||5R21CA256656-02 Interpret this number
||Colorado State University
||An Adaptive Physical Activity Maintenance Intervention for Cancer Survivors
It is well established that structured moderate to vigorous physical activity (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 the cancer-specific exercise guidelines.
Interventions that are supervised, and include theory-based behavior change strategies are effective for
increasing moderate to vigorous physical activity (MVPA) among cancer survivors; but following an
intervention, many survivors return to previously inactive, or insufficiently active lifestyles. To achieve the many
benefits associated with MVPA or ‘exercise’, cancer survivors must not only adopt or begin a program, but also
be able to maintain these PA levels long-term. In addition to individual behavior change strategies,
interpersonal, and environmental support for PA can extend the success of PA interventions. This can be
achieved by increasing the accessibility of tailored, evidence-informed cancer-specific exercise programs at
community-based locations. Thus, we propose to engage in a research-practice partnership to deliver an
adaptive PA maintenance intervention for cancer survivors. In the R21 phase, we will examine acceptability of
maintenance intervention components, and conduct a needs assessment for intervention delivery at three-
community partner locations. In the R33 phase, we will utilize an adaptive intervention design to determine the
optimal level of support needed to maintain PA following a community-based exercise program. We will enroll
cancer survivors who are not currently achieving aerobic and resistance exercise guidelines in a three-month,
supervised, group-based exercise and PA behavior change program at one of three community fitness
facilities. Upon completion of the program, participants will be encouraged to continue exercising during a
three-month free-living follow-up period, during which time there will be no active intervention. After this follow-
up period, exercise levels will be assessed. Those who are not achieving aerobic and resistance exercise
guidelines for cancer survivors 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 will be randomized to either: (c) no
further intervention, or (d) monthly PA behavior change discussion sessions. After three-months of the
subsequent PA maintenance intervention, exercise levels will be assessed again (i.e., 6-months after
completion of the initial exercise program). 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 community-based facilities will
increase potential for scalability and widespread dissemination. Findings from this study will prepare our team
to test this intervention in a full-scale adaptive trial, powered for efficacy.
Telemedicine-based inspiratory muscle training and walking promotion with lung cancer survivors following curative intent therapy: a parallel-group pilot randomized trial.
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Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2023-09-01; 31(9), p. 546.