An Adaptive Physical Activity Maintenance Intervention for Cancer Survivors

Posted on May 18, 2022May 18, 2022 by coprhcon

BACKGROUND

Structured moderate to vigorous physical activity (MVPA; i.e., aerobic and resistance exercise) improves many physical and psychosocial health outcomes for cancer survivors. However, it is estimated that less than half of cancer survivors are achieving MVPA guidelines. Interventions that are supervised and include theory-based behavior change strategies are effective for increasing MVPA among cancer survivors; however, following an intervention, many survivors return to previously inactive, or insufficiently active lifestyles. To achieve the many benefits associated with MVPA, cancer survivors must not only adopt or begin a program, but also be able to maintain these MVPA levels long-term. Setting/Population: Participants will be adult cancer survivors who have completed active cancer treatment (i.e., chemotherapy, radiation therapy, surgery) within the previous five-years. The study will take place in partnership with three community-based exercise oncology programs in Colorado and Wyoming.

METHODS

A Sequential Multiple Assignment Randomized Trial (SMART) will be used to determine the optimal level of support needed to maintain levels of MVPA, following completion of a community-based exercise program. Participants will enroll in one of the three community-based exercise oncology programs, and upon completion, will be encouraged to continue exercising during a three-month free-living follow-up period. After this follow-up period, MVPA levels will be assessed. Those who are not achieving MVPA guidelines will be classified as ‘incomplete responders’ and randomized to one of two subsequent interventions: (a) monthly PA behavior change discussion sessions, or (b) monthly PA behavior change discussion sessions plus bi-weekly exercise sessions. Responders, who are classified as meeting MVPA guideline levels, will be randomized to either: (c) no further intervention, or (d) monthly PA behavior change discussion sessions. After three-months of the PA maintenance intervention, MVPA levels will be assessed again (i.e., 6-months after completion of the initial exercise program). Fisher’s Exact Tests will compare the proportion of participants meeting MVPA guidelines at the 6-month time-point within the responders and incomplete responder subgroups.

CONCLUSIONS

This project is significant because it aims to develop a tailored approach to enhancing PA maintenance, by identifying non-responders and providing them with the additional support necessary to engage in MVPA long-term. Delivering the intervention in partnership with community-based facilities will increase potential for scalability and widespread dissemination. Findings from this study will prepare our team to test our PA maintenance intervention in a full-scale adaptive trial, powered for efficacy.

Posted in 2022 Poster Session, Pragmatic Trial Pilots and Designs.