translational behavioral medicine. 2011;1(4):523-9