Home-based physical activity interventions for breast cancer patients receiving primary therapy: a systematic review.

PURPOSE: Breast cancer continues to be the leading cause of cancer in women in the US, so it is important to provide these women with good therapies. However, there are adverse effects to these therapies. Physical activity plays an important role in alleviating these adverse effects of breast cancer therapy. However, the effectiveness of home-based physical activity interventions such as walking programs has not been detailed by prior reviews. METHODS: This article reviews articles published to date to examine whether home-based physical activity interventions are effective in improving physical activity and other outcomes among breast cancer patients who are undergoing primary therapy for the disease. The present review is based upon bibliographic searches in PubMed and CINAHL and relevant search terms. Articles published in English from 1980 through February 28, 2019 were identified. A total of 360 article citations were identified in PubMed and non-duplicates in CINAHL. RESULTS: After screening the abstracts or full texts of these articles and reviewing the references of previous review articles, we found 15 studies that met the eligibility criteria. Four of the studies were pre/post-test trials, 10 were randomized controlled trials, and one study was an observational study. CONCLUSION: Results from studies published to date indicate that among women receiving primary breast cancer therapy, home-based physical activity programs have positive effects on physical functioning and symptoms such as fatigue. Among women receiving adjuvant chemotherapy or radiation therapy, home-based physical activity programs are effective in reducing symptoms and improving physical functioning. Additional studies are needed to clarify the impact of home-based physical therapy interventions on other outcomes including quality-of-life, bone mineral density, cognitive functioning, and chemotherapy-induced peripheral neuropathy.

Assessing the role of spirituality in coping among African Americans diagnosed with cancer.

Spirituality plays an important role in cancer coping among African Americans. The purpose of this study was to report on the initial psychometric properties of instruments specific to the cancer context, assessing the role of spirituality in coping. Items were developed based on a theoretical model of spirituality and qualitative patient interviews. The instruments reflected connections to self, others, God, and the world. One hundred African American cancer survivors completed the instruments by telephone. The instruments showed adequate internal reliability, mixed convergent validity, discriminant validity, and interpretable factor structures.

Role of religious involvement and spirituality in functioning among African Americans with cancer: testing a mediational model.

The present study tested a mediational model of the role of religious involvement, spirituality, and physical/emotional functioning in a sample of African American men and women with cancer. Several mediators were proposed based on theory and previous research, including sense of meaning, positive and negative affect, and positive and negative religious coping. One hundred patients were recruited through oncologist offices, key community leaders and community organizations, and interviewed by telephone. Participants completed an established measure of religious involvement, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-SP-12 version 4), the Positive and Negative Affect Schedule (PANAS), the Meaning in Life Scale, the Brief RCOPE, and the SF-12, which assesses physical and emotional functioning. Positive affect completely mediated the relationship between religious behaviors and emotional functioning. Though several other constructs showed relationships with study variables, evidence of mediation was not supported. Mediational models were not significant for the physical functioning outcome, nor were there significant main effects of religious involvement or spirituality for this outcome. Implications for cancer survivorship interventions are discussed.

Role of religion in cancer coping among African Americans: a qualitative examination.

The present study used qualitative methods to examine if and how African Americans with cancer use religiosity in coping. Patients (N = 23) were recruited from physician offices and completed 1-1(1/2) hour interviews. Themes that emerged included but were not limited to control over one's illness, emotional response, importance of social support, role of God as a healer, relying on God, importance of faith for recovery, prayer and scripture study, and making sense of the illness. Participants had a great deal to say about the role of religion in coping. These themes may have utility for development of support interventions if they can be operationalized and intervened upon.

Development and validation of measures of religious involvement and the cancer experience among African Americans.

Research indicates that African Americans diagnosed with cancer tend to use religion in coping. However less is known about the specific role that religion plays in the coping process. Based on previous qualitative work, five instruments were developed to assess the role of religious involvement in cancer coping: God as helper, God as healer, Faith in healing, Control over cancer and New perspective. The instruments were administered to 100 African Americans with cancer. Each exhibited high internal reliability, and concurrent and discriminant validity. These instruments may have applied value for the development of church-based cancer support/survivorship interventions.

Role of spirituality in cancer coping among African Americans: a qualitative examination.

INTRODUCTION: This study used qualitative methods to examine whether, and if so how, African American cancer survivors use spirituality in coping with the disease. Spirituality was defined using a model involving connectedness to self, others, a higher power, and the world. METHODS: Twenty-three African American patients with various forms of cancer were recruited from physician offices and completed 1-1.5 h interviews. Data were coded by multiple coders using an inductive process and open-coding. RESULTS: Themes that emerged included, but were not limited to the aforementioned types of connectedness, one theme being connections to God. Given the important role of social support in the cancer experience, participants also emphasized their connectedness to others, which is in support of the spirituality model. Participants also articulated the notion that connections with others were not always positive, indicating that some perceived certain connections as having a detrimental impact on their well-being. Participants also expressed the desire to share their cancer story with others, often gained a new perspective on life, and obtained new self-understanding as a result of their illness experience. DISCUSSION/CONCLUSIONS: Findings indicate that African Americans perceive that spirituality plays a strong role in their cancer coping and survivorship. Spirituality may address a human need for certitude in crisis. Further research is warranted for model testing, and to examine the role of spirituality in cancer coping among those of different backgrounds and cancer types/stages. IMPLICATIONS FOR CANCER SURVIVORS: These themes may have utility for the development of support interventions for cancer survivors.

Barriers to occupational and environmental medicine services in the southeastern United States.

OBJECTIVES: We sought to determine whether low-income and minority populations in the Southeast face barriers to access to occupational and environmental medicine (OEM) services. METHODS: Access to OEM services was defined as the presence of an OEM physician in a county or the proximity of a clinic in the Association of Occupational and Environmental Clinics network to a county. RESULTS: Counties with higher percentages of low-income, all non-white minority, and African-American populations in South Carolina, Georgia, Alabama, and Mississippi were more likely to be farther away from an AOEC clinic. Counties with higher percentages of low-income populations were less likely to have an OEM physician. However, the percentages of minority and African-American populations in these counties were not associated with the presence of an OEM physician. CONCLUSION: Both low-income and minority populations in the Southeast face barriers to OEM services.

The American College of Radiology's BI-RADS 3 Classification in a Nationwide Screening Program: current assessment and comparison with earlier use.

The Breast Imaging Reporting and Data System allows radiologists to classify lesions as "probably benign-short interval follow-up suggested" (category 3). The purpose of this study is to evaluate the recent use of the category 3 designation in a national cancer detection program. We analyzed data from the National Breast and Cervical Cancer Early Detection Program, a nationwide collaboration between the Centers for Disease Control and Prevention (CDC) and local health agencies that provides cancer screening for low-income, uninsured women. The study population included all women at least 40 years old who had mammograms in the program through September 1999 (n = 826,424). Of the 826,424 mammograms, the percentage classified as category 3 in the initial phase (1991-1996, previously reported, n = 372,760) was 7.7%; of the most recent 453,664 mammograms (1996-1999), 6.0% were given this designation. During the same periods, the percentage of abnormal mammograms decreased from 2.6% to 2.1% and those needing "additional imaging" (category 0) increased from 5.0% to 6.9%. The percentage receiving a category 3, category 0, or abnormal designation decreased with increasing age for each classification. The percentage of category 3 mammograms varied by site from 1.1% to 12.2%. Overall the proportions of category 3 mammograms decreased over time, while requests for additional examinations increased. This suggests that patients were more likely than before to receive additional examinations prior to their final designation. The persistent wide variability in category 3 indicates further education and attention to the use of this category is warranted.