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Table 1 Structure and content of the Shape-up following cancer treatment sessions

From: Diet and exercise in uterine cancer survivors (DEUS pilot) - piloting a healthy eating and physical activity program: study protocol for a randomized controlled trial

# Session Session title Session content Approximate time
Session 1 Preparing to Shape-up Welcome and introduction to the programme 25 min
Setting ground rules for the group 10 min
Discussion about previous experience of diet and physical activity changes, how cancer has shaped their eating and activity patterns, and hopes and fears about the programme 15 min
Motivation for change 10 min
Break 5 min
Setting a lifestyle target 10 min
Information and discussion about the importance of self-monitoring and food diaries 10 min
Round-up and preparation for next session 5 min
Take-home message 5 min
Session 2 Keeping to a regular eating pattern Review: Discussion about self-monitoring and food diaries and goal progress  
Volunteer-led discussion: Keeping to a regular eating pattern
Key learning points: The importance of keeping to a regular eating pattern, the definition of a regular eating pattern, the importance of breakfast, suggestions for goals, and disadvantages of eating regularly.
New topic: Goals and rewards
Discussion about the principles of goal-setting, group exercise about setting SMART goals, exercise about goal planning, discussion about rewards, and group exercise about non-food rewards
Round-up and preparation for next session
Take-home message
Session 3 Physical activity Review: Discussion about keeping a diary, setting a regular eating goal, goal-setting, rewards, and goal progress 20 min
Volunteer-led discussion: Physical activity 30 min
Key learning points: The importance of physical activity for health and wellbeing, the difference between physical activity and exercise, goals to aim for (30 min of moderate physical activity per day and muscle fitness exercises twice a week), and the importance of incremental increase in physical activity levels.  
Break 10 min
Setting an activity goal: individual exercise to help them focus on what they need to think about in order to improve their activity levels and group exercise for improving goal-setting skills 15 min
Round-up, and preparation for next session 10 min
Take-home message 5 min
Session 4 Eating a balanced diet Review: Discussion about last week’s topics and creating a physical activity goal and goal progress 20 min
Volunteer-led discussion: Getting a healthier balance of foods. 30 min
Key learning points: the five food groups, choosing which foods to make (plenty of whole grains, fruits, and vegetables; moderate amounts from the ‘meat, fish and alternatives’ and ‘milk and dairy’ groups, preferably low-fat; have little amounts of ‘foods high in fat or sugar’ and prefer healthy oils; limit processed meat, and sugary and alcoholic drinks; prefer foods low in salt).  
Break 5 min
New topic: Lapses 25 min
Information, group exercise, and discussion on how to deal with lapses  
Round-up, and preparation for next session 5 min
Take-home message 5 min
Session 5 Keeping an eye on food serving sizes Review: Discussion about last week’s topics, goal progress, and exercise about managing lapses 20 min
Volunteer-led discussion: Keeping an eye on food serving sizes 50 min
Key learning points: Each participant brings a weighed portion of some foods, and group members discuss understanding food serving sizes and how many servings they should aim for (the food servings reflect a 2,000 kcal diet for women).  
Break 10 min
Round-up and preparation for next session 5 min
Take-home message 5 min
Session 6 External triggers Review: Discussion about last week’s topics and goal progress 20 min
Volunteer-led discussion: External triggers 35 min
Key learning points: The difference between external and internal triggers, and main strategies for dealing with external triggers  
Break 5 min
New topic: Internal triggers 20 min
Discussion about hunger and cravings, group exercise for the dealing with cravings and the difference between craving and hunger and discussion about fatigue  
Round-up and preparation for next session 5 min
Take-home message 5 min
Session 7 Internal triggers Review: Discussion about last week’s topics, goal progress, and feelings about the group coming to an end 20 min
Volunteer-led discussion: Internal triggers 40 min
Key learning points: Definition of internal triggers (hunger, cravings, fatigue, emotions, and unhelpful thoughts) and strategies to deal with those  
Break 5 min
New topic: Lapse chains 10 min
Information about lapse chains and group exercise of putting together a behaviour chain  
Round-up, and preparation for next session 10 min
Take-home message 5 min
Session 8 Food labels and the Shape-up change plan Review: Discussion about last week’s topics and goal progress and reviewing earlier areas of the programme 10 min
Volunteer-led discussion: Food labels 30 min
Key learning points: The ingredient list and the various names of sugar and saturated fat in food labels, the importance of checking the sugar, saturated fat, and salt content in the labels, and tips for smart shopping  
Break 5 min
New topic: The Shape-up change plan 20 min
Information about how to complete a Shape-up change plan and individual exercise on filling a mock plan  
Discussion: Group members discuss their change plan, they re-evaluate their lifestyle target from Session 1, and are given information about the importance of continuing with self-monitoring 20 min
Round-up, and maintaining changes for the long term 5 min
Take-home message 5 min