A Community Dance Intervention Engaging Breast Cancer Survivors in a Middle-income Country

February 13, 2022 updated by: Olga Lucia Sarmiento

"My Body, My Rhythm, My Voice": a Community Dance Intervention Engaging Breast Cancer Survivors in Physical Activity in a Middle-income Country

Interventions to promote physical activity among women breast cancer survivors (BCS) in low to middle-income countries are limited. We conducted a study to assess the acceptability and preliminary effectiveness of an 8-week, 3 times/week group dance intervention for BCS delivered in Bogotá, Colombia. The effect of the intervention on participants' physical activity levels, motivation to engage in physical activity, and quality of life were evaluated, and interviews were thematically analyzed to assess program acceptability.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This is a quasi-experimental study with a control group and an intervention group.

The study population are patients over 18 years of age with a diagnosis of breast cancer who have received management and are currently in remission phase (more than 1 year after finishing management with chemotherapy and radiotherapy) and who do not report having any medical contraindication for the practice of physical activity (angina, acute myocardial infarction, pulmonary embolism, arterial hypertension and uncontrolled diabetes mellitus, severe lymphedema). The control group will be patients who attend their medical check-ups at the National Cancer Institute of Colombia and the intervention group will be patients who are cared for by units of the Bogotá's medical service. It will have the written approval of the ethics committee of the respective hospitals.

Being an exploratory study that investigates the acceptability and main motivations for attending physical activity sessions on a regular basis, it is considered that a sample of 30 people in the control group and 30 people in the intervention group could provide the necessary information to have in mind to develop studies with more significant sample sizes in the future.

For 8 weeks the intervention group will be offered 24 classes of musicalized directed physical activity (through a training protocol adapted for patients with this underlying pathology), and 8 craft workshops, to be held in the same space as the physical activity sessions. Additionally, at the same time, healthy habits will be promoted with the control group through text messages during 8 weeks, with a two workshops (at the beginning and the end of this period). The classes and workshops will be held at the facilities of the health provider institution in a place that guarantees the privacy of the participants.

For the recruitment of patients in the intervention group, women who were diagnosed with altered BI-RADS will be contacted by telephone. For the recruitment of patients from the control group, the head nurse who coordinates the follow-up program for breast cancer patients will be asked to invite the women in the study to participate. Additionally, all invited patients will receive the information through an attached information sheet.

Before the start of the intervention and after it, the following measurements will be made:

  1. The questionnaires include questions about sociodemographic data, medical information, quality of life, general state of health, optimism and pessimism about life, anxiety and depression, perception of fatigue, knowledge about physical activity, self-efficacy in physical activity and social support for the practice of physical activity. These questionnaires will be administered by pollsters trained and registered through the Qualtrics application. These questionnaires will be applied by trained interviewers in a personal meeting in both health centers, in a space that ensures the confidentiality and security of the information.
  2. Objective measurements that include levels of physical activity by accelerometry and body composition by bio-impedance. These measurements will be carried out by a professional in Respiratory Therapy in the facilities of the institution that provides services where the women have been recruited, as appropriate control group or intervention group. The research team will provide the transportation service to take the participants to the facilities. To guarantee the physical safety of the people who participate, there will be a person certified in life support, who will ensure that the participant who requires entering in the most efficient way to the health system. It is worth clarifying that all study participants will have affiliation to a Health Promoting Entity through which they attend their oncology controls, and additionally, the research group will have a medical insurance policy for the patients who participate in the intervention to cover any event that may arise during it.
  3. Collection of qualitative information through focus groups led by an anthropology professional to explore what breast cancer survivors look for in a physical activity program and the main motivations and barriers to attending said program and its acceptability. In addition, information will be collected through interviews with experts who work in health promotion, disease prevention, and cancer patient management to identify those factors that are important to be able to articulate the recreation sector with the health sector in the implementation of a targeted physical activity program for breast cancer survivors. Approximately 10 to 15 interviews will be carried out according to the saturation of the information; the recruitment of these experts will be done through snowball sampling where an expert will refer to contacts related to this topic.

Statistical analyzes will be carried out with SPSS and SAS, an ANOVA analysis of variance, Kruskal-Wallis and McNemar's tests of repeated measures will be carried out to establish the change in the results before and after the intervention. To support the analysis of qualitative data from both the focus groups and the interviews, the NVIVO12 software will be used.

Participants will receive the aggregated results of the general study ensuring confidentiality. Additionally, the participants will receive individually the results of the anthropometric tests and stress tests so that they know their physical condition; those who find a level of risk of coronary heart disease will be explicitly suggested to consult a specialist doctor through their insurer.

Study Type

Interventional

Enrollment (Actual)

64

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Colombia
      • Bogotá, Colombia, 111711
        • School of Medicine, Universidad de los Andes

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (ADULT, OLDER_ADULT)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Female

Description

Inclusion Criteria:

  • BCS at least six months post treatment completion
  • More than 18 years of age
  • Living in Bogotá
  • Willing to attend the program and the assessments

Exclusion Criteria:

  • The presence of metastatic disease and other health conditions for which community physical activity was contraindicated

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: PREVENTION
  • Allocation: NON_RANDOMIZED
  • Interventional Model: PARALLEL
  • Masking: NONE

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
NO_INTERVENTION: Control group
No intervention
EXPERIMENTAL: Intervention group
My Body, My Rhythm, My Voice
Behavioral: My Body, My Rhythm, My Voice
My Body was a behavioral intervention informed by the social cognitive and self-determination theories. Based on the discussions and a systematic review of the literature, we designed the 8-week, 3 times/week rumba physical activity intervention. The goal of the intervention was to gradually increase all participants' physical activity levels to achieve significant health benefits. As part of the physical activity intervention, participants were also taught by their instructor during each class how to utilize behavioral and cognitive self-regulatory skills to increase and maintain their physical activity participation. Examples of such skills were action planning, coping planning, counter conditioning, self-evaluation, among others.
Other Names:
  • My Body

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in participants' physical activity levels
Time Frame: Physical activity levels were assessed at baseline and after the 8th week
To assess the change from baseline participants' physical activity levels at 8 weeks, participants wore accelerometers for 7 consecutive days from awakening to bedtime using an elasticized belt around the waist at the right mid-axillary line. For wear-time validation, a minimum of four weekdays and a weekend day with at least 10 hours of wear during the waking time was required. Accelerometers were initialized to collect data at a sampling frequency of 80 Hz, downloaded in one-second epochs and grouped in 60-second epochs for analysis.
Physical activity levels were assessed at baseline and after the 8th week
Change in participants' motivation to engage in physical activity
Time Frame: Motivational regulation for physical activity was assessed at baseline and after the 8th week
To assess the change from baseline participants´ motivational regulation for physical activity at 8 weeks, we used the validated Spanish version of the Behavioral Regulation in Exercise Questionnaire-3 [BREQ-3], a 23-item inventory assessing the Self-Determination Theory relevant constructs (which conceptualizes motivation as a continuum ranging from amotivation to a high level of intrinsic motivation). Responses to each item were reported on a 5-point scale ranging from 0 (not true for me) to 4 (very true for me).
Motivational regulation for physical activity was assessed at baseline and after the 8th week
Change in participants' quality of life
Time Frame: Quality of life was assessed at baseline and after the 8th week
To assess the change of quality of life, we used the official Colombian Spanish translation of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. It incorporates five functioning subscales, three symptom subscales, six single symptoms, an item for illness-related financial difficulties, and a two-item general health/global QoL subscale. Each item was reported on a 4-point scale ranging from 1 (not at all) to 4 (very much), except for the general health subscale, which response options range from 1 (very poor) to 7 (excellent). High scores on the functioning subscales and the global health status/QoL subscale represent higher quality of life, while high scores on the symptom subscales indicate high levels of symptomatology. We also used a subscale of the EORTC questionnaire specific to breast cancer patients regarding physical symptoms for lymphedema; it comprises seven items with responses also ranging from 1 (not at all) to 4 (very much).
Quality of life was assessed at baseline and after the 8th week
Acceptability of My Body
Time Frame: Semi-structured interviews were conducted after the 8th week
We used a semi-structured interviewing technique to ensure in-depth insights about BCS' perspectives towards physical activity, their anticipated and actual experienced barriers and facilitators to engage in the physical activity intervention, their expected and reported benefits from the physical activity intervention, and the perceived positive and negative aspects of the program.
Semi-structured interviews were conducted after the 8th week

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Sociodemographic variables
Time Frame: Surveys were collected at the baseline
To characterize the population, we collected surveys inquiring about sociodemographic variables (i.e., age, education, socioeconomic level, employment status, healthcare access).
Surveys were collected at the baseline
Body mass index
Time Frame: BMI was assessed at the baseline
Anthropometric data (height, weight) were directly measured by trained interviewers according to standardized procedures using scale and stadiometer. Body mass index (BMI) was calculated using the formula weight (kg)/height2 (m2); and classified according to the World Health Organization BMI classification
BMI was assessed at the baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Olga Lucia Sarmiento

Collaborators

National Cancer Institute (NCI)
University of California, Los Angeles
National Institutes of Health (NIH)
Stanford University
Pontificia Universidad Javeriana
Universidad Manuela Beltrán
Hospital de San Jose

Investigators

  • Principal Investigator: Olga Lucía Sarmiento, PhD, Department of Public Health, School of Medicine, Universidad de los Andes, Bogotá, Colombia

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (ACTUAL)

March 1, 2019

Primary Completion (ACTUAL)

November 30, 2019

Study Completion (ACTUAL)

August 31, 2020

Study Registration Dates

First Submitted

December 7, 2021

First Submitted That Met QC Criteria

February 13, 2022

First Posted (ACTUAL)

February 23, 2022

Study Record Updates

Last Update Posted (ACTUAL)

February 23, 2022

Last Update Submitted That Met QC Criteria

February 13, 2022

Last Verified

February 1, 2022

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P20CA217199-9492018
  • P20CA217199 (NIH)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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