Development, implementation and formative evaluation of a motivational-volitional intervention to promote sustainable physical activity in breast cancer survivors.

OBJECTIVE: The aim of the current project was the development, implementation and evaluation of the programme, Motivational-Volitional Intervention-Movement After Breast Cancer (Mo-Vo-BnB), an intervention for the sustainable promotion of physical activity of breast cancer survivors. METHODS: In a multi-stage interdisciplinary development process, the pedagogical-didactic, psychological and physical evidence-based programme was developed and implemented for women after breast cancer who were approved for medical rehabilitation and were minimally, physically active (<60 min/week). Train-the-trainer seminars were carried out for the implementation. Four sessions were implemented in two German clinics. The training quality, didactic methods and accompanying material were evaluated 6 weeks and 12 months after implementation by patients, trainers and project members (n = 127 evaluations). RESULTS: The standardised and published MoVo-BnB programme can provide practical and quality training. Content and methods can be implemented according to the manual. Training quality, didactic methods, and accompanying materials were evaluated positively. CONCLUSION: The results suggest that MoVo-BnB is a useful standardised intervention for promoting the physical activity of breast cancer survivors. The demonstrated process is also suitable for other projects. CLINICAL TRIAL REGISTRATION: German Clinical Trials Register (DRKS): DRKS00011122; Trial registration date: 2016 October 13.

[A Motivational-Volitional Program for Women after Breast Cancer Increases Physical Activity 12 Months Post Rehabilitation - Results of a Prospective Controlled Trial]. / Ein motivational-volitionales Programm für Frauen nach Brustkrebs verbessert die sportliche Aktivität 12 Monate nach der Rehabilitation ­ Ergebnisse einer prospektiven kontrollierten Studie.

PURPOSE: To assess the effectiveness of a motivational-volitional program for women after breast cancer (MoVo-BnB) who engage less than 60 minutes per week in physical activity. METHODS: This is a non-randomised, prospective bi-centered controlled trial in 2 in-patient medical rehabilitation centers. Data are assessed at 4 measurement points: at admission, discharge, 6 and 12 months post discharge. The control group (CG; n=266) has received the standard rehabilitation, and the intervention group (IG; n=279) attended additionally the group program (4 sessions lead by physiotherapeutic and health pedagogic personnel). The primary outcome is self-reported physical activity (BSA-F); secondary outcomes are health related quality of life (QLQ-C30), breast cancer specific quality of health (QLQ-BR23) and program acceptance. Analysis of change are performed by ANCOVA for each follow-up, adjusting for baseline values. RESULTS: At 12 months follow up, the level of exercise in the intervention group is 22 min/week higher than in the control group (95% CI: 2,6 to 41.5; p=0.02). Further, 49.1% of the intervention group exercises for at least 60 min/week compared to 37.6% of the control group (p≤0.01). We have observed no significant differences between the groups for quality of life. The participants' evaluation of the intervention is positive and does not differ substantially between the 2 clinics (p=0.3). CONCLUSION: Our findings demonstrate that a cognitive-behavioral program based on the motivation-volitional model can lead to long-term improvement in exercise behavior in breast cancer patients, who is initially minimally active. Physical activity should be encouraged after breast cancer diagnosis. The results suggest that practitioners working in cancer aftercare might like to consider using a motivational-volitional program for improving and maintaining physical activity behavior for physical sedentary target groups.

Psychoeducational group intervention for breast cancer survivors: a non-randomized multi-center pilot study.

PURPOSE: The aim of the study was to evaluate an outpatient psychoeducational group program for breast cancer patients aimed to improve various psychosocial parameters, enhancing the patients' competence and reducing fear of recurrence. METHODS: The study is based on a multi-center, non-randomized control group design with three measurement time points (T1 baseline, T2 end of the intervention, T3 6-week follow-up). Breast cancer patients were assessed with various standardized questionnaires including fear of progression, self-efficacy, depression, and quality of life. RESULTS: A total of 50 breast cancer patients participated (intervention group n = 27, control group n = 23). The results show a significant reduction in the fear of progression/recurrence (FoPR) (p = 0.003) and a significant increase in self-efficacy (SE) (p = 0.007) for the intervention group with a large (FoPR, Eta2 = .178) and medium (SE, Eta2 = .113) effect size, respectively. For all other outcome criteria such as depressive symptoms, social support, or quality of life, no significant changes over time or differences between both groups were found. CONCLUSIONS: The psychoeducational program has been proven to be effective for breast cancer survivors, but further investigation based on a randomized trial is necessary. PRACTICE IMPLICATIONS: To improve participation rate assessment of patient's needs and close cooperation with rehabilitation centers, psychosocial counseling services, and medical oncologists are recommended.

Effectiveness of a motivational-volitional group intervention to increase physical activity among breast cancer survivors compared to standard medical rehabilitation-Study protocol of a prospective controlled bi-centred interventional trial.

Despite proven benefits of regular physical activity, the majority of breast cancer survivors do not meet recommended physical activity guidelines. The Motivation-Volition (MoVo) Concept was designed to help people to set up and maintain a health-enhancing lifestyle. Studies have proven the short- and long-term efficacy of the MoVo intervention programmes. The intervention consists of four group sessions (60 min). The sessions contain informational parts, structured training in setting goals, planning exercises, problem-solving, single person working and group discussion. We apply a sequential control group design in two inpatient rehabilitation facilities to evaluate the effect of a motivational-volitional group intervention compared to standard rehabilitation. Our target groups are inactive women after breast cancer. Primary outcome is the amount of physical activity per week. Secondary outcomes include physical functioning, fatigue and depression. 800 patients diagnosed with breast cancer on medical rehabilitation will be included, 400 participants per clinic and group. Participants will be assessed by questionnaires upon clinic arrival, before discharge and six and twelve months after discharge. The study will provide evidence on the effect of a MoVo group intervention for physical inactive women after breast cancer. Positive results may have an impact on long-term improvement in exercise behaviour and health status.