PROJECT SUMMARY / ABSTRACT
Rural cancer survivors are less likely to meet physical activity recommendations than urban cancer survivors,
contributing to physical inactivity-related cancer health disparities. Evidence-based interventions to reduce
psychosocial distress and increase physical activity in cancer survivors were developed in urban or clinical
settings and often fail when implemented in rural community settings. The goal of this career development
award is to assist Scherezade K. Mama, DrPH in her long-term goal of becoming an independent investigator
in designing and implementing physical activity interventions in underserved populations, including rural cancer
survivors, to improve health outcomes and reduce health disparities. Dr. Mama’s short-term goals include
gaining expertise in the use of psychosocial intervention methods, cancer survivorship and interventions to
improve survivorship outcomes, intensive longitudinal methods, and dissemination and implementation
research. In collaboration with her multidisciplinary team of mentors and advisors, she has developed a
training plan to reach these goals via coursework, workshops, scientific meetings, directed readings, and a
mentored research project. The primary objective of the proposed research project is to use a community-
engaged approach to develop and evaluate an intervention to reduce psychosocial stress and increase
physical activity in rural breast cancer survivors in central Pennsylvania. Focus groups (n=6) with community
stakeholders and rural breast cancer survivors will be conducted to (a) determine how to best modify an
evidence-based intervention for rural cancer survivors and for implementation in a community setting and (b)
feedback the modified intervention. Rural breast cancer survivors (n=50) will be recruited through an existing
community partnership to participate in the 3-month adapted community-based intervention or to receive usual
care. The intervention consists of face-to-face and home-based sessions incorporating aerobic exercise and
mind-body strategies to reduce psychosocial distress and increase physical activity. Participants complete
assessments at four time points (baseline, 6-weeks, post-intervention, 6-months) and complete daily diaries
assessing daily distress and physical activity throughout the 3-month intervention period. In-depth interviews
will be conducted with intervention participants (n=25) and community stakeholders (n=10) after the 6-month
study period to explore implementation outcomes. Findings from this study will fill a critical gap in the literature
on the translation of evidence-based interventions into sustained practice in community settings and will inform
the next phase of this research, an effectiveness-implementation hybrid study of a large-scale community-
based randomized controlled trial to reduce psychosocial distress and increase physical activity in rural breast
cancer survivors. Completion of the proposed research and training aims will provide Dr. Mama with the skills,
experience, and preliminary data needed to launch a successful independent research career in physical
activity promotion, cancer prevention and control, and health disparities.
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