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Grant Details

Grant Number: 5R01CA218093-03 Interpret this number
Primary Investigator: Winters-Stone, Kerri
Organization: Oregon Health & Science University
Project Title: Exercising Together: a Randomized Controlled Trial of Partnered Exercise Training on the Health of Couples Coping with Cancer
Fiscal Year: 2020


Prostate (PC), breast (BC) and colorectal (CRC) cancer are the most common and survivable cancers; most survivors of these cancers will be married when diagnosed. Compared to couples that aren't facing a chronic illness, both cancer survivors and their spouses suffer from poorer physical and mental health and higher mortality. Cancer often disrupts the marriage and declines in relationship quality are linked to shorter survival. Exercise has been shown to offer symptomatic relief from side effects of cancer treatment and improve quality of life among cancer survivors; but, has not been used to simultaneously improve the physical and mental health of survivors and spouses and protect the marriage by adapting it to be a shared, team-based activity. Our pilot study of a novel partnered exercise program, Exercising Together, has shown preliminary feasibility and acceptability, but was limited to couples facing PC and fitness outcomes. We propose a larger, more rigorous evaluation of Exercising Together expanding the sample to include couples coping early on with other common cancers, measuring clinically relevant outcomes and including comparison groups that will allow us to distinguish the unique benefits of partnered training on individual and couple health from the possible benefits of exercising in a group with others and/or of engaging both partners in a new health behavior. We plan to conduct a 3-arm, single-blind, parallel design, randomized trial in 294 couples (N=588 participants) coping with PC, BC or CRC, aged 40-70 years old and within 2 years of completion of primary treatment for cancer. Our study compares couples randomized partnered strength training (Exercising Together) in a supervised group setting to (Arm 2) separate supervised group exercise (survivor-only and spouse-only classes) and (Arm 3) separate unsupervised exercise where survivors and spouses exercise on their own at home. Couples will train 2x/wk for 6 months with a 6-month follow-up. The aims of this study are to determine the efficacy of Exercising Together on 1) relationship quality in couples coping with PC, BC, or CRC, 2) physical (body composition, lipids, insulin resistance, blood pressure, inflammation, physical function) and mental (anxiety, depression, fear of recurrence) health of both the survivor and spouse and to evaluate the sustainability and interdependence of benefits from Exercising Together. This study is relevant to public health because the number of cancer survivors and caregivers in the healthcare system will double by 2050, yet there are no programs whatsoever that address the triple threat that cancer poses to the physical and mental health of both survivors and spouses and to their marital relationship. We are the first to focus on the interdependent nature of the couple through partnered exercise that promotes relationship building making this program unlike any other. Exercising Together is a completely new approach to cancer survivorship because it considers the health of the survivor and his/her spouse and their relationship as equally important targets. If successful, this unique approach could be applied to survivors of other cancers or diseases increasing the potential impact of this study.


Associations between perceptions of relationship quality and markers of inflammation and insulin resistance among couples coping with cancer.
Authors: Skiba M.B. , Dieckmann N.F. , Lyons K.S. , Winters-Stone K.M. .
Source: Journal of cancer survivorship : research and practice, 2023 Aug; 17(4), p. 957-966.
EPub date: 2022-11-26.
PMID: 36435952
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Remote administration of physical performance tests among persons with and without a cancer history: Establishing reliability and agreement with in-person assessment.
Authors: Guidarelli C. , Lipps C. , Stoyles S. , Dieckmann N.F. , Winters-Stone K.M. .
Source: Journal of geriatric oncology, 2022 Jun; 13(5), p. 691-697.
EPub date: 2022-02-15.
PMID: 35177378
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Exercise Recommendation for People With Bone Metastases: Expert Consensus for Health Care Providers and Exercise Professionals.
Authors: Campbell K.L. , Cormie P. , Weller S. , Alibhai S.M.H. , Bolam K.A. , Campbell A. , Cheville A.L. , Dalzell M.A. , Hart N.H. , Higano C.S. , et al. .
Source: JCO oncology practice, 2022 May; 18(5), p. e697-e709.
EPub date: 2022-01-06.
PMID: 34990293
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Delivering exercise medicine to cancer survivors: has COVID-19 shifted the landscape for how and who can be reached with supervised group exercise?
Authors: Winters-Stone K.M. , Boisvert C. , Li F. , Lyons K.S. , Beer T.M. , Mitri Z. , Meyers G. , Eckstrom E. , Campbell K.L. .
Source: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2022 Mar; 30(3), p. 1903-1906.
EPub date: 2021-11-06.
PMID: 34741653
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A pilot feasibility study of Exercising Together© during radiation therapy for prostate cancer: a dyadic approach for patients and spouses.
Authors: Winters-Stone K.M. , Lyons K.S. , Beer T.M. , Skiba M.B. , Hung A. .
Source: Pilot and feasibility studies, 2021-12-08; 7(1), p. 216.
EPub date: 2021-12-08.
PMID: 34879873
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Better Together? A Pilot Study of Romantic Partner Influence on Exercise Adherence and Cardiometabolic Risk in African-American Couples.
Authors: Hornbuckle L.M. , Rauer A. , Winters-Stone K.M. , Springer C. , Jones C.S. , Toth L.P. .
Source: Journal of racial and ethnic health disparities, 2021 Dec; 8(6), p. 1492-1504.
EPub date: 2020-11-11.
PMID: 33175348
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Study protocol for the Exercising Together© trial: a randomized, controlled trial of partnered exercise for couples coping with cancer.
Authors: Winters-Stone K.M. , Lyons K.S. , Dieckmann N.F. , Lee C.S. , Mitri Z. , Beer T.M. .
Source: Trials, 2021-08-30; 22(1), p. 579.
EPub date: 2021-08-30.
PMID: 34461975
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"It was just for us": qualitative evaluation of an exercise intervention for African-American couples.
Authors: Hornbuckle L.M. , Barroso C.S. , Rauer A. , Jones C.S. , Winters-Stone K.M. .
Source: BMC public health, 2021-05-01; 21(1), p. 838.
EPub date: 2021-05-01.
PMID: 33933048
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Patient-reported and objectively measured physical function in older breast cancer survivors and cancer-free controls.
Authors: Winters-Stone K.M. , Medysky M.E. , Savin M.A. .
Source: Journal of geriatric oncology, 2019 Mar; 10(2), p. 311-316.
EPub date: 2018-10-19.
PMID: 30344000
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Effect of Increasing Levels of Web-Based Behavioral Support on Changes in Physical Activity, Diet, and Symptoms in Men With Prostate Cancer: Protocol for a Randomized Controlled Trial.
Authors: Winters-Stone K.M. , Kenfield S.A. , Van Blarigan E.L. , Moe E.L. , Ramsdill J.W. , Daniel K. , Macaire G. , Paich K. , Kessler E.R. , Kucuk O. , et al. .
Source: JMIR research protocols, 2018-11-15; 7(11), p. e11257.
EPub date: 2018-11-15.
PMID: 30442638
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The Crossroads of Frailty and Heart Failure: What More Can We Learn?
Authors: Denfeld Q.E. , Lee C.S. .
Source: Journal of cardiac failure, 2018 Nov; 24(11), p. 733-734.
EPub date: 2018-10-06.
PMID: 30300685
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