A mixed-methods evaluation of a community physical activity program for breast cancer survivors

Catherine M Sabiston, Angela J Fong, Erin K O'Loughlin, Sarkis Meterissian, Catherine M Sabiston, Angela J Fong, Erin K O'Loughlin, Sarkis Meterissian

Abstract

Background: Given the benefits of physical activity for health and survival, clinicians are seeking opportunities for cancer patients to become more active independent of rehabilitation programs that are small, time-limited, and location specific. This proof-of-concept study evaluated a community-based physical activity program (Curves™) for increasing physical activity among women diagnosed and treated for breast cancer.

Methods: Women were recruited from a breast cancer clinic through physician chart review. In study 1, women (n = 14) received the community physical activity memberships (Curves™), guidelines, and a pedometer. This group was compared to women (n = 16) who received physical activity guidelines and a pedometer on changes in physical activity. In study 2, women (n = 66) completed self-report questionnaires after Curves™ memberships expired to evaluate the program. Study 3 was a qualitative study exploring the benefits and barriers of the physical activity program among women (n = 6) who attended Curves™ regularly.

Results: Provision of memberships to a community-based physical activity program did not improve physical activity levels beyond educational and information resources. However, there are a number of advantages to community-based physical activity programs, and the women offer a number of suggestions for improvements for community physical activity opportunities aimed at breast cancer survivors.

Conclusions: Women-only community-based physical activity programs may be a viable option to help introduce women to get active after treatment. Trial registration ISRCTN, ISRCTN14747810. Registered on 18 October 2017-Retrospectively registered, https://doi.org/10.1186/ISRCTN14747810.

Keywords: Barriers; Exercise; Facilitators; Oncology; Survivorship.

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow of participants through all three studies. Women recruited for the Lifestyle Exercise Training (LET) group were not provided Curves™ memberships until the completion of the study. All participants across the three studies are mutually exclusive (i.e., if a participant was enrolled in one study, they are no longer eligible for the remaining two studies)

References

    1. Canadian Cancer Society. Canadian Cancer Society’s Advisory Committee on Cancer Statistics. Vol. 2016, Canadian Cancer Statistics 2017. Toronto; 2017. .
    1. Feuerstein M, Ganz PA. Health services for cancer survivors. New York: Springer; 2011.
    1. Battaglini CL, Mills RC, Phillips BL, Lee JT, Story CE, Nascimento MG, et al. Twenty-five years of research on the effects of exercise training in breast cancer survivors: a systematic review of the literature. World J Clin Oncol. 2014;5(2):177–90. .
    1. Sabiston Catherine M., Brunet Jennifer. Reviewing the Benefits of Physical Activity During Cancer Survivorship. American Journal of Lifestyle Medicine. 2011;6(2):167–177. doi: 10.1177/1559827611407023.
    1. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz G. After breast cancer diagnosis. J Am Med Assoc. 2014;293(20):2479–2486. doi: 10.1001/jama.293.20.2479.
    1. Urbscheit N, Brown K. The association between physical activity and breast cancer recurrence and survival. Curr Nutr Rep. 2014;3:16–21. doi: 10.1007/s13668-013-0067-x.
    1. Nelson SH, Marinac CR, Patterson RE, Nechuta SJ, Flatt SW, Caan BJ, et al. Impact of very low physical activity, BMI, and comorbidities on mortality among breast cancer survivors. Breast Cancer Res Treat. 2016;155(3):551–557. doi: 10.1007/s10549-016-3694-2.
    1. Speck RM, Courneya KS, Mâsse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100. doi: 10.1007/s11764-009-0110-5.
    1. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão D, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–1426. doi: 10.1249/MSS.0b013e3181e0c112.
    1. Lynch BM, Dunstan DW, Healy GN, Winkler E, Eakin E, Owen N. Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003–2006) Cancer Causes Control. 2010;21(2):283–288. doi: 10.1007/s10552-009-9460-6.
    1. Sabiston C. M., Brunet J., Vallance J. K., Meterissian S. Prospective Examination of Objectively Assessed Physical Activity and Sedentary Time after Breast Cancer Treatment: Sitting on the Crest of the Teachable Moment. Cancer Epidemiology Biomarkers & Prevention. 2014;23(7):1324–1330. doi: 10.1158/1055-9965.EPI-13-1179.
    1. Fong AJ, Faulkner G, Jones JM, Sabiston CM. A qualitative analysis of oncology clinicians’ perceptions and barriers for physical activity counselling in breast cancer survivors. Support Care Cancer. 2018;26(9):3117–3126. doi: 10.1007/s00520-018-4163-8.
    1. Santa Mina D, Sabiston CM, Au D, Fong AJ, Copozzi LC, Langelier D, et al. Connecting people with cancer to physical activity and exercise programs: a pathways to create accessibility and engagement. Curr Oncol. 2018;25(2):149–162. doi: 10.3747/co.25.3977.
    1. Wurz A, St-Aubin A, Brunet J. Breast cancer survivors’ barriers and motives for participating in a group-based physical activity program offered in the community. Support Care Cancer. 2015;23(8):2407–2416. doi: 10.1007/s00520-014-2596-2.
    1. Santa Mina D, Au D, Brunet J, Jones J, Tomlinson G, Taback N, et al. The effects of the community-based, Wellspring Cancer-Exercise Program on functional and psychosocial outcomes in cancer survivors. Curr Oncol. 2017;24(5):284–294. doi: 10.3747/co.24.3585.
    1. Cerulli C, Minganti C, De Santis C, Tranchita E, Quaranta F, Parisi A. Therapeutic horseback riding in breast cancer survivors: a pilot study. J Altern Complement Med. 2014;20(8):623–629. doi: 10.1089/acm.2014.0061.
    1. Ng AV, Cybulski AN, Engel AA, Papanek PE, Sheffer MA, Waltke LJ, et al. Triathlon training for women breast cancer survivors: feasibility and initial efficacy. Support Care Cancer. 2016 doi: 10.1007/s00520-016-3531-5.
    1. Burke SSM, Sabiston CMC. Fostering growth in the survivorship experience : investigating breast cancer survivors’ lived experiences scaling Mt. Kilimanjaro from a posttraumatic growth perspective. Qual Rep. 2012;17:32–7. .
    1. McDonough MH, Sabiston CM, Ullrich-French S. The development of social relationships, social support, and posttraumatic growth in a dragon boating team for breast cancer survivors. J Sport Exerc Psychol. 2011;33(5):627–648. doi: 10.1123/jsep.33.5.627.
    1. Mutrie N, Campbell A, Barry S, Hefferon K, Mconnachie A, Ritchie D, et al. Five-year follow-up of participants in a randomised controlled trial showing benefits from exercise for breast cancer survivors during adjuvant treatment. Are there lasting effects? J Cancer Surviv. 2012;6(4):420–430. doi: 10.1007/s11764-012-0233-y.
    1. Kreider RB, Serra M, Beavers KM, Moreillon J, Kresta JY, Byrd M, et al. A structured diet and exercise program promotes favorable changes in weight loss, body composition, and weight maintenance. J Am Diet Assoc. 2011;111(6):828–843. doi: 10.1016/j.jada.2011.03.013.
    1. Kerksick C, Thomas A, Campbell B, Taylor L, Wilborn C, Marcello B, et al. Effects of a popular exercise and weight loss program on weight loss, body composition, energy expenditure and health in obese women. Nutr Metab (Lond). 2009;6(1):23. doi: 10.1186/1743-7075-6-23.
    1. Czajkowski SM, Heart N, Powell LH, Adler N, Francisco S, Naar-king S, et al. From ideas to efficacy: the ORBIT model for developing behavioral treatments for chronic diseases. Health Psychol. 2016;34(10):971–982. doi: 10.1037/hea0000161.
    1. Dunn AL, Andersen RE, Jakicic JM. Lifestyle physical activity interventions. Am J Prev Med. 1998;15(4):398–412. doi: 10.1016/S0749-3797(98)00084-1.
    1. Vallance Jeffrey K.H., Courneya Kerry S., Plotnikoff Ronald C., Yasui Yutaka, Mackey John R. Randomized Controlled Trial of the Effects of Print Materials and Step Pedometers on Physical Activity and Quality of Life in Breast Cancer Survivors. Journal of Clinical Oncology. 2007;25(17):2352–2359. doi: 10.1200/JCO.2006.07.9988.
    1. Demark-Wahnefried W, Kenyon AJ, Eberle P, Skye A, Kraus WE. Preventing sarcopenic obesity among breast cancer patients who receive adjuvant chemotherapy: results of a feasibility study. Clin Exerc Physiol. 2002;4(1):44–49.
    1. Eyigor S, Karapolat H, Yesil H, Uslu R, Durmaz B. Effects of pilates exercises on functional capacity, flexibility, fatigue, depression and quality of life in female breast cancer patients: a randomized controlled study. Eur J Phys Rehabil Med. 2010;46(4):481–487.
    1. Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, Hartman TJ, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors. JAMA. 2009;301(18):1883. doi: 10.1001/jama.2009.643.
    1. Mustian KM, Katula JA, Zhao H. A pilot study to assess the influence of tai chi chuan on functional capacity among breast cancer survivors. J Support Oncol. 2006;4(3):139–145.
    1. Snyder D, Morey MC, Sloane R, Stull V, Cohen HJ, Peterson B, et al. Reach out to ENhancE Wellness in Older Cancer Survivors (RENEW): design, methods and recruitment challenges of a home-based exercise and diet intervention to improve physical function among long- term survivors of breast, prostate, and colorectal cancer. Psycho-Oncology. 2009;439:429–439. doi: 10.1002/pon.1491.
    1. Demark-Wahnefried W, Clipp EC, Morey MC, Pieper CF, Sloane R, Snyder DC, et al. Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from Project LEAD. J Clin Oncol. 2006;24(21):3465–3473. doi: 10.1200/JCO.2006.05.7224.
    1. Vallance JKH, Plotnikoff RC, Karvinen KH, Mackey JR, Courneya KS. Maintenance in breast cancer survivors. Am J Health Behav. 2010;34(2):225–237. doi: 10.5993/AJHB.34.2.10.
    1. Andersen RE, Wadden T, Bartlett SJ, Zemel B, Verde TJ, Franckowiak SC. Effects of lifestyle activity vs structured aerobic exercise in obese women: a randomized trial. JAMA. 1999;281(4):335–340. doi: 10.1001/jama.281.4.335.
    1. Simkin-Silverman LR, Wing RR, Boraz MA, Kuller LH. Lifestyle intervention can prevent weight gain during menopause: results from a 5-year randomized clinical trial. Ann Behav Med. 2003;26(3):212–220. doi: 10.1207/S15324796ABM2603_06.
    1. Canadian Society of Exercise Physiology. Canadian physical activity and sedentary behaviour guidelines. 2012.p. 1–32. .
    1. Segal R, Zwaal C, Green E, Tomasone J, Loblaw A, Petrella T. Exercise for people with cancer: a systematic review. Curr Oncol. 2017;24(4):e290–e315. doi: 10.3747/co.24.3519.
    1. Wendel-Vos GCW, Schuit AJ, Saris WHM, Kromhout D. Reproducibility and relative validity of the short questionnaire to assess health-enhancing physical activity. J Clin Epidemiol. 2003;56(12):1163–1169. doi: 10.1016/S0895-4356(03)00220-8.
    1. Ajzen I. From intentions to actions: a theory of planned behavior. Action control. Heidelberg: Springer; 1985. pp. 11–39.
    1. Wigfield A, Eccles JS. Expectancy–value theory of achievement motivation. Contemp Educ Psychol. 2000;25(1):68–81. doi: 10.1006/ceps.1999.1015.
    1. Eccles JS, Wigfield A. Motivational beliefs, values, and goals. Annu Rev Psychol. 2002;53:109–132. doi: 10.1146/annurev.psych.53.100901.135153.
    1. Brunet J, Taran S, Burke S, Sabiston CM. A qualitative exploration of barriers and motivators to physical activity participation in women treated for breast cancer. Disabil Rehabil. 2013;35(24):2038–2045. doi: 10.3109/09638288.2013.802378.
    1. Ottenbacher Allison J., Day R. Sue, Taylor Wendell C., Sharma Shreela V., Sloane Richard, Snyder Denise C., Kraus William E., Demark-Wahnefried Wendy. Exercise among breast and prostate cancer survivors—what are their barriers? Journal of Cancer Survivorship. 2011;5(4):413–419. doi: 10.1007/s11764-011-0184-8.
    1. Sylvester BD, Standage M, McEwan D, Wolf SA, Lubans DR, Eather N, et al. Variety support and exercise adherence behavior: experimental and mediating effects. J Behav Med. 2016;39(2):214–224. doi: 10.1007/s10865-015-9688-4.
    1. Sylvester BD, Lubans DR, Eather N, Standage M, Wolf SA, McEwan D, et al. Effects of variety support on exercise-related well-being. Appl Psychol Health Well-Being. 2016;8(2):213–231. doi: 10.1111/aphw.12069.
    1. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006 doi: 10.1191/1478088706qp063oa#.VaWGhxNViko.
    1. Blaney J. M., Lowe-Strong A., Rankin-Watt J., Campbell A., Gracey J. H. Cancer survivors' exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: a questionnaire-survey. Psycho-Oncology. 2011;22(1):186–194. doi: 10.1002/pon.2072.
    1. Vigna S, Malmendier U. Paying not to go to the gym. Am Econ Rev. 2006;96:694–719. doi: 10.1257/aer.96.3.694.
    1. Strohacker Kelley, Galarraga Omar, Williams David M. The Impact of Incentives on Exercise Behavior: A Systematic Review of Randomized Controlled Trials. Annals of Behavioral Medicine. 2013;48(1):92–99. doi: 10.1007/s12160-013-9577-4.
    1. Wilson Philip M., Blanchard Chris M., Nehl Eric, Baker Frank. Predicting physical activity and outcome expectations in cancer survivors: an application of Self-Determination Theory. Psycho-Oncology. 2006;15(7):567–578. doi: 10.1002/pon.990.
    1. Courneya KS, McKenzie DC, Reid RD, Mackey JR, Gelmon K, Friedenreich CM, et al. Barriers to supervised exercise training in a randomized controlled trial of breast cancer patients receiving chemotherapy. Ann Behav Med. 2008;35(1):116–122. doi: 10.1007/s12160-007-9009-4.
    1. Thornton JS, Frémont P, Khan K, Poirier P, Fowles J, Wells GD, et al. Physical activity prescription : a critical opportunity to address a modi fi able risk factor for the prevention and management of chronic disease : a position statement by the Canadian Academy of Sport and Exercise Medicine. Br J Sports Med. 2016;50:1–6. doi: 10.1136/bjsports-2016-096291.
    1. Nadler M, Bainbridge D, Tomasone J, Cheifetz O, Juergens RA, Sussman J. Oncology care provider perspectives on exercise promotion in people with cancer: an examination of knowledge, practices, barriers, and facilitators. Support Care Cancer. 2017;25(7):2297–2304. doi: 10.1007/s00520-017-3640-9.
    1. Sabiston CM, McDonough MH, Crocker PRE. Psychosocial experiences of breast cancer survivors involved in a dragon boat program: exploring links to positive psychological growth. J Sport Exerc Psychol. 2007;29(4):419–438. doi: 10.1123/jsep.29.4.419.
    1. McDonough MH, Sabiston CM, Crocker PRE. An interpretative phenomenological examination of psychosocial changes among breast cancer survivors in their first season of dragon boating. J Appl Sport Psychol. 2008;20:425–440. doi: 10.1080/10413200802241857.
    1. Vallance JKH, Lavallee C, Culos-Reed N, Trudeau M. Rural and small town breast cancer survivors’ preferences for physical activity. Int J Behav Med. 2013;20(4):522–528. doi: 10.1007/s12529-012-9264-z.
    1. Phillips SM, Alfano CM, Perna FM, Glasgow RE. Accelerating translation of physical activity and cancer survivorship research into practice: recommendations for a more integrated and collaborative approach. Cancer Epidemiol Biomarkers Prev. 2014;23(5):687–699. doi: 10.1158/1055-9965.EPI-13-1355.

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