Lifestyle coaching is feasible in fatigued brain tumor patients: a Phase I / feasibility, multi-center, mixed-methods Randomized Controlled Trial

Alasdair G Rooney, William Hewins, Amie Walker, Mairi Mackinnon, Lisa Withington, Sara Robson, Claire Torrens, Lisa E M Hopcroft, Antony Clark, Garry Anderson, Helen Bulbeck, Joanna Dunlop, Michelle Welsh, Aimee Dyson, Julie Emerson, Carol Cochrane, Robert Hill, Jade Carruthers, Julia Day, David GillespieChristopher Hewitt, Emanuela Molinari, Mary Wells, Catherine Mcbain, Anthony J Chalmers, Robin Grant

Research output: Contribution to journalArticlepeer-review


There are no effective treatments for brain tumor-related fatigue. We studied the feasibility of two novel lifestyle coaching interventions in fatigued brain tumor patients.

This Phase I / feasibility multi-center RCT recruited patients with a clinically stable primary brain tumor and significant fatigue (mean Brief Fatigue Inventory [BFI] score ≥ 4/10). Participants were randomized in a 1-1-1 allocation ratio to: Control (usual care); Health Coaching (“HC”, an eight-week program targeting lifestyle behaviors); or HC plus Activation Coaching (“HC+AC”, further targeting self-efficacy). The primary outcome was feasibility of recruitment and retention. Secondary outcomes were intervention acceptability, which was evaluated via qualitative interview, and safety. Exploratory quantitative outcomes were measured at baseline (T0), post-interventions (T1, 10 weeks), and endpoint (T2, 16 weeks).

N=46 fatigued brain tumor patients (T0 BFI mean=6.8/10) were recruited and 34 were retained to endpoint, establishing feasibility. Engagement with interventions was sustained over time. Qualitative interviews (n=21) suggested that coaching interventions were broadly acceptable, although mediated by participant outlook and prior lifestyle. Coaching led to significant improvements in fatigue (improvement in BFI versus control at T1: HC=2.2 points [95%CI 0.6,3.8], HC+AC=1.8 [0.1,3.4], Cohen’s d [HC]=1.9; improvement in FACIT-Fatigue: HC=4.8 points [-3.7,13.3]; HC+AC=12 [3.5,20.5], d [HC&AC]=0.9). Coaching also improved depressive and mental health outcomes. Modelling suggested a potential limiting effect of higher baseline depressive symptoms.

Lifestyle coaching interventions are feasible to deliver to fatigued brain tumor patients. They were manageable, acceptable, and safe, with preliminary evidence of benefit on fatigue and mental health outcomes. Larger trials of efficacy are justified.
Original languageEnglish
JournalNeuro-Oncology Practice
Early online date14 Oct 2022
Publication statusE-pub ahead of print - 14 Oct 2022


  • brain tumor
  • fatigue
  • coaching
  • lifestyle
  • RCT


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