Reallocating Time to Physical Activity and Sleep: Associations with Body Mass Index in Cancer Survivors.

BACKGROUND: Body mass index (BMI) above ≥ 25 kg/m2 is associated with increased risk for cancer-related morbidity and mortality. Achieving recommended amounts of physical activity (PA), sedentary time (ST), and sleep can help cancer survivors (CS) attain a healthy BMI. This cross-sectional study examined the potential role of reallocating time between moderate and light PA, ST, and sleep on BMI in CS. METHOD: A sample of CS (N = 73, Mage = 53.7 ± 12.9) wore an activPAL and Actiwatch accelerometer for 7 days, 24 h per day to measure PA intensity and sleep, respectively. Self-reported height and weight or scale/stadiometer were used to calculate BMI. Isotemporal substitution models were used to reallocate time, averaged over the 7-day period, from one activity of interest to another and examine the associations with BMI. Statistical significance was set at p < .05. RESULTS: The following reallocations of 30 min were significantly associated with BMI: sleep to ST (+ 0.80 kg/m2, p = 0.02) and ST to light PA (- 0.53 kg/m2, p = 0.008). No significant associations with BMI were observed for reallocating time to or away from moderate-vigorous PA. CONCLUSION: The results of this study suggest that sleep and light PA may have important implications for achieving a healthy BMI in CS. Therefore, future research should include interventions which target light PA and sleep to determine if they can improve BMI in CS.

Evaluating individual level change in physical function response following an exercise program for cancer survivors.

PURPOSE: Cancer survivors physical function response to exercise programs at the group level is well-established. However, to advance toward a more personalized approach in exercise oncology, a greater understanding of individual response is needed. This study utilized data from a well-established cancer-exercise program to evaluate the heterogeneity of physical function response and explore characteristics of participants who did vs. did not achieve a minimal clinically important difference (MCID). METHODS: Physical function measures (grip strength, 6-min walk test (6MWT), and sit-to-stand) were completed pre/post the 3-month program. Change scores for each participant and the proportion achieving the MCID for each physical function measure were calculated. The independent t-tests, Fisher's exact test, and decision tree analyses were used to explore differences in age, body mass index (BMI), treatment status, exercise session attendance, and baseline value between participants who achieved the MCID vs. those who did not. RESULTS: Participants (N = 250) were 55 ± 14 years old, majority female (69.2%), white (84.1%), and diagnosed with breast cancer (36.8%). Change in grip strength ranged from - 42.1 to + 47.0 lb, and 14.8% achieved the MCID. Change in 6MWT ranged from - 151 to + 252 m, and 59% achieved the MCID. Change in sit-to-stand ranged from - 13 to + 20 reps, and 63% achieved the MCID. Baseline grip strength, age, BMI, and exercise session attendance were related to achieving MCID. CONCLUSIONS: Findings illustrate wide variability in the magnitude of cancer survivors' physical function response following an exercise program, and that a variety of factors predict response. Further investigation into the biological, behavioral, physiological, and genetic factors will inform tailoring of exercise interventions and programs to maximize the proportion of cancer survivors who can derive clinically meaningful benefits.

Telemedicine-based inspiratory muscle training and walking promotion with lung cancer survivors following curative intent therapy: a parallel-group pilot randomized trial.

PURPOSE: Following curative-intent therapy of lung cancer, many survivors experience dyspnea and physical inactivity. We investigated the feasibility, acceptability, safety, and potential efficacy of inspiratory muscle training (IMT) and walking promotion to disrupt a postulated "dyspnea-inactivity" spiral. METHODS: Between January and December 2022, we recruited lung cancer survivors from Kaiser Permanente Colorado who completed curative-intent therapy within 1-6 months into a phase-IIb, parallel-group, pilot randomized trial (1:1 allocation). The 12-week intervention, delivered via telemedicine, consisted of exercise training (IMT + walking), education, and behavior change support. Control participants received educational materials on general exercise. We determined feasibility a priori: enrollment of ≥ 20% eligible patients, ≥ 75% retention, study measure completion, and adherence. We assessed acceptability using the Telemedicine-Satisfaction-and-Usefulness-Questionnaire and safety events that included emergency department visits or hospitalizations. Patient-centered outcome measures (PCOMs) included dyspnea (University-of-California-San-Diego-Shortness-of-Breath-Questionnaire), physical activity (activPAL™ steps/day), functional exercise capacity (mobile-based-six-minute-walk-test), and health-related quality of life (HRQL, St.-George's-Respiratory-Questionnaire). We used linear mixed-effects models to assess potential efficacy. RESULTS: We screened 751 patients, identified 124 eligible, and consented 31 (25%) participants. Among 28 participants randomized (14/group), 22 (11/group) completed the study (79% retention). Intervention participants returned > 90% of self-reported activity logs, completed > 90% of PCOMs, and attended > 90% of tele-visits; 75% of participants performed IMT at the recommended dose. Participants had high satisfaction with tele-visits and found the intervention useful. There was no statistically significant difference in safety events between groups. Compared to control participants from baseline to follow-up, intervention participants had statistically significant and clinically meaningful improved HRQL (SGRQ total, symptom, and impact scores) (standardized effect size: -1.03 to -1.30). CONCLUSIONS: Among lung cancer survivors following curative-intent therapy, telemedicine-based IMT + walking was feasible, acceptable, safe, and had potential to disrupt the "dyspnea-inactivity" spiral. Future efficacy/effectiveness trials are warranted and should incorporate IMT and walking promotion to improve HRQL. TRIAL REGISTRATION: ClinicalTrials.gov NCT05059132.

Matching Exercise Volume in Active Control Groups for Yoga Interventions.

Context: The selection of a control group should foremost be determined by the study's primary intended outcome and trial design. When examining the effects of the physical movements that comprise yoga postures, an active control group, with physical exercise as the control, is often recommended. Objective: The current study aimed to define an active control group that participates in physical exercise, emphasizing the importance of matching the exercise's volume to that of an intervention group's yoga, and to provide a tangible example from a federally funded, recently completed, randomized controlled trial. Design: The research team designed a control group, providing a case study as a example of it. Setting: The study took place at Colorado State University. Intervention: The exercise component for the control group included 60 minutes of low-intensity exercise, matched with 60 minutes of Hatha yoga for the intervention group. Because the intervention included chronic pain self-management in addition to the exercise component, the education component for the control group included 45 minutes of group-based, general health-and-wellness education and discussion. Conclusions: Future randomized trials for yoga and other complementary or integrative health interventions should continue to use appropriate active control groups, which will serve to enhance the scientific rigor of conclusions that can be drawn with respect to the effectiveness of these interventions.

Reallocating time to physical activity and sleep: associations with quality of life in cancer survivors.

PURPOSE: Quality of life (QOL) is an important psychosocial outcome in cancer survivors (CS). Physical activity (PA), reducing sedentary time (ST), and sleep can help CS improve QOL; however, these behaviors are commonly studied in isolation, despite their interdependence during the 24-h day (i.e., time in one activity cannot increase without time decreasing in another activity). This study examined the effects of reallocating time between moderate to vigorous PA (MVPA), light PA, ST, and sleep on QOL in a mixed sample of CS. METHODS: A cross-sectional sample of CS (N = 73) diagnosed with breast (29.7%), colorectal (33.8%), or other (36.5%) cancer. MVPA, light PA, and ST were measured using the activPAL™ accelerometer, and sleep duration using the Actiwatch™ accelerometer. Both were worn for 7 days, 24 h per day. QOL was self-reported using the Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire. Isotemporal substitution models were used to reallocate 30 min between activities. Statistical significance was set at p < .05. RESULTS: Participants accumulated, M = 24.0 ± 18.9 min/day of MVPA, 291.7 ± 100.4 min/day of light PA, 593.1 ± 108.3 min/day of ST, and 486.6 ± 57.6 min/night of sleep. Isotemporal substitution effects for reallocating time between MVPA, light PA, ST, and sleep were not significantly associated with QOL. CONCLUSIONS: Findings from this study suggest that among CS who are achieving adequate levels of PA and sleep, changes in 30 min of these activities may not impact QOL. Future studies should aim to recruit a larger, more representative sample and explore the role of bouted activity time.

Usability, acceptability, and implementation strategies for the Exercise in Cancer Evaluation and Decision Support (EXCEEDS) algorithm: a Delphi study.

INTRODUCTION: Oncology guidelines recommend participation in cancer rehabilitation or exercise services (CR/ES) to optimize survivorship. Yet, connecting the right survivor, with the right CR/ES, at the right time remains a challenge. The Exercise in Cancer Evaluation and Decision Support (EXCEEDS) algorithm was developed to enhance CR/ES clinical decision-making and facilitate access to CR/ES. We used Delphi methodology to evaluate usability, acceptability, and determine pragmatic implementation priorities. METHODS: Participants completed three online questionnaires including (1) simulated case vignettes, (2) 4-item acceptability questionnaire (0-5 pts), and (3) series of items to rank algorithm implementation priorities (potential users, platforms, strategies). To evaluate usability, we used Chi-squared test to compare frequency of accurate pre-exercise medical clearance and CR/ES triage recommendations for case vignettes when using EXCEEDS vs. without. We calculated mean acceptability and inter-rater agreement overall and in 4 domains. We used the Eisenhower Prioritization Method to evaluate implementation priorities. RESULTS: Participants (N = 133) mostly represented the fields of rehabilitation (69%), oncology (25%), or exercise science (17%). When using EXCEEDS (vs. without), their recommendations were more likely to be guideline concordant for medical clearance (83.4% vs. 66.5%, X2 = 26.61, p < .0001) and CR/ES triage (60.9% vs. 51.1%, X2 = 73.79, p < .0001). Mean acceptability was M = 3.90 ± 0.47; inter-rater agreement was high for 3 of 4 domains. Implementation priorities include 1 potential user group, 2 platform types, and 9 implementation strategies. CONCLUSION: This study demonstrates the EXCEEDS algorithm can be a pragmatic and acceptable clinical decision support tool for CR/ES recommendations. Future research is needed to evaluate algorithm usability and acceptability in real-world clinical pathways.

Factors predicting gains in moderate-to-vigorous physical activity in prostate cancer survivors on androgen deprivation therapy.

BACKGROUND: Whether individual, environmental, and psychosocial factors predict changes in moderate-to-vigorous physical activity (MVPA) is poorly addressed in prostate cancer (PC) survivors undergoing androgen deprivation therapy (ADT). PURPOSE: This secondary analysis of a randomized controlled trial examined changes in MVPA following a supervised personal training (PT), supervised group-based (GROUP) program, or a home-based, smartphone-assisted exercise (HOME) intervention in PC survivors on ADT and explored individual, environmental, and psychosocial predictors of MVPA. METHODS: PC survivors on ADT underwent aerobic and resistance training for 6 months via PT, GROUP, or HOME. MVPA was captured via accelerometers and the Godin Leisure-Time Exercise Questionnaire. Changes in MVPA between groups were assessed using linear regression. The following predictors of MVPA were examined using Spearman correlations: the Neighborhood Environment Walkability Scale (NEWS); the Planning, Attitudes, and Behaviours (PAB) scale; the Relatedness to Others in Physical Activity Scale (ROPAS); and individual factors at baseline. RESULTS: Participants (n = 37) were 69.4 ± 6.5 years old and 78.4% were on ADT for ≥ 3 months. Changes in accelerometry-based bouts and MVPA as well as self-reported MVPA did not differ between groups at 6 months. The Aesthetics domain of the NEWS questionnaire at baseline was the strongest predictor of positive MVPA changes (r = .66). Attitude (r = .64), planning (r = .57), and motivation (r = .50) at baseline were also predictive of engaging in higher MVPA throughout the intervention. CONCLUSION: Changes in objective MVPA were modest. Additional emphasis on specific psychosocial and individual factors is important to inform theory-based interventions that can foster PA behavior change in PC survivors on ADT. Registration # NCT02046837.

Cancer-related fatigue mediates the relationships between physical fitness and attendance and quality of life after participation in a clinical exercise program for survivors of cancer.

PURPOSE: Cancer-related fatigue (CRF) is a common and limiting symptom reported by survivors of cancer, negatively impacting health-related quality of life (HRQoL). Exercise improves CRF, HRQoL, and physical fitness in survivors. Prospective research trials have shown that exercise-associated fitness improvements effects on HRQoL are mediated by CRF; however, this has not been investigated in a pragmatic real-world setting. This study utilizes data from a large heterogenous population of survivors participating in a clinical exercise program to investigate this mediation effect, as well as effects of program attendance. METHODS: Data were collected from 194 survivors completing the BfitBwell Cancer Exercise Program (July 2016-February 2020). Changes in HRQoL, CRF, and fitness were calculated and program attendance collected. Basic correlation analyses were performed. Linear regression analyses were performed to assess mediation by CRF. RESULTS: All measures of CRF, HRQoL, and physical fitness significantly improved following the exercise program. Improvements in physical fitness were significantly correlated with improvements in HRQoL (r = 0.15-0.18), as was program attendance (r = 0.26) and CRF (r = 0.59). The effects of physical fitness and program attendance on HRQoL were at least partially mediated by the effects of CRF. CONCLUSION: This study extends research findings on how exercise programs improve HRQoL in survivors of cancer to a real-world setting. Results indicate that clinical exercise programs should target reductions in CRF in survivors (during or after treatment) through improvements in physical fitness to improve HRQoL and that high attendance should be encouraged regardless of fitness changes.

Predictors of attendance during an exercise program for cancer survivors.

PURPOSE: Exercise programs delivered in community- or clinic-based settings improve physical and psychosocial outcomes among cancer survivors; however, adherence is essential to achieve such benefits. This study examined predictors of attendance to an exercise program in a large, diverse sample of cancer survivors. METHODS: Participants (n = 302) were enrolled in BfitBwell, an exercise program for adults diagnosed with cancer, and currently receiving or within 6 months of completing chemotherapy or radiation therapy. Participants were offered two supervised aerobic and resistance exercise sessions per week for 3 months. Predictors of attendance included demographics, cancer-related information, quality of life (QOL), fatigue, physical fitness, activity level, and importance of making various changes (e.g., improving fitness). Univariate linear regression first explored associations between predictor variables and adherence, and any important variables (p < .10) were included in a multivariate linear regression model. RESULTS: Participants were M = 54.9 ± 13.9 years old, mostly female (67.3%), white (83.6%), and most commonly diagnosed with breast cancer (34.8%). Average attendance was 16.2 ± 6.6 exercise sessions. Six-minute walk test distance, QOL, and fatigue were associated with exercise session attendance (p < .05). The multivariable model revealed that higher QOL predicted higher attendance (ß = .351, p = .005), and working full- or part-time significantly predicted lower attendance (ß =- .221, p =.021). CONCLUSIONS: Higher pre-program QOL and not working full- or part-time predicted higher exercise program attendance. Existing and future exercise programs for cancer survivors should consider ways to adapt program delivery to provide support to survivors who start with low QOL, and accommodate those who may face barriers to attending due to work schedule/conflict.

Incorporating Behavior Change Strategies Into an Exercise Trial to Improve Physical Activity Maintenance Among Adults at High Risk for Type II Diabetes.

This study examined the feasibility and effects of a 1-hr physical activity (PA) behavior change (PABC) discussion session on PA, 12 weeks after completing an exercise trial. Adults at high risk of Type II diabetes were randomized to the PABC or a control group. PA was self-reported using the International Physical Activity Questionnaire. Chi-square tests compared the proportion of participants classified as moderately active or greater at the 12-week follow-up. Participants (N = 50) were M = 61.8 ± 5.5 years old and mostly female (80%). All participants completed the PABC discussion session, and compliance with the International Physical Activity Questionnaire at 12-week follow-up was 78%. Barrier self-efficacy increased immediately following the PABC (MΔ0.5 ± 0.9; t(22) = -2.45, p = .023). At 12-week follow-up, 88% in the PABC were moderately active or greater, compared with 50% in the control (p = .015). Incorporating a PABC discussion session as part of an exercise efficacy trial was feasible and may help improve PA maintenance.

Community-based exercise programs for cancer survivors: a scoping review of practice-based evidence.

PURPOSE: Based on randomized controlled trials, exercise is an efficacious strategy to improve quality of life (QOL) among cancer survivors. However, the effectiveness of exercise programs to improve QOL in real-world settings is unknown, as are factors related to external validity. This hinders dissemination and scalability. This scoping review synthesized published research on community-based exercise programs for cancer survivors and reported on the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM). METHODS: A systematic literature search identified community-based exercise programs for adult cancer survivors (1980-March 2018), that met the following inclusion criteria: at least one face-to-face exercise session, the primary aim of program evaluation (i.e., feasibility/effectiveness), and pre/post measure of QOL. Data were coded using the RE-AIM framework. The effect size was calculated for overall QOL. RESULTS: Electronic database search yielded 553 articles; 31 studies describing unique programs were included for review. All studies described at least one element of implementation and most (80.6%) reported a significant (p < .05) improvement in at least one subscale, or total QOL. Few studies reported on indicators of reach (16.1%), adoption (6.5%), individual (16.1%), or system-level maintenance (32.3%). CONCLUSIONS: Community-based exercise programs are effective for improving QOL in adult cancer survivors. Recommendations are provided to improve reporting across RE-AIM dimensions, which is an important step to enhance the scalability of programs and thus, the potential for exercise to be fully integrated into system-level standard care for cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Community-based exercise programs are a resource to improve QOL for adult cancer survivors.

Group-based exercise interventions for increasing physical activity in cancer survivors: a systematic review of face-to-face randomized and non-randomized trials.

PURPOSE: To increase physical activity (PA), interventions based on group dynamics may be superior to interventions that target aggregates of people but do not have formal strategies to enhance cohesion. This review examined the extent to which group dynamics processes have been integrated within exercise and/or PA interventions in cancer survivors, and explored the implementation and effectiveness of these interventions for increasing PA. METHODS: A systematic review was conducted of English articles published January 2005-March 13, 2017 using the electronic databases PsycINFO, CINAHL, and PubMed Medline (National Library of Medicine). Studies in adult cancer survivors that had a controlled or uncontrolled experimental design, included face-to-face exercise, had a group-based component, and reported PA pre- and post-intervention were included. Self-reported PA effect sizes were estimated for pre- to post-intervention, separately for studies that implemented ≥ 1 group dynamics strategy versus none. RESULTS: Twenty-three studies were reviewed, 34.8% (n = 8) included ≥ 1 group dynamics strategy (M = 1.6 ± 0.7, range = 1-3). Most interventions were delivered in a healthcare or rehabilitation setting by an exercise professional, and face-to-face exercise dose ranged from 72.0-6000.0 min. PA effect size ranged from 0.3-1.2 for studies that implemented ≥ 1 group dynamics strategy versus 0.4-2.4 for those with none. Studies reviewed lacked detailed examples of group dynamics strategies, and none measured group cohesion. CONCLUSIONS: The additional benefit of group dynamics-based interventions for increasing PA in cancer survivors remains unclear. More research is needed to enhance the generalizability of face-to-face exercise interventions, and determine how to maximize the potential of including group dynamics strategies.

Exercise preferences and associations between fitness parameters, physical activity, and quality of life in high-grade glioma patients.

PURPOSE: Exercise has numerous benefits for cancer survivors, but very limited research to date has exclusively examined brain cancer patients, specifically those diagnosed with high-grade glioma (HGG). This study examined (1) the feasibility of recruiting HGG patients to an exercise-based study and performing fitness assessments; (2) exercise counseling and programming preferences; and (3) associations between fitness, physical activity (PA), and quality of life (QOL). METHODS: Participants completed assessments prior to starting Temozolamide chemotherapy with radiation (T1), at 2 months and 8 months. Fitness was measured with an incremental cycling exercise test to volitional exhaustion (VO2peak) and hand grip dynamometry. The Godin leisure time questionnaire measured PA and the functional assessment for cancer therapy, brain cancer module (FACT-Br) measured QOL. RESULTS: Of the 35 approached, N = 16 participated. Due to safety concerns, the aerobic fitness test protocol was altered. Participants preferred to exercise during treatment, alone and unsupervised, at home, and at a moderate intensity. Few participants (<25%) met guidelines for PA at any time point. At T1, aerobic capacity was associated with the FACT Trial Outcome Index (TOI) (r = 0.619, p < 0.05). At 2 months, PA minutes were associated with FACT-TOI (r = 0.653, p = 0.057), FACT-G (r = 0.711, p < 0.05), and FACT-Br scores (r = 0.722, p < 0.05). CONCLUSIONS: Recruitment rate was similar to a previous study in HGG populations, but study completion rate was lower. Most exercise counseling and programming preferences were similar to previous brain cancer patients. Assessing aerobic fitness to VO2peak was not feasible. Aerobic fitness and PA were positively associated with QOL.

Improved Physical Activity Screening Enhances Intervention Effectiveness in Ethnic Minority Women: A Longitudinal Study.

This study identified inconsistencies in physical activity (PA) reported at screening and baseline of a 6-month health promotion intervention and explored how these inconsistencies influenced intervention effectiveness in African American and Hispanic women. Participants completed a telephone screener to determine eligibility for a PA intervention. Inactive participants (≤90 minutes of PA/week) were invited to a baseline assessment, where they completed the International Physical Activity Questionnaire, measuring work, transportation, gardening/housework, and leisure-time PA. Women returned after 6 months to complete an identical post-intervention assessment. Despite being screened as inactive, baseline Questionnaire data indicated that 85.0% of participants (N = 274, M age = 44.6 years, M body mass index = 34.8 kg/m2) were active (>90 minutes of PA/week). Women who reported any work-related PA were 20.9 times more likely to be active at baseline than those who did not (p < .001). Participants who were inactive at both screening and baseline reported greater increases in domestic and gardening PA and total PA from baseline to postintervention (ps < .05). Overweight/obese ethnic minority women may misreport being physically inactive during screening if specific questions about type of PA are not included. Post hoc analyses controlling for screening inaccuracies may improve effectiveness of PA interventions and help intervention programs reach women who may benefit the most.

Benefits of 24 versus 12 weeks of exercise and wellness programming for women undergoing treatment for breast cancer.

PURPOSE: Community exercise programs can help maintain or improve health in cancer survivors. However, the most effective and feasible duration of a community exercise program for breast cancer survivors who are undergoing treatment is not known. This pre-post-design study evaluated the effects of the "Breast cancer patients Engaging in Activity while Undergoing Treatment" (BEAUTY) program on physical and psychosocial outcomes after 12 and 24 weeks. METHODS: BEAUTY is an ongoing community exercise and wellness program for breast cancer patients who are undergoing, or within 3 months of completing chemotherapy and radiation. Participants completed assessments at baseline, 12 weeks, and 24 weeks to measure body composition, hand-grip dynamometry, aerobic fitness, and flexibility. Self-report questionnaires assessed fatigue (FACIT-fatigue), cognitive function (FACT-cog), quality of life (QOL) (FACT-B), and depressive symptoms (CES-D). Main analyses were repeated measures general linear model for all outcomes. RESULTS: Assessments at all three time points were completed by N = 63 participants. At 24 weeks, waist to hip ratio (p = .019), duration of the submaximal treadmill test (p = .013), and estimated VO2max (p = .018) improved compared to baseline. Fatigue improved at 24 compared to 12 weeks (p = .002). FACT-B scores improved at 24 weeks when compared to both baseline (p = .002) and 12 weeks (p = .001). Depressive symptoms improved compared to baseline (p = .05) and 12 weeks (p = .009). CONCLUSIONS: Additional benefits were seen after 24 versus 12 weeks, suggesting that a longer duration exercise program during, or shortly after completing treatments for breast cancer, may be necessary to see improvements in fitness and psychosocial outcomes. Findings can be applied to community exercise and rehabilitation programs for breast cancer survivors.

The influence of sitting time and physical activity on health outcomes in public housing residents.

OBJECTIVES: Examine differences between levels of physical activity and sitting time for residents of public housing developments located in high vs low income neighborhoods, and whether physical activity or sitting time had a greater influence on health outcomes. DESIGN: Secondary data analysis from the Healthful Options Using Streets and Transportation in Our Neighborhoods (HOUSTON) project. SETTING: Public housing developments located in Houston, TX. PARTICIPANTS: African American, adult males and females. MAIN OUTCOME MEASURES: Self-reported PA and time spent sitting on weekdays were measured using the International Physical Activity Questionnaire (IPAQ) short form. Participants completed measures of BMI (kg/m2), % body fat (%BF) and resting blood pressure to assess health outcomes. Neighborhood income was defined as the median household income at the census block group level, obtained from the 2006-2010 American Community Survey. RESULTS: All participants (N = 216) had an annual household income of < or = $19,350, and neighborhood income ranged from $9,226 to $57,618. Participants reported an average of 4342.2 +/- 4828.3 MET-min/wk of physical activity, and 4.5 +/- 3.2 hours of sitting per weekday. Time spent sitting was associated with BMI (beta = .50, t = 2.4, P = .018), %BF (beta = .87, t = 3.6, P =.000), and diastolic blood pressure (beta = .62, t = 2.1, P = .041). Physical activity was not significantly associated with any health outcomes. CONCLUSION: Our findings indicate that public housing residents' health statuses are vulnerable to sedentary behaviors regardless of the affluence of the neighborhood surrounding the housing development.

Corrigendum: Adaptive yoga versus low-impact exercise for adults with chronic acquired brain injury: a pilot randomized control trial protocol.

[This corrects the article DOI: 10.3389/fnhum.2023.1291094.].

Depression, stress and body fat are associated with binge eating in a community sample of African American and Hispanic women.

OBJECTIVE: The purpose of this study was to examine the relationships among depressive symptoms, stress and severity of binge eating symptoms in a community sample of African American and Hispanic or Latina women. METHOD: Women (African American, n = 127; Hispanic or Latina, n = 44) completed measures of body composition, stress, depression, and binge eating. RESULTS: Scores on a depressive symptom scale indicated that 24.0 % of participants exhibited clinically significant levels of depressive symptoms. Mean binge eating scores were below the threshold for clinically diagnosed binge eating (12.99 ± 7.90). Mean stressful event scores were 25.86 ± 14.26 and the average stress impact score was 78.36 ± 55.43. Linear regression models found that body composition, stress impact score, and being classified as having clinically significant levels of depression were associated with severity of binge eating symptoms. CONCLUSION: Higher levels of percent body fat, a CES-D score ≥16 and higher WSI-Impact scores were associated with greater severity of binge eating symptoms.

An Evaluation of Participant Perspectives and Wear-Time Compliance for a Wrist-Worn Versus Thigh-Worn Accelerometer in Cancer Survivors.

BACKGROUND: Accelerometers are frequently used to measure free-living physical activity and sleep in cancer survivors. To obtain valid data, participants must adhere to wear-time guidelines; therefore, understanding survivor's preference may be critical when selecting an accelerometer. This study compared cancer survivors' reported discomfort and interference, and wear-time compliance between a wrist-worn accelerometer and a thigh-worn accelerometer. METHODS: This was a secondary data analysis. Cancer survivors (N = 52, mean age = 51.8 [13.0], 82.3% female) wore the Actiwatch-2 (wrist) and the activPAL (thigh) for 7 days, 24 hours per day. On day 7, participants completed a questionnaire to evaluate each accelerometer using a 1 to 5 Likert scale and open-ended questions. The Kolmogorov-Smirnov test evaluated differences in discomfort and interference. Paired samples t test evaluated differences in wear-time compliance. Open-ended responses were analyzed using thematic analysis methods. RESULTS: No differences were observed in discomfort, interference, or wear-time compliance (P = .08). Qualitative analysis resulted in 2 themes: discomfort and ease of use and interference and adverse reaction. Interferences were primarily reported with the Actiwatch-2, whereas discomfort and ease were primarily reported with the activPAL. CONCLUSION: No significant differences were observed regarding discomfort, interference, and compliance. Results of this study can prepare researchers for common issues regarding accelerometer compliance, allowing researchers to offer resources to alleviate discomforts or interferences that may affect wear-time compliance.

A Group-Based, Videoconference-Delivered Physical Activity Program for Cancer Survivors.

Introduction/Purpose: Virtually supervised, group-based exercise presents an innovative way to expand the reach of exercise-oncology programs and help cancer survivors increase physical activity (PA) and connect with other participants. This study examined the feasibility, acceptability, and preliminary effects of a group-based PA program delivered exclusively using videoconferencing software. Methods: This study used a single-group pre-post design. The 8-wk program consisted of aerobic and resistance exercise sessions once per week and three PA behavior change discussion sessions in groups of four to six. Feasibility was determined by enrollment, retention, safety, and adherence. Postprogram surveys evaluated acceptability using a Likert scale and open-ended responses. Changes in PA (Godin Leisure-Time Exercise Questionnaire), quality of life (QOL; Functional Assessment of Cancer Therapy- General), and upper and lower body muscular endurance (bicep curl and sit-to-stand test) were also evaluated. Results: Enrollment was feasible (n = 61 of 65 who expressed interest in the program), and retention (86.9%) and adherence (88% for exercise, 91% for discussion) were high; no adverse events were reported. Participants (mean age, 59.9 ± 10.1 yr; 96.2% female; 64.2% ovarian cancer, 28.3% breast cancer, 7.5% other cancer) reported they enjoyed the program (median, 7 of 7), and videoconferencing software was easy to use and had good video and audio quality (median, 5 of 5). From preprogram to postprogram, participants increased their weekly minutes of aerobic (mean (SD) change, 82.4 (144.2)) and resistance (mean (SD) change, 31.9 (42.7)) PA; sit-to-stand (mean (SD) change, 1.4 (3.9)) and bicep curl (mean (SD) change, 5.3 (6.8)) repetitions; and emotional (mean (SD) change, 0.82 (2.3) points), functional (mean (SD) change, 1.2 (3.6) points), and total QOL (mean (SD) change, 3 (7.9) points; all P < 0.05). Conclusions: A group-based PA program delivered using videoconference technology is feasible and acceptable for cancer survivors, and may increase PA and improve physical fitness and some aspects of QOL. A larger, controlled intervention is needed to determine efficacy, as well as pragmatic studies to directly compare this approach with conventional strategies (i.e., face-to-face programs).