Sedentary time transitions and associations with quality of life in cancer survivors during the COVID-19 pandemic.

BACKGROUND: Patterns in sedentary time (SED) and its impact on quality of life (QoL) in cancer survivors during the COVID-19 pandemic remains unknown. The purpose of this study was to 1) compare total and domain-specific SED before and during the pandemic; and 2) examine its association with QoL in a global sample of cancer survivors. METHODS: In an online survey, cancer survivors retrospectively self-reported domain-specific SED (e.g. transportation, television) before and during the pandemic via the Domain-Specific Sitting Time Questionnaire. QoL was assessed via the Functional Assessment of Cancer Therapy (FACT)-General and FACT-Fatigue. Paired t-tests compared daily SED before and during the pandemic. Analysis of covariance compared QoL among: those who remained high (>8 h/day), remained low (<8 h/day), increased (<8 h/day to >8 h/day), or decreased (>8 h/day to <8 h/day) daily SED. RESULTS: Among cancer survivors (N = 477, Mage=48.5 ± 15.4), 60.8% reported that their SED remained high, 19.7% remained low, 7.5% increased SED, and 11.9% decreased SED. Computer and television screen time significantly increased (p's<.001), while SED during transportation significantly decreased (p<.001). Sub-group analyses revealed that those who reduced SED who were normal or underweight (p=.042) or were meeting physical activity guidelines (p=.031) had significantly less fatigue than those who increased or remained high in SED, respectively. Those who remained high in SED with <3 comorbidities (p's =.005) had significantly better social well-being than those who increased SED. CONCLUSIONS: As we transition to a post-pandemic era, behavioral strategies for cancer survivors should focus on reducing screen time to improve QoL and fatigue.

"I have to get up and exercise because that's how I'm going to get over this": a qualitative exploration of exercise identity and behavior in early cancer survivorship.

PURPOSE: Exercise is beneficial for people living with and beyond cancer (LWBC); however, many people LWBC fail to meet the exercise guidelines. Having an identity related to exercise, a component of one's self-concept, correlates with exercising more frequently in general adult populations. Understanding how exercise identity influences exercise behaviors in people LWBC is warranted due to the many barriers people LWBC face in relation to physical activity. The purpose of this study was to explore the perceived impact of an exercise identity of the exercise behaviors and motivations among people LWBC. METHODS: Thirteen participants of mixed diagnoses (Mage = 60.8 ± 10.8 years) in the early survivorship period (i.e., within five years of primary treatment completion or diagnosis) participated in semi-structured interviews to identify influences of exercise identity on exercise behavior. Interviews were transcribed verbatim and analyzed using thematic analysis. RESULTS: Findings demonstrated that people LWBC with a strong exercise identity engage in high and varied exercise behaviors. Despite barriers such as changes in motivations and ability to engage in exercise, participants maintained exercise throughout cancer by constant adaptation of their outlook and behaviors related to exercise. These results demonstrate a maintenance of physical activity in relation to a strong exercise identity. IMPLICATIONS FOR CANCER SURVIVORS: Results of this study have implications for the design and implementation of exercise behavior change programs for people LWBC as it provides insights into predictors of sustained exercise behavior during and following cancer treatment.

Preferences and engagement with physical activity resources among cancer survivors during the COVID-19 pandemic.

PURPOSE: The COVID-19 pandemic has imposed additional barriers to physical activity (PA) in cancer survivors. Adaptations to PA programmes are needed during the pandemic. Therefore, the purpose of this study was to evaluate (1) the PA preferences of cancer survivors prior to and during the pandemic and (2) the available resources to engage in PA during the pandemic. METHODS: Using a cross-sectional study design, cancer survivors were recruited globally to participate in a self-administered survey assessing their PA preferences and available PA resources during the pandemic. Descriptive statistics were used to determine trends in PA preferences and resources. A sub-group analysis was conducted for age, gender, education, and PA levels. RESULTS: Cancer survivors (N = 493) were mainly women (70.4%) diagnosed with breast cancer (29.0%), with a mean age of 48.7 ± 15.8 years, and 87.1 ± 81.9 months since diagnosis. Since the start of the pandemic, cancer survivors were primarily walking (82.6%), and performing PA alone (62.7%) and at home (46.6%). Sub-group analysis revealed education level, PA levels, and age to be associated with significant differences in PA preferences. The most common equipment available to survivors in their homes were exercise mats (40.6%) and free weights (39.8%). Few survivors were made aware of at-home PA resources (19.1%), and approximately half indicated wanting to receive these resources (49.6%). CONCLUSIONS: Understanding cancer survivors' preferences and resources for PA during the pandemic is critical to designing effective home-based interventions. Interventions and recommendations should be tailored based on the level of education and PA participation, as well as age.

Changes in physical activity, sedentary behavior, and self-reported cognitive function in cancer survivors before and during the COVID-19 pandemic: A cross-sectional study.

BACKGROUND: Physical activity (PA) and reductions in sedentary behavior (SED) may mitigate cancer-related cognitive impairment. The purpose of this study was to examine (a) the associations between changes in PA, SED, and cognitive function in cancer survivors before and during the coronavirus disease 2019 (COVID-19) pandemic; and (b) clinical subgroups that moderate this association. METHODS: A cross-sectional survey was administered online to adult cancer survivors globally between July and November of 2020. This was a secondary analysis of a cross-sectional survey examining changes in self-reported PA and quality of life in cancer survivors before and during the COVID-19 pandemic. Self-reported Questionnaires assessed moderate-to-vigorous PA (MVPA) using the modified Godin Leisure Time Exercise Questionnaire, cognitive function using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) scale, and SED using the Domain-specific Sitting Time questionnaire. Cancer survivors were classified into no change in behavior, desirable change (i.e., increase MVPA to meet PA guidelines or decrease SED by ≥60 min/day), and undesirable change (i.e., decrease MVPA to <150 min/week or increase SED by ≥60 min/day). Analysis of covariance examined differences in FACT-Cog scores across the activity change categories. Planned contrasts compared differences in FACT-Cog scores between cancer survivors with (a) no meaningful change vs. any change, and (b) a desirable change vs. an undesirable change. RESULTS: There were no significant differences in FACT-Cog scores across activity-change categories in the full sample of cancer survivors (n = 371; age = 48.6 ± 15.3 years (mean ± SD)). However, cancer survivors who were diagnosed ≥5 years ago (t(160) = -2.15, p = 0.03) or who received treatment ≥5 years ago (t(102) = -2.23, p = 0.03) and who had a desirable change in activity reported better perceived cognitive abilities than those who had an undesirable change. CONCLUSION: PA promotion efforts should consider reducing SED in addition to maintaining MVPA in long-term cancer survivors to mitigate cancer-related cognitive impairment during the COVID-19 pandemic.

Matched and moving: exploring daily social support among women partnered for exercise after a breast cancer diagnosis.

PURPOSE: Exercise and social support are non-pharmacological strategies that improve health and wellbeing in women treated for breast cancer (WTBC). However, strategies to facilitate support and exercise in WTBC are typically resource intensive. The purpose of this study was to examine whether various forms of social support received from a matched peer were associated with increased exercise among WTBC. METHODS: A daily diary study was conducted to examine naturally occurring social support as it relates to daily exercise behavior. Forty-six WTBC were matched (23 pairs) and completed pre-screening survey assessing eligibility and baseline levels of exercise. Participants were given Fitbit devices to track physical activity behavior and completed daily surveys across 3 weeks assessing perceptions of exercise-related social support at fixed times at the end of each day. RESULTS: Mixed models accounting for day of study, baseline support, and baseline exercise levels revealed that higher levels of daily exercise-related tangible social support were associated with more daily steps (b = 506, SE = 143) and more light physical activity (LPA) minutes (b = 7.01, SE = 3.15). Informational social support was associated with higher moderate to vigorous physical activity (MVPA) minutes (b = 3.18, SE = 1.60). CONCLUSIONS: Overall, peer matching programs aimed at increasing exercise-related social support among WTBC might encourage exercise behaviors, especially among women who share exercise-specific information (e.g., benefits, type, activities).

Correlates of Physical Activity Participation among Individuals Diagnosed with Cancer: An Application of the Multi-Process Action Control Framework.

BACKGROUND: The purpose of this study was to test Multi-Process Action Control (M-PAC) processes as correlates of physical activity (PA) intention formation and translation (i.e., action control) in individuals diagnosed with cancer. METHODS: This study was a cross-sectional survey, completed from July to November of 2020 during the COVID-19 pandemic. PA and M-PAC processes were self-reported using the Godin Leisure-Time Exercise Questionnaire and questionnaires for reflective (instrumental/affective attitudes, perceived opportunity/capability), regulatory (e.g., goal-setting, planning), and reflexive processes (habit, identity). Separate hierarchical multinomial logistic regression models determined correlates of intention formation and action control. RESULTS: Participants (n = 347; Mage= 48.2 ± 15.6) were primarily diagnosed with breast cancer (27.4%) and at a localized stage (85.0%). Most participants intended to perform PA (70.9%), yet only 50.4% met guidelines. Affective judgements (p < 0.001) and perceived capability (p < 0.01) were significantly associated with intention formation. Preliminary models indicated employment, affective judgements, perceived capability, and self-regulation to be significant (ps < 0.05) correlates of action control, but in the final model, only surgical treatment (p = 0.02) and PA identity (p < 0.001) were significantly associated with action control. CONCLUSION: Reflective processes were associated with PA intention formation, while reflexive processes were associated with PA action control. Behavior change efforts for individuals diagnosed with cancer should extend beyond social-cognitive approaches to include regulatory and reflexive processes of PA behavior (i.e., PA identity).

First-Year Implementation of the EXercise for Cancer to Enhance Living Well (EXCEL) Study: Building Networks to Support Rural and Remote Community Access to Exercise Oncology Resources.

Barriers to exercise-oncology programs remain for those living with and beyond cancer in rural and remote communities, including geographic isolation and access to programs. The EXercise for Cancer to Enhance Living Well (EXCEL) study was designed to support exercise-oncology implementation in rural and remote communities across Canada. The purpose of this analysis was to evaluate the first-year reach, adoption, and implementation of the EXCEL study. Reach outcomes included participant characteristics, study enrolment, and referral type (self vs. healthcare-provider [HCP] referral). Adoption outcomes included the number of clinical contacts, trained qualified exercise professionals (QEPs), and QEPs delivering EXCEL exercise classes. Implementation outcomes included retention, adherence, assessment completion rates, and adverse-event reporting. A total of 290 individuals living with cancer enrolled in EXCEL in year one, with an 81.4% retention to the study intervention. Most participants self-referred to EXCEL (75.8%). EXCEL's HCP network consisted of 163 clinical contacts, and the QEP network included 45 trained QEPs, 22 of whom delivered EXCEL classes. Adherence to the exercise intervention was 78.2%, and only one adverse event (mild) was reported. Fitness assessment and patient-reported outcome completion rates were above 85% pre- and post-intervention. EXCEL has developed HCP and QEP networks supporting exercise referral and online delivery, and the intervention is meeting feasibility markers. These implementation findings will inform the continued gathering of feedback across stakeholders to ensure that best evidence informs best practices.

Changes in physical activity and associations with quality of life among a global sample of cancer survivors during the COVID-19 pandemic.

PURPOSE: Meeting physical activity (PA) guidelines (i.e., ≥ 150 min/week of aerobic PA and/or 2 days/week of resistance training) is beneficial for maintaining cancer survivors' well-being. The impact of the COVID-19 pandemic on PA participation in cancer survivors and its association on quality of life (QoL) remains unknown. The purpose of this study was to compare PA levels prior to and during the COVID-19 pandemic, and examine the association between changes in PA and QoL in cancer survivors. METHODS: A global sample of cancer survivors participated in a cross-sectional, online survey. Participants self-reported their PA participation before and during the pandemic using the Godin Leisure Time Exercise Questionnaire and QoL with the Functional Assessment of Cancer Therapy (FACT) scales. Paired t-tests compared PA before and during the pandemic. Analysis of covariance examined differences in QoL between PA categories: non-exercisers, inactive adopters, complete and partial relapsers, single and combined guideline maintainers. RESULTS: PA participation of cancer survivors (N = 488) significantly decreased during the pandemic (p's < .001). Cancer survivors were classified as non-exercisers (37.7%), inactive adopters (6.6%), complete (13.1%) and partial (6.1%) relapsers, and single (23.8%) or combined (12.7%) guideline maintainers. Partial relapsers had significantly lower QoL and fatigue than inactive adopters, and combined guideline maintainers (p's < .05) that were clinically meaningful. CONCLUSION: PA decreased during the pandemic which has negative implications for QoL and fatigue in cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: PA is critical for maintaining QoL during the pandemic; therefore, behavioral strategies are needed to help cancer survivors adopt and maintain PA.

"Your Body Is Not At All Where You Left It": Adolescent and Young Adult Cancer Survivors' Experiences Transitioning Back Into Physical Activity After Treatment.

Physical activity (PA) can help manage cancer treatment-related side effects and improve well-being following treatment; however, resuming PA after a period of inactivity due to cancer can be challenging. The purpose of this study was to explore adolescents and young adults (AYAs) experiences transitioning back into PA after a period of inactivity due to cancer treatment. Twelve previously active AYAs (Mage = 30 ± 5.8 years) were purposefully sampled and engaged in a semi-structured interview. The following four themes were generated through a reflexive thematic analysis: PA is described as important and valuable; navigating one's appearance and fitness changes after cancer treatment within the PA context; supportive care is essential to successful PA transitions; and juxtaposed environments: fitness facilities, cities, and green spaces. Developing strategies aimed at gradually transitioning into PA should be a priority to improve AYAs' well-being through survivorship.

A distance-based, randomized controlled trial for reducing sedentary behavior among prostate cancer survivors: a study protocol.

BACKGROUND: Prostate cancer survivors (PCS) experience long-term side effects beyond treatment such as fatigue, depression and anxiety. Quality and engaging supportive care programs are needed to reduce these chronic and debilitating effects. Independent of physical activity (PA), high volumes of sedentary behavior (SB) are associated with chronic disease-related risk factors and poorer cancer-specific quality of life (QoL). Simultaneously increasing PA and decreasing SB may be an effective health promotion strategy. Given that PCS may face several barriers to engaging in supervised programs, there is a need to develop and assess the efficacy of interventions that employ distance-based approaches for behavior change. The primary aim of this study is to determine the effects of a 12-week intervention (Fitbit + behavioral counselling) vs. Fitbit-only control group in reducing SB among PCS. Secondary outcomes include light-intensity PA, QoL, motivational outcomes, and patient satisfaction. METHODS: This two-armed, randomized controlled trial will recruit inactive PCS (stage I-IV) across Canada who self-report engaging in >8 hours/day of SB. Participants will be randomized to the intervention (n=60; Fitbit and behavioral support) or active control group (n=60; Fitbit-only). The intervention consists of the use of a Fitbit and a series of six behavioral support sessions (two group, four individual) to aid PCS in gradually replacing SB with light-intensity PA by increasing their daily step counts to 3,000 steps above their baseline values. The Fitbit-only control condition will receive a Fitbit and public health PA resources. The primary outcome is change in SB measured objectively using activPAL inclinometers. All secondary outcomes will be measured via self-report, except for PA which will be measuring using Fitbits. Data will be collected at baseline, post-intervention, and at 6-month post-intervention. DISCUSSION: Reducing SB and increasing light-intensity PA plays an important, yet often undervalued role in the health and well-being of PCS. This study will create a unique distance-based platform that can be used by clinical and community-based organizations as a low-cost, supportive care tool to improve health outcomes for PCS. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT05214937 . Registered January 28, 2022 Protocol version: v.1.

Associations of light physical activity, moderate-to-vigorous physical activity and sedentary behavior with quality of life in men on androgen deprivation therapy for prostate cancer: a quantile regression analysis.

To examine associations of physical activity (PA) and sedentary time (SED) with quality of life (QoL) in men on androgen deprivation therapy (ADT) for prostate cancer. A pooled analysis of 106 men on ADT was conducted. PA and SED were assessed using accelerometers. The Functional Assessment of Cancer Therapy (FACT) was used to assess self-reported QoL. Quantile regression examined the associations of QoL with PA and SED. Total time spent in SED was positively associated with FACT-General at the 50th (p = 0.010) and 75th percentile (p = 0.022). SED in ≥ 30-min bouts was inversely associated with FACT-General at the 50th  (p = 0.025) and 75th percentile (p = 0.029). Breaks in SED were positively associated with physical well-being at the 75th percentile (p = 0.004). Light-intensity PA was positively associated with FACT-Prostate at the 25th percentile (p = 0.020). SED and PA were associated with QoL outcomes, but time in each varied across men reporting the poorest QoL compared to those in the highest QoL distributions.

Connecting breast cancer survivors for exercise: protocol for a two-arm randomized controlled trial.

BACKGROUND: Peer-based exercise interventions that cultivate new opportunities for support with a fellow cancer survivor may result in increased exercise volume. It is not clear whether adding qualified exercise professional (QEP) support to peer-based interventions improves health outcomes. Therefore, the purpose of this study is to determine whether breast cancer survivor (BCS) dyads who receive 10 weekly sessions of virtually delivered QEP support have improved outcomes compared to BCS dyads who do not receive QEP support. METHODS: Participants Adult BCS with medical clearance for exercise, who have an internet-connected device, and currently engage in < 150 min of moderate-intensity exercise per week. Intervention BCS will be matched using evidence-based criteria. The intervention group will receive dyadic exercise information sessions and a program tailored by a QEP for 10 weeks (intervention period) and have access to the QEP for an additional 4 weeks (tapering period). The control will not receive any QEP support. Outcomes The primary outcome is post-intervention self-reported exercise volume. Secondary outcomes include device-assessed exercise volume (i.e., Fitbit), social support, and health-related quality of life. Randomization 108 participants, matched in dyads, will be randomized 1:1 to the MatchQEP or Match groups using a web-based scheme. Statistical analysis Outcomes will be measured at baseline, post-intervention, post-tapering, and at 12 weeks post-intervention follow-up. DISCUSSION: The findings from this RCT will determine if matched BCS dyads who receive 10 weeks of virtually delivered QEP support have higher levels of self-report and device-measured exercise, social support, and health related quality of life compared to matched dyads without QEP-delivered exercise guidance. To our knowledge this will be the first study to assess the combined effect of peer- and QEP support on exercise volume. Project findings will inform and optimize intervention methods aimed to increase exercise among BCS through accessible exercise supports. TRIAL REGISTRATION: The study is registered on ClinicalTrials.gov (study identifier: NCT04771975, protocol Version Number: 2, date: July 22, 2021).

Body image among adolescents and young adults diagnosed with cancer: A scoping review.

OBJECTIVE: Cancer and treatment can produce temporary or permanent body changes, which may affect the body image (BI) of adolescents and young adults diagnosed with cancer (AYAs). This evidence has not been comprehensively summarized. A scoping review was conducted to explore the available evidence on BI among AYAs and identify the definitions, theories, models, frameworks, measures, and methods used to assess BI. METHODS: Databases MEDLINE, EMBASE, PsycINFO (via Ovid) and CINAHL and Gender Studies (via EBSCO) were searched to identify published studies from 1 January 2000 to 25 November 2019. Inclusion criteria were: qualitative, quantitative, or mixed methodology; at least one BI-related measure or theme; published in English; and majority of the sample between 13 and 39 years at diagnosis and a mean age at diagnosis between 13 and 39 years. Two authors screened the titles, abstracts, and full-text articles and data were extracted and summarized. RESULTS: The search yielded 11,347 articles and 82 met inclusion criteria. Articles included 45 quantitative, 33 qualitative, and four mixed-methods studies. The majority of studies used cross-sectional designs, while BI definitions, theories, models, frameworks, and measures were varied. Studies explored descriptive, psychological, physical, coping, and social factors, with BI being described most often as an outcome rather than a predictor. CONCLUSIONS: Theory-based research that employs a holistic BI definition and uses longitudinal or intervention study designs or a qualitative methodology is needed to better understand the BI experience of AYAs and inform the development of strategies and programs to reduce BI concerns and increase positive body experiences.

Preferences for exercise and physical activity support in adolescent and young adult cancer survivors: a cross-sectional survey.

PURPOSE: Exercise and physical activity (hereafter, collectively referred to as PA) preferences and benefits are becoming increasingly well characterised in cancer survivors, yet evidence from adolescent and young adult cancer survivors (AYAs) is scant. We describe the overall PA behaviour and support preferences of AYAs and explore subgroup differences to inform AYA-specific research and support. METHODS: AYAs diagnosed with cancer between the ages of 18-39 years, irrespective of current age, were approached in clinic at a large cancer centre for this cross-sectional survey that assessed self-reported demographics, medical history, PA behaviour and PA support preferences. RESULTS: A total of 318 AYAs completed the survey. Approximately 40% of AYAs were not meeting PA guidelines, and only 5% reported engagement with cancer PA support services. Most AYAs wanted PA support (78%), to increase PA levels (70%), and were interested in engaging in PA interventions that were individually supervised (82%), home-based (79%), performed ≥ 3 days/week (75%) and for ≥ 30 minutes/session (78%), offered following treatment (63%), restricted by age (63%), and involved strength (83%), walking (78%), and flexibility (75%) exercise. PA preferences most often differed according to sex, treatment status, current PA behaviour and PA support setting. CONCLUSION: AYAs have a great capacity and interest in specific types of PA support. Poor engagement with existing PA support services highlights the need for further AYA-specific research. Better understanding of AYAs' unique PA behaviour and support preferences can inform the development of urgently needed research and support services for this understudied and rapidly growing population.

The Use of Theory to Develop Physical Activity Interventions in Urological Cancer Survivors: A Narrative Review.

OBJECTIVES: To summarize the current available evidence on the use of behavior change theories to explain and change physical activity behavior in urological cancer survivors. DATA SOURCES: Five electronic databases including Medline, Web of Science, Embase, Cochrane, and Psych INFO and reference lists of key studies were searched between database inception and November 2020. Peer-reviewed articles on the use of behavior change theories to understand or change physical activity in urological cancer survivors were included. CONCLUSION: The theory of planned behavior and the social cognitive theory were the most used theories to explain and change physical activity behavior in urological cancers, respectively. However, the use of behavior change theories in physical activity interventions for urological cancers is still low across all urological tumor groups. Planning frameworks such as the intervention mapping approach should be used to enhance the systematic use of behavior change theories during every phase of intervention development. In addition, more research is needed to identity which behavior change techniques are most effective to change physical activity behavior in urological cancer survivors. IMPLICATIONS FOR NURSING PRACTICE: Nurses play a key role in the urological cancer patients' clinical pathway and should be able to motivate patients to engage in sufficient physical activity levels. Therefore, it is important that nurses understand the underlying reasons why patients (do not) engage in physical activity and which behavior change techniques are most effective in changing a patients' behavior.

Testing the Associations Between Body Image, Social Support, and Physical Activity Among Adolescents and Young Adults Diagnosed With Cancer.

Physical activity (PA) is important for managing the side effects and long-term outcomes of cancer treatment, yet many adolescents and young adults diagnosed with cancer (AYAs) are not meeting PA guidelines. Body image and social support are two factors that can influence PA behavior and require further attention in this population. The purpose of this study was to examine the associations between body image, social support, and PA among AYAs. An online cross-sectional survey administered through the Research Electronic Data Capture platform was used to assess self-reported body image (body-related self-conscious emotions of appearance and fitness shame, guilt, authentic pride, and hubristic pride), social support (general and cancer-specific), and PA (mild, moderate-to-vigorous, and resistance exercise) in AYAs (N = 119; M age = 34.5 ± 5.5 years). Based on findings from path analyses, body image and social support were directly associated with PA (R 2 = 0.09-0.33). Social support was also directly associated with body image. However, there were no indirect effects. These findings provide preliminary support for the influential role of appearance and fitness body-related emotions and cancer-specific social support on PA. The results have important implications for the development of targeted strategies aimed at improving body image (e.g., cognitive dissonance and compassion-focused interventions) and social support (e.g., facilitating the provision of cancer-specific support), with the overall goal of increasing AYAs' PA.

A pilot feasibility randomized controlled trial adding behavioral counseling to supervised physical activity in prostate cancer survivors: behavior change in prostate cancer survivors trial (BOOST).

The purpose of this study was to evaluate the feasibility of delivering a supervised physical activity program plus standard exercise counseling (PA + EC) versus a supervised physical activity plus motivationally-enhanced behavioral counseling (PA + BC) in prostate cancer survivors. Secondary outcomes included objectively assessed PA, quality of life, body composition, cardiorespiratory fitness, cognitive functioning, and physical function. Twenty-six prostate cancer survivors were randomized to a 12-week supervised PA program plus standard exercise counseling or a 12-week supervised PA plus behavioral counseling based on the Multi-Process Action Control framework. Feasibility was determined through enrolment rate, measurement completion rate, loss-to-follow-up, adherence to the intervention, adverse events, and program evaluation items assessing burden and satisfaction. Of the 26 prostate cancer survivors enrolled (Mage = 65.6 ± 6.8), 96% completed the intervention. Measurement completion rates for the study measures were 88.5%. Adherence to the supervised PA sessions was 92% (completed 11/12 supervised PA sessions) and 100% (completed 12/12 supervised PA sessions) in the PA + EC and PA + BC group, respectively. Adherence to the home-based PA sessions was 70% (completed 7/10 home-based sessions) and 90% (completed 9/10 home-based sessions) in the PA + EC and PA + BC group, respectively. Overall, prostate cancer survivors were highly satisfied with the intervention components and found it rewarding, useful for research helping others, and useful for them personally. The patterns in the secondary outcomes were consistent with a positive impact of the intervention, favoring the PA + BC group. Preliminary evidence suggests that adding behavioral counseling to supervised PA in prostate cancer survivors may be feasible and result in better adherence to PA compared to exercise counseling alone, although additional refinement is needed. A combination of supervised and home-based PA may be feasible for behavior change in the self-management of prostate cancer. The study is registered with http://ClinicalTrials.gov (ID NCT03191968).

Acute effects of aerobic exercise and relaxation training on fatigue in breast cancer survivors: A feasibility trial.

OBJECTIVE: This three-armed randomized controlled feasibility trial tested the acceptability and acute effects of aerobic exercise and technology-guided mindfulness training (relative to standalone interventions) on cancer-related fatigue among breast cancer survivors (BCS). METHODS: BCS recruited from Central Illinois completed pre- and post-testing using established measures and were randomized to one of three groups (combined aerobic exercise with guided-mindfulness relaxation, aerobic exercise only, and relaxation only), conducted in three 90 min sessions over the course of 7 days in a fitness room and research office on a university campus. RESULTS: We enrolled 40 BCS (Mage = 57.33 ± 8.75), MBMI = 27.38 ± 5.27, Mfatigue = 4.56 ± 1.81 as measured by the Piper Fatigue Scale. More favorable post-intervention evaluations were reported by the combined group, compared to aerobic exercise or relaxation only (p < 0.05). Reductions in fatigue favoring the combined group (p = 0.05) showed a modest effect size (Cohen's d = 0.91) compared to aerobic exercise only. CONCLUSIONS: These findings provide preliminary evidence for the feasibility of combining evidence-based techniques to address fatigue among BCS. The combined approach, incorporating mobile health technology, presents an efficacious and well-received design. If replicated in longer trials, the approach could provide a promising opportunity to deliver broad-reaching interventions for improved outcomes in BCS. Preregistered-ClinicalTrials NCT03702712.

A comparison of total and domain-specific sedentary time in breast cancer survivors and age-matched healthy controls.

Breast cancer survivors (BCS) engage in more sedentary behavior (SED) than those without cancer. However, the context in which SED is accrued is unknown. The purpose of this study is to examine differences in total and domain-specific SED of BCS and healthy controls. 20 BCS and 20 age-matched, healthy controls wore ActiGraph GT3X + accelerometers to measure SED and activity. Participants self-reported SED for transportation, occupational, screen time and leisure purposes. Multiple linear regressions were used to estimate differences in SED between BCS and controls. BCS spent significantly more time watching TV (152.4 vs. 60.3; p < 0.01) and less time in total SED (490.8 vs. 587.4; p = 0.046) and other leisure activities (57.6 vs. 106.9; p < 0.01) than healthy controls. BCS engage in more TV watching and less time in other leisure activities than controls, thus interventions should focus on reducing TV time. Understanding facilitators of TV viewing is needed to determine specific intervention targets.