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Vooturi S, Siri B, Sirisha S, Jayalakshmi S. Socio economic factors and adherence to home based exercise in people with epilepsy. Epilepsy Behav Rep 2024; 27:100698. [PMID: 39170032 PMCID: PMC11338148 DOI: 10.1016/j.ebr.2024.100698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 07/22/2024] [Accepted: 07/22/2024] [Indexed: 08/23/2024] Open
Abstract
Exercise is a well-established component in the management of chronic illness both as a primary prevention and secondary intervention. The assumption that in otherwise healthy individuals, higher socioeconomic status (SES) is positively associated with physical activity (PA) has been debated. We report the influence of SES on adherence to home-based exercise program in people with epilepsy (PWE) from a developing country. Participants' response to self-reported Social Needs Screening Tool of the American Academy of Family Physicians was collected. The current study is a secondary follow-up and post-hoc analysis of data from patients we have previous published. The average age of the study population was 26.93 ± 10.20 years with 57.8 % men. Among the 116 study participants, 31 (26.72 %) were adherent to the exercise program. Unemployment (14.1 % vs. 0.0 %; p = 0.034) was higher, fewer people had least high school education (76.6 % vs 93.5 %; p = 0.050) in PWE who did not adhere to exercise program. A significantly higher number of PWE who were not adherent to exercise reported that their family members or anyone else never physically hurt them (97.6 % vs 80.6 %; p = 0.05), never threaten (94.1 % vs 74.2 %; p = 0.007) and/or never scream at them (90.6 % vs 74.2 %; p = 0.011). In PWE education and employment are associated with adherence to home-based exercise programs. The role of family support and personal safety in adherence to exercise should be evaluated in detail.
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Affiliation(s)
- Sudhindra Vooturi
- Department of Rehabilitation, Krishna Institute of Medical Sciences, Secunderabad, Telangana
| | - Bathula Siri
- Department of Rehabilitation, Krishna Institute of Medical Sciences, Secunderabad, Telangana
| | - Sai Sirisha
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana
| | - Sita Jayalakshmi
- Department of Neurology, Krishna Institute of Medical Sciences, Secunderabad, Telangana
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SenthilKumar G, Schottstaedt AM, Peterson LL, Pedersen LN, Chitambar CR, Vistocky A, Banerjee A, Longo JM, Kelly T, Currey A, Stolley MR, Bergom C. Stay on Track: A Pilot Randomized Control Trial on the Feasibility of a Diet and Exercise Intervention in Patients with Breast Cancer Receiving Radiotherapy. CANCER RESEARCH COMMUNICATIONS 2024; 4:1211-1226. [PMID: 38530195 PMCID: PMC11075661 DOI: 10.1158/2767-9764.crc-23-0148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 08/14/2023] [Accepted: 03/18/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE Among patients with breast cancer undergoing radiotherapy, posttreatment cardiovascular disease and worsened quality of life (QoL) are leading causes of morbidity and mortality. To overcome these negative radiotherapy effects, this prospective, randomized clinical trial pilots a 12-week Stay on Track exercise and diet intervention for overweight patients with nonmetastatic breast cancer undergoing whole-breast radiotherapy. EXPERIMENTAL DESIGN The intervention group (n = 22) participated in three personal exercise and dietary counseling sessions, and received three text reminders/week to adhere to recommendations. The control group (n = 22) was administered a diet/exercise information binder. All patients received a Fitbit, and at baseline, 3 months, and 6 months, measurements of biomarkers, dual-energy X-ray absorptiometry scans, QoL and physical activity surveys, and food frequency questionnaires were obtained. A satisfaction survey was administered at 3 months. RESULTS Stay on Track was well received, with high rates of adherence and satisfaction. The intervention group showed an increase in self-reported physical activity and preserved QoL, a decrease in body mass index and visceral fat, and higher American Cancer Society/American Institute of Cancer Research dietary adherence. The control participants had reduced QoL, anti-inflammatory markers, and increased metabolic syndrome markers. Both groups had decreased overall body mass. These changes were within group effects. When comparing the intervention and control groups over time, there were notable improvements in dietary adherence in the intervention group. CONCLUSIONS Targeted lifestyle interventions during radiotherapy are feasible and could decrease cardiovascular comorbidities in patients with breast cancer. Larger-scale implementation with longer follow-up can better determine interventions that influence cardiometabolic health and QoL. SIGNIFICANCE This pilot study examines cardiometabolic benefits of a combined diet and exercise intervention for patients with breast cancer undergoing radiotherapy. The intervention included an activity tracker (FitBit) and text message reminders to promote adherence to lifestyle interventions. Large-scale implementation of such programs may improve cardiometabolic outcomes and overall QoL among patients with breast cancer.
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Affiliation(s)
- Gopika SenthilKumar
- Department of Physiology and Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | | | - Lindsay L. Peterson
- Division of Medical Oncology, Department of Medicine, Washington University School of Medicine, St. Louis, Missouri
- Alvin J. Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri
| | - Lauren N. Pedersen
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri
| | - Christopher R. Chitambar
- Division of Medical Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Alexis Vistocky
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Anjishnu Banerjee
- Division of Biostatistics, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - John M. Longo
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Tracy Kelly
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Adam Currey
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Melinda R. Stolley
- Division of Hematology and Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Carmen Bergom
- Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, Wisconsin
- Alvin J. Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri
- Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri
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Rodrigues B, Encantado J, Franco S, Silva MN, Carraça EV. Psychosocial correlates of physical activity in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 2024:10.1007/s11764-024-01559-6. [PMID: 38448768 DOI: 10.1007/s11764-024-01559-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/28/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND Physical activity (PA) is a non-pharmacological approach to optimize health benefits in cancer survivors and is recommended as part of care. However, most cancer survivors fail to meet PA recommendations. The current systematic review and meta-analysis aimed to identify psychosocial correlates of free-living PA in cancer survivors. METHODS Three electronic databases were searched (PubMed, PsycINFO, and SportDiscus). Meta-analyses were conducted for psychosocial correlates tested ≥ 3 times. RESULTS Sixty-four articles were included. Eighty-eight different free-living PA correlates were identified. Meta-analyses (n = 32 studies) tested 23 PA correlates, of which 16 were significant (p < 0.05). Larger effect sizes (0.30 < ES > 0.45) were found for exercise self-efficacy, perceived behavioral control, intention, lower perceived barriers for exercise, enjoyment, perceived PA benefits, and attitudes. Small-to-moderate effects (0.18 < ES < 0.22) were found for subjective norms, physical functioning, quality of life, depression, and mental health. These findings were generally in line with narrative results. CONCLUSIONS This systematic review highlights important psychosocial correlates of free-living PA that can be targeted in future PA promotion interventions for cancer survivors. Constructs mainly from SCT and TPB were the most studied and appear to be associated with free-living PA in this population. However, we cannot currently assert which frameworks might be more effective. Further studies of better methodological quality, per correlate and theory, exploring longer-term associations and across different types of cancer, are needed. IMPLICATIONS FOR CANCER SURVIVORS Having higher exercise self-efficacy, perceived behavioral control, intention, enjoyment and perceived PA benefits, more positive attitudes towards PA, and lower perceived barriers for exercise, can help increase PA in cancer survivors.
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Affiliation(s)
- Bruno Rodrigues
- Faculty of Sport, University of Porto (Research Centre in Physical Activity, Health and Leisure), R. Dr. Plácido da Costa 91, 4200-450, Porto, Portugal.
| | - Jorge Encantado
- Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, Cruz Quebrada, Portugal
| | - Sofia Franco
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
| | - Marlene N Silva
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
| | - Eliana V Carraça
- CIDEFES, Universidade Lusófona, Lisboa & CIFI2D, Universidade do Porto, Porto, Universidade Lusófona and Universidade do Porto, Lisbon and Porto, Portugal
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Paterson C, Armitage L, Turner M. Current Landscape of Ecological Momentary Assessment (Real-Time Data) Methodology in Cancer Research: A Systematic Review. Semin Oncol Nurs 2023; 39:151514. [PMID: 37865555 DOI: 10.1016/j.soncn.2023.151514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 09/18/2023] [Accepted: 09/20/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To critically synthesize and describe the use and methods of ecological momentary assessment (EMA) in cancer research. DATA SOURCES A systematic review was conducted and has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) Guideline. Electronic databases (APA PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, MEDLINE, Scopus, and Web of Science Core Collection) were searched using a variety of keywords and subject headings by an expert systematic review librarian. All publications were double screened by two reviewers using predetermined exclusion and inclusion criteria throughout the full review process. The review used Covidence Systematic Review Software. Methodological quality assessment and data extraction were performed. A narrative synthesis was conducted to examine the aim for EMA, the characteristics of the study samples, the EMA sampling procedures, EMA completion rates, outcome measures, and any implications of findings for survivorship care. CONCLUSION A total of 42 EMA studies in cancer were included. Most studies used an electronic mobile device to capture EMA data apart from several that used paper diaries. Existing studies were found to have significant heterogeneity in methods and widely varying approaches to design and self-report measurements. While EMA in cancer research holds significant promise to advance cancer care research into the future by increasing ecological validity and reducing retrospective bias and can capture the unique idiographic within-person change over time, in real-time, further research is needed to develop standardized EMA self-report questionnaires. IMPLICATIONS FOR NURSING PRACTICE This is the first comprehensive systematic review to describe the use and methods of EMA in cancer research. There is significant heterogeneity in methods and widely varying approaches to design and self-report measurements in EMA cancer research. People affected by cancer found taking part in EMA studies reported benefit from the experience. However, researchers must engage with cancer survivors in the development and co-design of future EMA questionnaires to ensure relevant and acceptability of EMA data collection protocols.
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Affiliation(s)
- C Paterson
- Caring Futures Institute, Flinders University, Australia; Central Adelaide Local Health Network, Adelaide; Robert Gordon University, Aberdeen, Scotland, UK; Faculty of Health, University of Canberra, Bruce, ACT, Australia.
| | - L Armitage
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
| | - M Turner
- Faculty of Health, University of Canberra, Bruce, ACT, Australia
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Brummel B, van Heumen C, Smits A, van den Berg M, Ezendam NPM, Pijnenborg JMA, de van der Schueren MAE, Wilkinson SA, van der Meij BS. Barriers to and facilitators of a healthy lifestyle for patients with gynecological cancer: a systematic review of qualitative and quantitative research with healthcare providers and patients. Maturitas 2023; 177:107801. [PMID: 37541112 DOI: 10.1016/j.maturitas.2023.107801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 08/06/2023]
Abstract
The prevalence of an unhealthy lifestyle among patients with gynecological cancer is high and associated with increased risk of all-cause mortality. Although lifestyle changes have the potential to improve outcomes, lifestyle counseling is not routinely integrated into standard care. This review explores research on the barriers to and facilitators of both the promotion of healthy lifestyles by healthcare providers (HCPs) and healthy lifestyle changes by patients with gynecological cancer. The Theoretical Domains Framework (TDF) was used to deductively code the identified factors for a comprehensive understanding of the barriers and facilitators. A search across five databases yielded a total of 12,687 unique studies, of which 43 were included in the review. Of these 43, 39 included gynecological cancer patients and only 6 included HCPs. Among the barriers identified for HCPs, most studies evaluated barriers regarding weight loss counseling. Limited knowledge, reluctance to address weight loss, skepticism about the benefits, and workload concerns were commonly reported barriers for HCPs. HCPs will benefit from education and training in lifestyle counseling, including effective communication skills like motivational interviewing. Gynecological cancer patients lacked tools, support, knowledge, and faced mental health issues, environmental constraints, and physical limitations. The review emphasizes the importance of addressing these barriers and utilizing identified facilitators, such as social support, to promote and support healthy lifestyle behaviors on the part of patients and their promotion by HCPs. Future research should focus not only on patients but also on supporting HCPs and implementing necessary changes in current practices.
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Affiliation(s)
- Bo Brummel
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, the Netherlands
| | - Cindy van Heumen
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands
| | - Anke Smits
- Department of Obstetrics & Gynecology, Radboudumc, 6525 GA Nijmegen, the Netherlands
| | - Manon van den Berg
- Department of Gastroenterology and Hepatology- Dietetics, Radboudumc, 6525 GA Nijmegen, the Netherlands
| | - Nicole P M Ezendam
- Center of Research on Psychological and Somatic Disorders (CoRPS), Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, the Netherlands; Netherlands Comprehensive Cancer Organisation, 5612 HZ Eindhoven, the Netherlands
| | | | - Marian A E de van der Schueren
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, the Netherlands
| | - Shelley A Wilkinson
- Department of Obstetric Medicine, Mater Mothers Hospital, South Brisbane 4101, Australia; Lifestyle Maternity, Brisbane, QLD 4069, Australia
| | - Barbara S van der Meij
- Department of Human Nutrition and Health, Wageningen University & Research, 6708 WE Wageningen, the Netherlands; Department of Nutrition, Dietetics and Lifestyle, HAN University of Applied Sciences, 6525 EN Nijmegen, the Netherlands; Bond University Nutrition and Dietetics Research Group, Bond University, Gold Coast, QLD 4226, Australia.
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Ricke E, Dijkstra A, Bakker EW. Prognostic factors of adherence to home-based exercise therapy in patients with chronic diseases: A systematic review and meta-analysis. Front Sports Act Living 2023; 5:1035023. [PMID: 37033885 PMCID: PMC10080001 DOI: 10.3389/fspor.2023.1035023] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Background Patients with a chronic disease may have an increased risk of non-adherence to prescribed home-based exercise therapy. We performed a systematic review with the aim to identify variables associated with adherence to home-based exercise therapy in patients with chronic diseases and to grade the quality of evidence for the association between these prognostic factors and adherence. Methods Cohort studies, cross-sectional studies and the experimental arm of randomized trials were identified using a search strategy applied to PubMed, Embase, PsychINFO and CINAHL from inception until August 1, 2022. We included studies with participants ≥18 years with a chronic disease as an indication for home-based exercise therapy and providing data on prognostic factors of adherence to home-based exercise. To structure the data, we categorized the identified prognostic factors into the five WHO-domains; (1) Patient-related, (2) Social/economic, (3) Therapy-related, (4) Condition-related, and (5) Health system factors. Risk of bias was assessed using the Quality in Prognostic Studies (QUIPS) tool. Prognostic factors of adherence were identified and the quality of the evidence between the prognostic factors and adherence were graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework for predictor studies. We performed a meta-analysis of the obtained information. Results A total of 57 studies were included. Within patient-related factors moderate- and high-quality evidence suggested that more self-efficacy, exercise history, motivation and perceived behavioral control predicted higher adherence. Within social-economic factors moderate-quality evidence suggested more education and physical health to be predictive of higher adherence and within condition-related factors moderate- and low-quality evidence suggested that less comorbidities, depression and fatigue predicted higher adherence. For the domains therapy-related and health-system factors there was not enough information to determine the quality evidence of the prognostic factors. Conclusion These findings might aid the development of future home-based exercise programs as well as the identification of individuals who may require extra support to benefit from prescribed home-based exercise therapy. Systematic Review Registration https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=277003, identifier PROSPERO CRD42021277003.
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Affiliation(s)
- Ellen Ricke
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
- Correspondence: Ellen Ricke
| | - Arie Dijkstra
- Department of Social Psychology, University of Groningen, Groningen, Netherlands
| | - Eric W. Bakker
- Department of Epidemiology and Data Science | Division EBM, Academic Medical Centre, Amsterdam, Netherlands
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Bittel KM, O'Briant KY, Ragaglia RM, Buseth L, Murtha C, Yu J, Stanely JM, Hudgins BL, Hevel DJ, Maher JP. Associations Between Social Cognitive Determinants and Movement-Related Behaviors in Studies using Ecological Momentary Assessment Methods: A Systematic Review (Preprint). JMIR Mhealth Uhealth 2022; 11:e44104. [PMID: 37027185 PMCID: PMC10131703 DOI: 10.2196/44104] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND The social cognitive framework is a long-standing framework within physical activity promotion literature to explain and predict movement-related behaviors. However, applications of the social cognitive framework to explain and predict movement-related behaviors have typically examined the relationships between determinants and behavior across macrotimescales (eg, weeks and months). There is more recent evidence suggesting that movement-related behaviors and their social cognitive determinants (eg, self-efficacy and intentions) change across microtimescales (eg, hours and days). Therefore, efforts have been devoted to examining the relationship between social cognitive determinants and movement-related behaviors across microtimescales. Ecological momentary assessment (EMA) is a growing methodology that can capture movement-related behaviors and social cognitive determinants as they change across microtimescales. OBJECTIVE The objective of this systematic review was to summarize evidence from EMA studies examining associations between social cognitive determinants and movement-related behaviors (ie, physical activity and sedentary behavior). METHODS Studies were included if they quantitatively tested such an association at the momentary or day level and excluded if they were an active intervention. Using keyword searches, articles were identified across the PubMed, SPORTDiscus, and PsycINFO databases. Articles were first assessed through abstract and title screening followed by full-text review. Each article was screened independently by 2 reviewers. For eligible articles, data regarding study design, associations between social cognitive determinants and movement-related behaviors, and study quality (ie, Methodological Quality Questionnaire and Checklist for Reporting Ecological Momentary Assessment Studies) were extracted. At least 4 articles were required to draw a conclusion regarding the overall associations between a social cognitive determinant and movement-related behavior. For the social cognitive determinants in which a conclusion regarding an overall association could be drawn, 60% of the articles needed to document a similar association (ie, positive, negative, or null) to conclude that the association existed in a particular direction. RESULTS A total of 24 articles including 1891 participants were eligible for the review. At the day level, intentions and self-efficacy were positively associated with physical activity. No other associations could be determined because of conflicting findings or the small number of studies investigating associations. CONCLUSIONS Future research would benefit from validating EMA assessments of social cognitive determinants and systematically investigating associations across different operationalizations of key constructs. Despite the only recent emergence of EMA to understand social cognitive determinants of movement-related behaviors, the findings indicate that daily intentions and self-efficacy play an important role in regulating physical activity in everyday life. TRIAL REGISTRATION PROSPERO CRD42022328500; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=328500.
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Affiliation(s)
- Kelsey M Bittel
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
| | - Kate Y O'Briant
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
| | - Rena M Ragaglia
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
| | - Lake Buseth
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
| | - Courtney Murtha
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
| | - Jessica Yu
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
| | - Jennifer M Stanely
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
| | - Brynn L Hudgins
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
| | - Derek J Hevel
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
| | - Jaclyn P Maher
- Department of Kinesiology, University Of North Carolina Greensboro, Greensboro, NC, United States
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Bates LC, Damare MI, Hanson ED, Moore JB, Bae-Jump V, Meyer ML, Stoner L. Sedentary Behavior Reduction: A Stepwise Approach to Increasing Physical Activity and Reducing Cardiovascular Disease Risk in Endometrial Cancer Survivors. Rev Cardiovasc Med 2022; 23:250. [PMID: 39076920 PMCID: PMC11266804 DOI: 10.31083/j.rcm2307250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/25/2022] [Accepted: 06/02/2022] [Indexed: 07/31/2024] Open
Abstract
Endometrial cancer survivors experience high rates of cardiovascular disease (e.g., heart disease, obesity, diabetes). The heightened cardiovascular disease risk may be attributed to cancer treatment coupled with sub-optimal lifestyle behaviors following treatment, including high amounts of sedentary behavior (SB). Public health agencies have graded the association of evidence between SB and cardiovascular disease as strong. However, while clinicians may wish to prescribe SB substitution strategies to reduce SB, guidelines do not currently exist. An additional challenge to behavior change pertains to the unique barriers that endometrial cancer survivors face, including treatment-associated fatigue and limited self-efficacy. Engaging in healthy movement behaviors, including minimizing SB and achieving recommended amounts of physical activity, are critical for health and well-being as well as cardiometabolic disease prevention. The purpose of this perspective paper is to propose an informed approach to physical activity promotion aimed to initiate movement and promote long-term behavior change by starting with an emphasis on reducing SB in endometrial cancer survivors. First, we address why endometrial cancer survivors should be targeted with SB reduction. Then, we suggest a stepwise approach to increasing physical activity by starting with SB reduction, including consideration to behavioral theories. Finally, we provide suggestions for future directions.
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Affiliation(s)
- Lauren C. Bates
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Margaret I. Damare
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Erik D. Hanson
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA
| | - Justin B. Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27101, USA
| | - Victoria Bae-Jump
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA
- Division of Gynecology Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599 USA
| | - Michelle L. Meyer
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Human Movement Science Curriculum, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, NC 27599, USA
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Psychosocial Determinants of Lifestyle Change after a Cancer Diagnosis: A Systematic Review of the Literature. Cancers (Basel) 2022; 14:cancers14082026. [PMID: 35454932 PMCID: PMC9032592 DOI: 10.3390/cancers14082026] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/28/2022] [Accepted: 04/07/2022] [Indexed: 11/25/2022] Open
Abstract
Simple Summary Although cancer survivors may experience health benefits from favorable lifestyle changes, many cancer survivors do not adhere to lifestyle recommendations or make favorable lifestyle changes after cancer diagnosis. This systematic review of the literature aimed to provide an overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. It provides a structured overview of the large variety of determinants of changes in different lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) derived from the 123 included papers (71 quantitative and 52 qualitative). Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors and inform researchers and healthcare professionals about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Abstract The aim of this study is to provide a systematic overview of the scientific literature on sociodemographic, psychological and social determinants that may facilitate or hamper lifestyle change after the diagnosis cancer. Four databases (PubMed, PsychINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) were searched for relevant papers up to October 2021. Of the 9586 references yielded by the literature search, 123 papers were included: 71 quantitative and 52 qualitative papers. Findings showed a large variety of determinants influencing lifestyle change after cancer diagnosis, with differences between lifestyle behaviors (physical activity, diet, smoking, alcohol, sun protection, and multiple lifestyle behaviors) and findings from quantitative vs. qualitative studies. Findings demonstrate the important role of oncology healthcare professionals in promoting healthy lifestyle changes in cancer survivors. In addition, findings inform researchers involved in the development of health promotion programs about the methods and strategies they can use to promote healthy lifestyle changes in cancer survivors. Favorable lifestyle changes are expected to have beneficial effects on cancer risk and overall health in cancer survivors.
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Rosko AE, Huang Y, Jones D, Presley CJ, Jaggers J, Owens R, Naughton M, Krok-Schoen JL. Feasibility of implementing an exercise intervention in older adults with hematologic malignancy. J Geriatr Oncol 2022; 13:234-240. [PMID: 34446377 PMCID: PMC8863976 DOI: 10.1016/j.jgo.2021.07.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 05/20/2021] [Accepted: 07/29/2021] [Indexed: 10/20/2022]
Abstract
Older adults with Hematologic Malignancy (HM) are vulnerable to functional decline secondary to disease and treatment. Interventions for physical deconditioning, in concert with routine hematology care are limited. The feasibility of accrual, retention, and demand for an exercise intervention among a high-risk HM population was piloted. METHODS Older adults with HM, on active treatment, with functional impairment were recruited prospectively to participate in a 6-month Otago Exercise Programme (OEP). Measures of motivation, self-efficacy, patient identified barriers to exercise, barriers to clinical trial enrollment, study satisfaction, and serious adverse events were captured. RESULTS 63 patients were approached, 18 declined trial enrollment, 45 consented, 30 patients enrolled in the exercise program. The main barrier for trial enrollment was transportation/travel concerns (n = 15). Of the 45 consented participants, 8 (12.7%) dropped out due to clinical deterioration, 5 (7.9%) withdrew, and 2 (3.2%) were ineligible prior to exercise-intervention intiation. The median age was 75.5 years (range 62-83) with plasma cell dyscrasia (63%), non-Hodgkin lymphoma (20%) and leukemia (17%). Retention of the physical therapist (PT) led-OEP was 76.6% of patients (n = 23/30), and end-of-study retention was 66.7% (n = 20/30). Of the evaluable patients, 23/29 completed the PE-led OEP yielding a completion rate of 79%. Participants were extremely motivated (72.4%) and strongly intended (89.7%) to engage in regular physical activity. Exercising when tired increased from a median score of 50 at Visit 1 to 70 at Visit 2, but dropped significantly to 45 at Visit 3 (p < 0.001). Participants reported significantly lower self-efficacy to exercise over the next 6 months from Visit 1 to Visit 3 (p = 0.001). CONCLUSIONS Older patients with HM had higher completion of in-person, PT-led exercise compared to at-home, independent exercise. Older adults were motivated and found the program acceptable, yet the ability to sustain a structured exercise program was challenging due to changes in health status. ClinicalTrials.gov Identifier: NCT02791737.
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Affiliation(s)
- Ashley E. Rosko
- The Ohio State University Comprehensive Cancer Center, Columbus, OH,Division of Hematology, The Ohio State University, Columbus, OH,Corresponding author at: A345 Starling Loving Hall, 320 W. 10th Ave., Columbus, OH 43210,
| | - Ying Huang
- Division of Hematology, The Ohio State University, Columbus, OH
| | - Desiree Jones
- Division of Hematology, The Ohio State University, Columbus, OH
| | - Carolyn J. Presley
- The Ohio State University Comprehensive Cancer Center, Columbus, OH,Division of Medical Oncology, The Ohio State University, Columbus, OH
| | - Jordon Jaggers
- College of Medicine, The Ohio State University, Columbus, OH
| | - ReNea Owens
- Rehabilitation Services, The Ohio State University, Columbus, OH
| | - Michelle Naughton
- The Ohio State University Comprehensive Cancer Center, Columbus, OH,Cancer Prevention and Control, The Ohio State University, Columbus, OH
| | - Jessica L. Krok-Schoen
- The Ohio State University Comprehensive Cancer Center, Columbus, OH,Division of Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, OH
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11
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Paxton RJ, Bui C, Fullwood D, Daniel D, Stolley M, Oliver JS, Wang K, Dubay JW. Are Physical Activity and Sedentary Behavior Associated With Cancer-Related Symptoms in Real Time?: A Daily Diary Study. Cancer Nurs 2022; 45:E246-E254. [PMID: 33156014 PMCID: PMC10597574 DOI: 10.1097/ncc.0000000000000908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Few studies have examined the real-time and dynamic relationship between lifestyle behaviors and treatment-related symptoms. OBJECTIVE The aim of this study was to examine the associations of daily physical activity and sedentary behavior with symptom burden, pain interference, and fatigue among patients who were undergoing active cancer treatment. METHODS A total of 22 (mean age = 57 years; 73% women; 55% Black) cancer patients were recruited from a local hospital and reported a daily diary of physical activity, sedentary behavior, symptom burden, pain interference, and fatigue over 10 days. Adjusted mixed-effects models were used to examine all associations. RESULTS Body mass index moderated the relationship between physical activity and symptom burden (γ = 0.06, P < .01) and physical activity and fatigue (γ = 0.09, P < .05). On days where physical activity was higher than average, symptom burden and fatigue scores were lower among patients who had lower body mass index values. Also, age moderated the relationship between sedentary behavior and symptom burden (γ = -0.04, P < .05); on days where patients sat more, symptom burden was lower among patients who were younger than the average age. CONCLUSIONS Overall, these data indicate that treatment-related symptoms vary daily within cancer patients and that physical activity may alleviate treatment-related symptoms for leaner patients. Larger samples and objective assessments of physical activity and sedentary behavior are needed to validate our results. IMPLICATIONS FOR PRACTICE Oncology nurses may be in the best position to promote physical activity during treatment as a strategy to manage symptom burden.
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Affiliation(s)
- Raheem J Paxton
- Author Affiliations: Department of Community Medicine and Population Health (Dr Paxton); Life Research Institute (Dr Bui); Capstone College of Nursing (Dr Oliver); and Department of Social Work (Ms Wang), University of Alabama, Tuscaloosa; Department of Aging and Geriatric, University of Florida, Gainesville (Dr Fullwood); DCH Manderson Cancer Center (Ms Daniel and Dr Dubay); and Medical College of Wisconsin (Dr Stolley), Milwaukee
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12
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Carmack CL, Parker NH, Demark-Wahnefried W, Shely L, Baum G, Yuan Y, Giordano SH, Rodriguez-Bigas M, Pettaway C, Basen-Engquist K. Healthy Moves to Improve Lifestyle Behaviors of Cancer Survivors and Their Spouses: Feasibility and Preliminary Results of Intervention Efficacy. Nutrients 2021; 13:nu13124460. [PMID: 34960013 PMCID: PMC8709140 DOI: 10.3390/nu13124460] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/02/2021] [Accepted: 12/09/2021] [Indexed: 01/02/2023] Open
Abstract
Spouses offer a primary source of support and may provide critical assistance for behavior change. A diet-exercise intervention previously found efficacious in improving cancer survivors' lifestyle behaviors was adapted to utilize a couples-based approach. The aims were to test the feasibility of this couples-based (CB) intervention and compare its efficacy to the same program delivered to the survivor-only (SO). Twenty-two survivor-spouse couples completed baseline assessments and were randomized to the CB or SO interventions. The study surpassed feasibility benchmarks; 91% of survivors and 86% of spouses completed a 6-month follow-up. Survivors and spouses attended 94% and 91% of sessions, respectively. The SO survivors showed significant improvements on the 30-s chair stand and arm curl tests, weight, and fruit and vegetable (F and V) consumption. The CB survivors showed significant improvements on the 6-min walk and 2-min step tests, body weight, and fat and F and V consumption. Improvement in the 30-s chair stand and arm curl tests was significantly better for SO survivors. The SO spouses showed no significant changes in outcome measures, but the CB spouses showed significant improvements in moderate-to-strenuous physical activity, weight, and fat and F and V consumption. Weight loss was significantly greater in CB spouses compared to SO spouses. Findings demonstrate feasibility, warranting further investigation of CB approaches to promote lifestyle change among cancer survivors and spouses.
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Affiliation(s)
- Cindy L. Carmack
- Department of Palliative Care, Rehabilitation & Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
- Correspondence:
| | | | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Laura Shely
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX 77030, USA;
| | - George Baum
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.B.); (K.B.-E.)
| | - Ying Yuan
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Sharon H. Giordano
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Miguel Rodriguez-Bigas
- Department of Colon & Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Curtis Pettaway
- Department of Urology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (G.B.); (K.B.-E.)
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13
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Emerson JA, Dunsiger S, Lee HH, Kahler CW, Bock B, Williams DM. Daily Instrumental and Affective Attitudes About Exercise: An Ecological Momentary Assessment Study. Ann Behav Med 2021; 56:726-736. [PMID: 34165140 DOI: 10.1093/abm/kaab047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Daily decisions to exercise may be influenced by day-to-day changes in affective attitudes (AA) and instrumental attitudes (IA) toward exercise. However, the within-day association between AA, IA, and exercise behavior has received little attention. PURPOSE To examine the effects of more temporally proximal (daily) AA and IA on daily exercise behavior beyond traditionally assessed distal (at the beginning of an exercise program) AA and IA. METHODS In the context of a 3-month exercise promotion program (N = 50), distal AA and IA were assessed at baseline. Ecological momentary assessment was used to assess proximal AA, IA, and exercise each day. RESULTS Between-subject differences in distal AA (OR = 1.28, p = .03) and distal IA (OR = 1.34, p = .01) were predictive of average likelihood of exercise each day over the 3-month period. Within-subject differences in proximal AA (OR = 1.19, p = .007), but not proximal IA (OR = 1.11, p = .18), predicted exercise each day beyond the between-subjects effects of distal AA and IA. Exploratory analysis revealed an interaction, such that the within-subjects impact of proximal AA on daily exercise was most evident among individuals who held more negative distal AA at baseline (OR = 0.80, p < .0001). CONCLUSIONS Attitude type (affective versus instrumental) and temporality (distal versus proximal) are important to consider in attempts to predict and understand exercise behavior. In addition to targeting change in distal attitudes, exercise interventions should target changes in daily AA to impact exercise later in the same day.
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Affiliation(s)
- Jessica A Emerson
- Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI 02903, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903, USA
| | - Shira Dunsiger
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Harold H Lee
- Department of Social and Behavioral Sciences, Harvard University TH Chan School of Public Health, Boston, MA, USA
| | - Christopher W Kahler
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Beth Bock
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, 222 Richmond St., Providence, RI 02903, USA
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - David M Williams
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
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14
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Lu JH, Chueh KS, Chuang SM, Wu YH, Lin KL, Long CY, Lee YC, Shen MC, Sun TW, Juan YS. Low Intensity Extracorporeal Shock Wave Therapy as a Potential Treatment for Overactive Bladder Syndrome. BIOLOGY 2021; 10:biology10060540. [PMID: 34208659 PMCID: PMC8235660 DOI: 10.3390/biology10060540] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/08/2021] [Accepted: 06/12/2021] [Indexed: 01/19/2023]
Abstract
Simple Summary Overactive bladder (OAB) is a common urologic condition with urinary frequency, urinary urgency, nocturia, and urgency incontinence, which can get in the way of a patient’s social life, exercise, work, and sleep. Exploring a promising option for OAB patients is very important, especially one with less side effects or invasive alternations. This study uses low intensity extracorporeal shock wave therapy (LiESWT) to investigate the therapeutic effect and duration on OAB symptoms. Abstract Background: The present study attempted to investigate the therapeutic effect and duration of low intensity extracorporeal shock wave therapy (LiESWT) on overactive bladder (OAB) symptoms, including social activity and the quality of life (QoL). Methods: In this prospective, randomized, single-blinded clinical trial, 65 participants with OAB symptom were randomly divided into receive LiESWT (0.25 mJ/mm2, 3000 pulses, 3 pulses/second) once a week for 8 weeks, or an identical sham LiESWT treatment without the energy transmission. We analyzed the difference in overactive bladder symptom score (OABSS) and 3-day urinary diary as the primary end. The secondary endpoint consisted of the change in uroflowmetry, post-voided residual (PVR) urine, and validated standardized questionnaires at the baseline (W0), 4-week (W4) and 8-week (W8) of LiESWT, and 1-month (F1), 3-month (F3) and 6-month (F6) follow-up after LiESWT. Results: 8-week LiESWT could significantly decrease urinary frequency, nocturia, urgency, and PVR volume, but meaningfully increase functional bladder capacity, average voided volume and maximal flow rate (Qmax) as compared with the W0 in the LiESWT group. In addition, the scores calculated from questionnaires were meaningfully reduced at W4, W8, F1, F3, and F6 in the LiESWT group. Conclusions: Our results revealed that the therapeutic efficacy of LiESWT could improve voided volume and ameliorate OAB symptoms, such as urgency, frequency, nocturia, and urinary incontinence, and lasted up to 6 month of follow-up. Moreover, LiESWT treatment brought statistically significant and clinically meaningful improvements in social activity and QoL of patients. These findings suggested that LiESWT could serve as an alternative non-invasive therapy for OAB patients.
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Affiliation(s)
- Jian-He Lu
- Emerging Compounds Research Center, Department of Environmental Science and Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung County 91201, Taiwan;
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (S.-M.C.); (Y.-C.L.); (M.-C.S.); (T.-W.S.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
| | - Kuang-Shun Chueh
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (S.-M.C.); (Y.-C.L.); (M.-C.S.); (T.-W.S.)
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-L.L.); (C.-Y.L.)
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80661, Taiwan
| | - Shu-Mien Chuang
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (S.-M.C.); (Y.-C.L.); (M.-C.S.); (T.-W.S.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
| | - Yi-Hsuan Wu
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-L.L.); (C.-Y.L.)
| | - Kun-Ling Lin
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-L.L.); (C.-Y.L.)
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80661, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
| | - Cheng-Yu Long
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-L.L.); (C.-Y.L.)
- Department of Obstetrics and Gynecology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Obstetrics and Gynecology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 81267, Taiwan
- Regenerative Medicine and Cell Therapy Research Center (RCC), Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Yung-Chin Lee
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (S.-M.C.); (Y.-C.L.); (M.-C.S.); (T.-W.S.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
- Department of Urology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung 81267, Taiwan
| | - Mei-Chen Shen
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (S.-M.C.); (Y.-C.L.); (M.-C.S.); (T.-W.S.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
| | - Ting-Wei Sun
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (S.-M.C.); (Y.-C.L.); (M.-C.S.); (T.-W.S.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
| | - Yung-Shun Juan
- Department of Urology, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-S.C.); (S.-M.C.); (Y.-C.L.); (M.-C.S.); (T.-W.S.)
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan;
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan; (K.-L.L.); (C.-Y.L.)
- Department of Urology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung 80661, Taiwan
- Regenerative Medicine and Cell Therapy Research Center (RCC), Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- Correspondence: ; Tel.: +886-7-3121101; Fax: +886-7-3506269
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15
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Allicock M, Kendzor D, Sedory A, Gabriel KP, Swartz MD, Thomas P, Yudkin JS, Rivers A. A Pilot and Feasibility Mobile Health Intervention to Support Healthy Behaviors in African American Breast Cancer Survivors. J Racial Ethn Health Disparities 2021; 8:157-165. [PMID: 32385847 DOI: 10.1007/s40615-020-00767-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/13/2020] [Accepted: 04/22/2020] [Indexed: 12/13/2022]
Abstract
African American breast cancer (AA BC) survivors are more likely to have cancer-related comorbidities compared with other women, ultimately putting them at higher risk for overall mortality and breast cancer-specific mortality. Survivorship care guidelines emphasize the importance of attention to obesity, weight management, and physical activity. Mobile technologies have been effective for improving health behaviors among cancer survivors, though few studies have focused on AA BC survivors. Creating Healthy Actions through Technology (CHAT) was a 4-week pilot intervention that employed an ecological momentary assessment (EMA) to improve survivors' physical activity and diet behaviors. We evaluated the acceptability, feasibility, and impact of a mHealth intervention for AA BC survivors. Participants (N = 22) were randomized to intervention (n = 13) or control (n = 9). All participants completed daily EMAs via smartphone for 4 weeks and wore accelerometers for seven consecutive days at baseline, 4, and 8 weeks. Intervention participants additionally received tailored health messages. Diet was measured using a self-reported questionnaire and physical activity with accelerometers. Participant engagement was high. Of 84 EMA assessments, the average response was 63 (SD 16.1). Participant accelerometer wear was at least 6 of the 7 days (SD 1.7) for each assessment. Eighty-five percent of participants reported the intervention helped change behaviors. Intervention participants reduced their sedentary time by 4.37 (SD = 7.14) hours/day versus controls (p = .05), reduced fast food intake by 1.5 servings (p = 0.008), and increased vigorous activity by 0.56 (SD = 28.10) minutes, which was non-significant (p = 0.959). Findings show feasibility and acceptability and potential of the intervention to positively impact physical activity among AA BC survivors.
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Affiliation(s)
- Marlyn Allicock
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA.
- Department of Health Promotion & Behavioral Sciences, 5323 Harry Hines Blvd., V8.112, Dallas, TX, 75390-9128, USA.
| | - Darla Kendzor
- The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Tobacco Intervention Research Clinic, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Abigail Sedory
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Kelley Pettee Gabriel
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Michael D Swartz
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Priya Thomas
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Joshua S Yudkin
- School of Public Health, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Aeisha Rivers
- Memorial Breast Cancer Center, Memorial Regional Hospital, Memorial Hospital West, Hollywood, FL, USA
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16
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Aliakbari F, Alipour FM, Tavassoli E, Sedehi M. The effect of empowerment program based on the social cognitive theory on the activity of daily living in patients with chronic obstructive pulmonary disease. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:146. [PMID: 32766331 PMCID: PMC7377143 DOI: 10.4103/jehp.jehp_752_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 02/01/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE AND AIM Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. The patient's fear and anxiety of shortness of breath and coughing during exercise may lead to a decrease in patients' daily activities. Therefore, the present study aimed to determine the effect of empowerment program based on the social cognitive theory (SCT) on the daily activity of patients with COPD. METHODS This quasi-experimental study was performed on 70 patients with COPD referred to Kashani and Hajar centers in 2019. Samples were randomly divided into two groups of experimental and control. Data collection tools included demographic information questionnaire and activity of daily living questionnaire, specific for COPD, and a researcher-made questionnaire for measuring SCT constructs. For the experimental group, the training program consisted of four theoretical and practical sessions of 40 min/week. The data were collected at three time points, before, immediately and 3 months after the training are 3 time. The data were analyzed by SPSS software using descriptive and inferential statistics. RESULTS The difference between the mean scores of behavioral ability, self-efficacy, and empowerment in the three stages was significant only in the experimental group (P < 0.001). The mean daily activity score of patients before, immediately, and 3 months after intervention showed a statistically significant difference between the two groups (52.46 ± 21.98, 63.36 ± 21.95, and 71.34 ± 19.02), respectively, in the intervention group, and (51.79 ± 19.29, 53.70 ± 19.28, and 53.82 ± 19.26), respectively, in the control group (P < 0.001). CONCLUSION The results of this study showed that empowerment of patients through interventions based on SCT can increase the daily activity of patients with COPD. Because nurses play an important role in patient education and improvement, it is hoped that the findings of this study will be used as a strategy to increase the daily activity and ultimately improve the quality of life in these patients.
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Affiliation(s)
- Fatemeh Aliakbari
- Community Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Forouzan Mohammad Alipour
- Community Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Elahe Tavassoli
- Health School, Shahrekord University of Medical Science, Shahrekord, Iran
| | - Morteza Sedehi
- Health School, Shahrekord University of Medical Science, Shahrekord, Iran
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17
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Liao Y, Song J, Robertson MC, Cox-Martin E, Basen-Engquist K. An Ecological Momentary Assessment Study Investigating Self-efficacy and Outcome Expectancy as Mediators of Affective and Physiological Responses and Exercise Among Endometrial Cancer Survivors. Ann Behav Med 2020; 54:320-334. [PMID: 31722394 DOI: 10.1093/abm/kaz050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Previous studies have shown affective and physiological states in response to exercise as predictors of daily exercise, yet little is known about the mechanism underlying such effects. PURPOSE To examine the mediating effects of self-efficacy and outcome expectancy on the relationships between affective and physiological responses to exercise and subsequent exercise levels in endometrial cancer survivors. METHODS Ecological momentary assessment (EMA) surveys were delivered up to eight 5- to 7-day periods over 6 months. Participants (n = 100) rated their affective and physiological states before and after each exercise session (predictors) and recorded their self-efficacy and outcome expectancy each morning (mediators). Exercise (outcome) was based on self-reported EMA surveys and accelerometer measures. A 1-1-1 multilevel mediation model was used to disaggregate the within-subject (WS) and between-subject (BS) effects. RESULTS At the WS level, a more positive affective state after exercise was associated with higher self-efficacy and positive outcome expectation the next day, which in turn was associated with higher subsequent exercise levels (ps < .05). At the BS level, participants who typically had more positive affective and experienced less intense physiological sensation after exercise had higher average self-efficacy, which was associated with higher average exercise levels (ps < .05). CONCLUSIONS In endometrial cancer survivors, affective experience after exercise, daily self-efficacy and positive outcome expectation help explain the day-to-day differences in exercise levels within-person. Findings from this study highlight potentials for behavioral interventions that target affective experience after exercise and daily behavioral cognitions to promote physical activity in cancer survivors' everyday lives.
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Affiliation(s)
- Yue Liao
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jaejoon Song
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Michael C Robertson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Emily Cox-Martin
- Division of Medical Oncology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX
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18
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Zapata-Lamana R, Lalanza JF, Losilla JM, Parrado E, Capdevila L. mHealth technology for ecological momentary assessment in physical activity research: a systematic review. PeerJ 2020; 8:e8848. [PMID: 32257648 PMCID: PMC7103204 DOI: 10.7717/peerj.8848] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/03/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To systematically review the publications on ecological momentary assessment (EMA) relating to physical activity (PA) behavior in order to classify the methodologies, and to identify the main mHealth technology-based tools and procedures that have been applied during the first 10 years since the emergence of smartphones. As a result of this review, we want to ask if there is enough evidence to propose the use of the term "mEMA" (mobile-based EMA). DESIGN A systematic review according to PRISMA Statement (PROSPERO registration: CRD42018088136). METHOD Four databases (PsycINFO, CINALH, Medline and Web of Science Core Collection) were searched electronically from 2008 to February 2018. RESULTS A total of 76 studies from 297 potential articles on the use of EMA and PA were included in this review. It was found that 71% of studies specifically used "EMA" for assessing PA behaviors but the rest used other terminology that also adjusted to the inclusion criteria. Just over half (51.3%) of studies (39) used mHealth technology, mainly smartphones, for collecting EMA data. The majority (79.5%) of these studies (31 out of 39) were published during the last 4 years. On the other hand, 58.8% of studies that only used paper-and-pencil were published during the first 3 years of the 10-year period analyzed. An accelerometer was the main built-in sensor used for collecting PA behavior by means of mHealth (69%). Most of the studies were carried out on young-adult samples, with only three studies in older adults. Women were included in 60% of studies, and healthy people in 82%. The studies lasted between 1 and 7 days in 57.9%, and between three and seven assessments per day were carried out in 37%. The most popular topics evaluated together with PA were psychological state and social and environmental context. CONCLUSIONS We have classified the EMA methodologies used for assessing PA behaviors. A total of 71% of studies used the term "EMA" and 51.3% used mHealth technology. Accelerometers have been the main built-in sensor used for collecting PA. The change of trend in the use of tools for EMA in PA coincides with the technological advances of the last decade due to the emergence of smartphones and mHealth technology. There is enough evidence to use the term mEMA when mHealth technology is being used for monitoring real-time lifestyle behaviors in natural situations. We define mEMA as the use of mobile computing and communication technologies for the EMA of health and lifestyle behaviors. It is clear that the use of mHealth is increasing, but there is still a lot to be gained from taking advantage of all the capabilities of this technology in order to apply EMA to PA behavior. Thus, mEMA methodology can help in the monitoring of healthy lifestyles under both subjective and objective perspectives. The tendency for future research should be the automatic recognition of the PA of the user without interrupting their behavior. The ecological information could be completed with voice messages, image captures or brief text selections on the touch screen made in real time, all managed through smartphone apps. This methodology could be extended when EMA combined with mHealth are used to evaluate other lifestyle behaviors.
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Affiliation(s)
| | - Jaume F. Lalanza
- Department of Basic Psychology, Universitat Autónoma de Barcelona, Bellaterra, Spain
| | - Josep-Maria Losilla
- Department of Psychobiology and Methodology of Health Science, Universitat Autónoma de Barcelona, Bellaterra, Spain
- Sport Research Institute UAB, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Eva Parrado
- Department of Basic Psychology, Universitat Autónoma de Barcelona, Bellaterra, Spain
- Sport Research Institute UAB, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - Lluis Capdevila
- Department of Basic Psychology, Universitat Autónoma de Barcelona, Bellaterra, Spain
- Sport Research Institute UAB, Universitat Autònoma de Barcelona, Bellaterra, Spain
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19
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Oberste M, Medele M, Javelle F, Lioba Wunram H, Walter D, Bloch W, Bender S, Fricke O, Joisten N, Walzik D, Großheinrich N, Zimmer P. Physical Activity for the Treatment of Adolescent Depression: A Systematic Review and Meta-Analysis. Front Physiol 2020; 11:185. [PMID: 32265725 PMCID: PMC7096373 DOI: 10.3389/fphys.2020.00185] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/17/2020] [Indexed: 12/31/2022] Open
Abstract
Background: A noticeable proportion of adolescents with depression do not respond to guideline recommended treatment options. This systematic review and meta-analysis investigated the effectiveness of physical activity interventions as an alternative or complementary treatment for adolescents (12-18 years) with depression. The characteristics of the physical activity treatment that were most effective in reducing symptoms in adolescents with depression and the impact of methodological shortcomings in the existing research were also examined. Methods: Medline, PsycINFO, SPORTDiscus, ProQuest, and CENTRAL were searched for eligible records. Effect size estimates were pooled based on the application of a random-effects model. Potential moderation by physical activity characteristics (i.e., intensity, type, context, and time frame) and methodological features (i.e., type of control group and diagnostic tool to identify depression at baseline) was investigated by means of subgroup analyses and meta-regressions. The certainty of evidence was assessed by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. The primary outcome was the antidepressant effect of physical activity at postintervention measurement time point. As secondary outcomes, the sustainability of effects after the end of physical activity treatment and the acceptability of physical activity treatments were assessed. Overall, 10 studies were included in the qualitative synthesis and 9 studies involving 431 patients were included in the quantitative synthesis. Results: A moderate, significant antidepressant effect of physical activity was found (Hedges' g = -0.47, 95% CI = -0.71 to -0.24). Heterogeneity was small (T2 = 0.0313, I 2 = 27%, p = 0.18). However, the certainty of evidence was downgraded to low because the included studies contained serious methodological limitations. Moderator analyses revealed that session intensity significantly moderated the antidepressant effect of physical activity. Moreover, noticeably smaller effect sizes were found in studies that used non-physical activity sham treatments as control treatments (e.g., playing board games), compared to studies that used no control group treatments. Only three studies assessed the sustainability of effects after the end of physical activity treatment. The results suggest that the antidepressant effects further increase after the end of physical activity interventions. There was no significant difference in dropout risk between the physical activity and control groups. Conclusions: This review suggests that physical activity is effective in treating depression in adolescents. Physical activity sessions should be at least moderately intense [rate of perceived exertion (RPE) between 11 and 13] to be effective. Furthermore, our results suggest that physical activity treatments are well accepted. However, the low methodological quality in included studies might have led to effect overestimation. Therefore, more studies with higher methodological quality are needed to confirm the recommendation for physical activity treatments in adolescents with depression.
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Affiliation(s)
- Max Oberste
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Marie Medele
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Florian Javelle
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Heidrun Lioba Wunram
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- Children's Hospital, Medical Faculty, University of Cologne, Cologne, Germany
| | - Daniel Walter
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- School of Child and Adolescent Cognitive Behavior Therapy (AKiP) at the University Hospital Cologne, Cologne, Germany
| | - Wilhelm Bloch
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Stephan Bender
- Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
| | - Oliver Fricke
- Chair of Child and Adolescent Psychiatry, Witten/Herdecke University, Department of Child and Adolescent Psychiatry, Psychotherapy and Child Neurology, Gemeinschaftskrankenhaus Herdecke, Herdecke, Germany
| | - Niklas Joisten
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - David Walzik
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
| | - Nicola Großheinrich
- Department of Social Sciences, Catholic University of Applied Science of North Rhine – Westphalia, Cologne, Germany
| | - Philipp Zimmer
- Department of Molecular and Cellular Sport Medicine, Institute of Cardiovascular Research and Sports Medicine, German Sport University Cologne, Cologne, Germany
- Department of “Performance and Health (Sports Medicine)”, Institute of Sport and Sport Science, Technical University Dortmund, Dortmund, Germany
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20
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Robertson MC, Green CE, Liao Y, Durand CP, Basen-Engquist KM. Self-efficacy and Physical Activity in Overweight and Obese Adults Participating in a Worksite Weight Loss Intervention: Multistate Modeling of Wearable Device Data. Cancer Epidemiol Biomarkers Prev 2019; 29:769-776. [PMID: 31871110 DOI: 10.1158/1055-9965.epi-19-0907] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 10/08/2019] [Accepted: 12/03/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Physical activity is associated with a reduced risk of numerous types of cancer and plays an important role in maintaining a healthy weight. Wearable physical activity trackers may supplement behavioral intervention and enable researchers to study how determinants like self-efficacy predict physical activity patterns over time. METHODS We used multistate models to evaluate how self-efficacy predicted physical activity states among overweight and obese individuals participating in a 26-week weight loss program (N = 96). We specified five states to capture physical activity patterns: (i) active (i.e., meeting recommendations for 2 weeks), (ii) insufficiently active, (iii) nonvalid wear, (iv) favorable transition (i.e., improvement in physical activity over 2 weeks), and (v) unfavorable transition. We calculated HRs of transition probabilities by self-efficacy, body mass index, age, and time. RESULTS The average prevalence of individuals in the active, insufficiently active, and nonvalid wear states was 13%, 44%, and 16%, respectively. Low self-efficacy negatively predicted entering an active state [HR, 0.51; 95% confidence interval (CI), 0.29-0.88]. Obesity negatively predicted making a favorable transition out of an insufficiently active state (HR, 0.61; 95% CI, 0.40-0.91). Older participants were less likely to transition to the nonvalid wear state (HR, 0.53; 95% CI, 0.30-0.93). Device nonwear increased in the second half of the intervention (HR, 1.73; 95% CI, 1.07-2.81). CONCLUSIONS Self-efficacy is an important predictor for clinically relevant physical activity change in overweight and obese individuals. Multistate modeling is useful for analyzing longitudinal physical activity data. IMPACT Multistate modeling can be used for statistical inference of covariates and allow for explicit modeling of nonvalid wear.See all articles in this CEBP Focus section, "Modernizing Population Science."
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Affiliation(s)
- Michael C Robertson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center School of Public Health, Houston, Texas
| | - Charles E Green
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center, Houston, Texas
| | - Yue Liao
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Casey P Durand
- Department of Health Promotion and Behavioral Science, The University of Texas Health Science Center School of Public Health, Houston, Texas
| | - Karen M Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas.
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21
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Robertson MC, Lyons EJ, Song J, Cox-Martin M, Li Y, Green CE, Pinto BM, Carmack CL, Harrison C, Baum G, Basen-Engquist KM. Change in physical activity and quality of life in endometrial cancer survivors receiving a physical activity intervention. Health Qual Life Outcomes 2019; 17:91. [PMID: 31133040 PMCID: PMC6537149 DOI: 10.1186/s12955-019-1154-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 05/07/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Endometrial cancer survivors are at an increased risk of poor quality of life outcomes. Physical activity is positively associated with general quality of life in this population, however, little is known about how changes in physical activity may be associated with changes in specific aspects of quality of life. The aim of this secondary data analysis was to explore the relationships between change in physical activity and change in physical, mental, social, and other aspects of quality of life in endometrial cancer survivors receiving a physical activity intervention. METHODS Endometrial cancer survivors (N = 100) participated in a telephone-based physical activity intervention for six months. At baseline and post-intervention we measured physical activity via accelerometry and ecological momentary assessment, and quality of life via the Short Form Health Survey (SF-36), the Quality of Life of Adult Cancer Survivors instrument, the Brief Symptom Inventory, the Pittsburgh Sleep Quality Index, and the Perceived Stress Scale. We conducted structural equation modeling path analyses to investigate how physical activity post-intervention was associated with the quality of life measures' subscales post-intervention, adjusting for baseline levels and potentially confounding covariates. RESULTS Increasing physical activity was positively associated with improvements in general health (p = .044), role limitation due to physical health (p = .005), pain (p = .041), and somatic distress (p = .023). There was no evidence to indicate that change in physical activity was associated with change in other aspects of quality of life. CONCLUSIONS Endometrial cancer survivors are at higher risk for suffering from challenges to physical quality of life, and findings from this study suggest that increasing physical activity may alleviate some of these problems. Further research is needed to determine whether other aspects of quality of life are linked to change in physical activity. TRIAL REGISTRATION Trial registration number: NCT00501761 Name of registry: clinicaltrials.gov Date of registration: July 16, 2007. Date of enrollment: June 16, 2005.
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Affiliation(s)
- Michael C. Robertson
- Center for Energy Balance, Department of Behavioral Science, MD Anderson Cancer Center, Cancer Prevention Building, Unit 1330, 1155 Pressler St, Houston, TX 77030 USA
- Health Promotion & Behavioral Sciences, University of Texas School of Public Health, 1200 Pressler Street, Houston, TX 77030 USA
| | - Elizabeth J. Lyons
- Department of Nutrition and Metabolism, School of Health Professions, University of Texas Medical Branch at Galveston, 301 University Boulevard, Galveston, TX 77555-1124 USA
| | - Jaejoon Song
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler St, Houston, TX 77030 USA
| | - Matthew Cox-Martin
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado at Denver-Anschutz Medical Campus, Aurora, CO USA
| | - Yisheng Li
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler St, Houston, TX 77030 USA
| | - Charles E. Green
- Department of Pediatrics, McGovern Medical School, The University of Texas Health Science Center, 6431 Fannin St, Houston, TX 77030 USA
| | - Bernardine M. Pinto
- College of Nursing, University of South Carolina, 1601 Greene Street, Room 302B, Columbia, SC 29208-4001 USA
| | - Cindy L. Carmack
- Department of Palliative Care, Rehabilitation, and Integrative Medicine, MD Anderson Cancer Center, Cancer Prevention Building, Unit 1330, 1155 Pressler St, Houston, TX 77030 USA
| | - Carol Harrison
- Center for Energy Balance, Department of Behavioral Science, MD Anderson Cancer Center, Cancer Prevention Building, Unit 1330, 1155 Pressler St, Houston, TX 77030 USA
| | - George Baum
- Center for Energy Balance, Department of Behavioral Science, MD Anderson Cancer Center, Cancer Prevention Building, Unit 1330, 1155 Pressler St, Houston, TX 77030 USA
| | - Karen M. Basen-Engquist
- Center for Energy Balance, Department of Behavioral Science, MD Anderson Cancer Center, Cancer Prevention Building, Unit 1330, 1155 Pressler St, Houston, TX 77030 USA
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22
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Kampshoff CS, Verdonck-de Leeuw IM, van Oijen MG, Sprangers MA, Buffart LM. Ecological momentary assessments among patients with cancer: A scoping review. Eur J Cancer Care (Engl) 2019; 28:e13095. [PMID: 31090160 PMCID: PMC9285429 DOI: 10.1111/ecc.13095] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/01/2019] [Accepted: 04/12/2019] [Indexed: 12/21/2022]
Abstract
Introduction Ecological momentary assessment (EMA) is an emerging method to assess an individual's current thoughts, affect, behaviour, physical states and contextual factors as they occur in real‐time and in their natural environment. Whereas EMA is frequently used in mental health, little is known about the added value of EMA in oncology research. This review aimed to synthesise methodological information and results of studies that applied EMA among patients with cancer to inform future researchers about the opportunities and challenges. Methods We included full‐text articles on studies that: (a) were conducted among adult cancer patients; and (b) examined cancer and treatment‐related experiences by EMA. Information from selected studies was synthesised: study designs, EMA data collection methods, response‐related results and main findings. Results Twelve studies were included, which all applied an observational design. The EMA data collection methods varied considerably and the reporting of response‐related results were poor. Nevertheless, EMA was found feasible as no systematic patterns of problems were reported and reported response‐related results were acceptable. Furthermore, EMA was found useful as it facilitated examination of real‐time experiences and behaviour. Conclusion Ecological momentary assessment is useful and feasible in oncology research. Future studies would benefit from guidelines for designing and reporting EMA studies.
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Affiliation(s)
- Caroline S Kampshoff
- Department of Medical Oncology, Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Irma M Verdonck-de Leeuw
- Department of Otolaryngology-Head and Neck Surgery, Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Clinical, Neuro- and Developmental Psychology, Section Clinical Psychology, Amsterdam Public Health (APH) Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn G van Oijen
- Department of Medical Oncology, Cancer Center Amsterdam (CCA), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Mirjam A Sprangers
- Department of Medical Psychology, Amsterdam Public Health (APH) Research Institute, Cancer Center Amsterdam (CCA), Amsterdam UMC (location Academic Medical Center), University of Amsterdam, Amsterdam, The Netherlands
| | - Laurien M Buffart
- Department of Medical Oncology, Cancer Center Amsterdam (CCA), Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health (APH) Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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23
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Lucas AR, Focht BC, Cohn DE, Klatt MD, Buckworth J. Recruiting Endometrial Cancer Survivors to Studies Examining Lifestyle Behaviors and Quality of Life: Challenges Faced and Lessons Learned. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2018; 33:857-864. [PMID: 28188570 PMCID: PMC5552444 DOI: 10.1007/s13187-017-1187-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There are a growing number of cancer survivors in the USA. Despite lifestyle behaviors being strongly associated with morbidity and mortality following primary treatment, recruitment to clinical research studies that aim to improve such behaviors remains a significant challenge. Furthermore, pilot and feasibility studies are critical for the refinement of research methods and form an important training opportunity for early career scientists. This report details the challenges faced and lessons learned in the process of recruiting a population of overweight/obese endometrial cancer survivors (ECS) to two separate studies focused on lifestyle behaviors: a survey study and a randomized behavioral intervention study that aimed to improve diet, physical activity, and quality of life. We used in-clinic and mail-based approaches to reach eligible patients identified from clinic records. Surveys were offered via paper or online. To evaluate the recruitment process, we compared clinic records and enrollment data over time and location. Chi-squared tests were also used to compare recruitment strategies. We address specific challenges at the patient level, the clinic/provider level, and the organizational level. Overall response rate was 13.9% to the survey and 4% to the intervention. Responses to in-clinic offers were greater than to mail-based approaches for the survey with no difference for the intervention. Identifying the unique characteristics of each survivorship population, adequate planning, resource allocation, and involvement of key staff are essential to supporting recruitment efforts to research studies. Having the support of physicians and nurses is especially critical to the success of recruitment.
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Affiliation(s)
- Alexander R Lucas
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - Brian C Focht
- Kinesiology, Department of Human Sciences, The Ohio State University, Columbus, OH, 43201, USA
| | - David E Cohn
- Division of Gynecologic Oncology, The Ohio State University College of Medicine, M-210 Starling Loving Hall, 320 West 10th Avenue, Columbus, OH, 43201, USA
| | - Maryanna D Klatt
- Clinical Family Medicine, The Ohio State University College of Medicine, Suite 250 Northwood-High Building # 261, 2231 North High Street, Columbus, OH, 43201, USA
| | - Janet Buckworth
- Department of Kinesiology, University of Georgia, 115K Ramsey Center 330 River Road, Athens, GA, USA
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24
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Kim J, Marcusson-Clavertz D, Togo F, Park H. A Practical Guide to Analyzing Time-Varying Associations between Physical Activity and Affect Using Multilevel Modeling. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2018; 2018:8652034. [PMID: 30105083 PMCID: PMC6076963 DOI: 10.1155/2018/8652034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/15/2018] [Accepted: 05/24/2018] [Indexed: 11/29/2022]
Abstract
There is growing interest in within-person associations of objectively measured physical and physiological variables with psychological states in daily life. Here we provide a practical guide with SAS code of multilevel modeling for analyzing physical activity data obtained by accelerometer and self-report data from intensive and repeated measures using ecological momentary assessments (EMA). We review previous applications of EMA in research and clinical settings and the analytical tools that are useful for EMA research. We exemplify the analyses of EMA data with cases on physical activity data and affect and discuss the future challenges in the field.
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Affiliation(s)
- Jinhyuk Kim
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - David Marcusson-Clavertz
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Department of Psychology, Lund University, Lund, Sweden
| | - Fumiharu Togo
- Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Hyuntae Park
- Department of Health Care and Science, College of Health Science, Dong-A University, Busan, Republic of Korea
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25
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Newton RU, Kenfield SA, Hart NH, Chan JM, Courneya KS, Catto J, Finn SP, Greenwood R, Hughes DC, Mucci L, Plymate SR, Praet SFE, Guinan EM, Van Blarigan EL, Casey O, Buzza M, Gledhill S, Zhang L, Galvão DA, Ryan CJ, Saad F. Intense Exercise for Survival among Men with Metastatic Castrate-Resistant Prostate Cancer (INTERVAL-GAP4): a multicentre, randomised, controlled phase III study protocol. BMJ Open 2018; 8:e022899. [PMID: 29764892 PMCID: PMC5961562 DOI: 10.1136/bmjopen-2018-022899] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Preliminary evidence supports the beneficial role of physical activity on prostate cancer outcomes. This phase III randomised controlled trial (RCT) is designed to determine if supervised high-intensity aerobic and resistance exercise increases overall survival (OS) in patients with metastatic castrate-resistant prostate cancer (mCRPC). METHODS AND ANALYSIS Participants (n=866) must have histologically documented metastatic prostate cancer with evidence of progressive disease on androgen deprivation therapy (defined as mCRPC). Patients can be treatment-naïve for mCRPC or on first-line androgen receptor-targeted therapy for mCRPC (ie, abiraterone or enzalutamide) without evidence of progression at enrolment, and with no prior chemotherapy for mCRPC. Patients will receive psychosocial support and will be randomly assigned (1:1) to either supervised exercise (high-intensity aerobic and resistance training) or self-directed exercise (provision of guidelines), stratified by treatment status and site. Exercise prescriptions will be tailored to each participant's fitness and morbidities. The primary endpoint is OS. Secondary endpoints include time to disease progression, occurrence of a skeletal-related event or progression of pain, and degree of pain, opiate use, physical and emotional quality of life, and changes in metabolic biomarkers. An assessment of whether immune function, inflammation, dysregulation of insulin and energy metabolism, and androgen biomarkers are associated with OS will be performed, and whether they mediate the primary association between exercise and OS will also be investigated. This study will also establish a biobank for future biomarker discovery or validation. ETHICS AND DISSEMINATION Validation of exercise as medicine and its mechanisms of action will create evidence to change clinical practice. Accordingly, outcomes of this RCT will be published in international, peer-reviewed journals, and presented at national and international conferences. Ethics approval was first obtained at Edith Cowan University (ID: 13236 NEWTON), with a further 10 investigator sites since receiving ethics approval, prior to activation. TRIAL REGISTRATION NUMBER NCT02730338.
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Affiliation(s)
- Robert U Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia
- School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia
- School of Medical and Health Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Stacey A Kenfield
- Department of Urology, University of California San Francisco, San Francisco, California, USA
| | - Nicolas H Hart
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia
- School of Medical and Health Science, Edith Cowan University, Perth, Western Australia, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - June M Chan
- Department of Urology, University of California San Francisco, San Francisco, California, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Kerry S Courneya
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada
| | - James Catto
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Stephen P Finn
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Daniel C Hughes
- Institute for Health Promotion Research, University of Texas Health, San Antonio, Texas, UK
| | - Lorelei Mucci
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Stephen R Plymate
- Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, Washington, USA
| | - Stephan F E Praet
- Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, Washington, USA
- University of Canberra Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | | | - Erin L Van Blarigan
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | | | - Mark Buzza
- Movember Foundation, Melbourne, Victoria, Australia
| | - Sam Gledhill
- Movember Foundation, Melbourne, Victoria, Australia
| | - Li Zhang
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Daniel A Galvão
- Exercise Medicine Research Institute, Edith Cowan University, Perth, Western Australia, Australia
- School of Medical and Health Science, Edith Cowan University, Perth, Western Australia, Australia
| | - Charles J Ryan
- Department of Urology, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Fred Saad
- Department of Urology, Centre Hospitalier de L'Universite de Montreal, Montreal, Quebec, Canada
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Ainsworth MC, Pekmezi D, Bowles H, Ehlers D, McAuley E, Courneya KS, Rogers LQ. Acceptability of a Mobile Phone App for Measuring Time Use in Breast Cancer Survivors (Life in a Day): Mixed-Methods Study. JMIR Cancer 2018; 4:e9. [PMID: 29759953 PMCID: PMC5972204 DOI: 10.2196/cancer.8951] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/19/2018] [Accepted: 03/16/2018] [Indexed: 12/16/2022] Open
Abstract
Background Advancements in mobile technology allow innovative data collection techniques such as measuring time use (ie, how individuals structure their time) for the purpose of improving health behavior change interventions. Objective The aim of this study was to examine the acceptability of a 5-day trial of the Life in a Day mobile phone app measuring time use in breast cancer survivors to advance technology-based measurement of time use. Methods Acceptability data were collected from participants (N=40; 100% response rate) using a self-administered survey after 5 days of Life in a Day use. Results Overall, participants had a mean age of 55 years (SD 8) and completed 16 years of school (SD 2). Participants generally agreed that learning to use Life in a Day was easy (83%, 33/40) and would prefer to log activities using Life in a Day over paper-and-pencil diary (73%, 29/40). A slight majority felt that completing Life in a Day for 5 consecutive days was not too much (60%, 24/40) or overly time-consuming (68%, 27/40). Life in a Day was rated as easy to read (88%, 35/40) and navigate (70%, 32/40). Participants also agreed that it was easy to log activities using the activity timer at the start and end of an activity (90%, 35/39). Only 13% (5/40) downloaded the app on their personal phone, whereas 63% (19/30) of the remaining participants would have preferred to use their personal phone. Overall, 77% (30/39) of participants felt that the Life in a Day app was good or very good. Those who agreed that it was easy to edit activities were significantly more likely to be younger when compared with those who disagreed (mean 53 vs 58 years, P=.04). Similarly, those who agreed that it was easy to remember to log activities were more likely to be younger (mean 52 vs 60 years, P<.001). Qualitative coding of 2 open-ended survey items yielded 3 common themes for Life in a Day improvement (ie, convenience, user interface, and reminders). Conclusions A mobile phone app is an acceptable time-use measurement modality. Improving convenience, user interface, and memory prompts while addressing the needs of older participants is needed to enhance app utility. Trial Registration ClinicalTrials.gov NCT00929617; https://clinicaltrials.gov/ct2/show/NCT00929617 (Archived by WebCite at http://www.webcitation.org/6z2bZ4P7X)
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Affiliation(s)
- Matthew Cole Ainsworth
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Dori Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Heather Bowles
- National Cancer Institute, Division of Cancer Prevention, Bethesda, MD, United States
| | - Diane Ehlers
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Edward McAuley
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada
| | - Laura Q Rogers
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
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Physical Activity in Parents of Young African American Children: The Application of Social Cognitive Theory. Res Theory Nurs Pract 2018. [DOI: 10.1891/1541-6577.32.1.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background:Social cognitive theory (SCT) proposes that personal and environmental factors influence behavior bidirectionally. Research examining the personal and environmental factors of physical activity (PA) among African Americans (AAs) framed by SCT is scarce.Purpose:The purpose of this article is to enhance knowledge of SCT as a foundation for health promotion and PA research, in general, and among AAs. Findings from a previous study provide exemplars for key factors and relationships in SCT.Implications for Research and Practice:The SCT serves as a good framework for researchers studying health promotion and PA in generalamong AA parents.
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Armbruster SD, Song J, Gatus L, Lu KH, Basen-Engquist KM. Endometrial cancer survivors' sleep patterns before and after a physical activity intervention: A retrospective cohort analysis. Gynecol Oncol 2018; 149:133-139. [PMID: 29395314 PMCID: PMC5915323 DOI: 10.1016/j.ygyno.2018.01.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 01/20/2018] [Accepted: 01/23/2018] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To identify the baseline sleep patterns of endometrial cancer survivors and examine the impact of a physical activity intervention on their sleep quality via retrospective secondary analysis. METHODS Early-stage endometrial cancer survivors participated in a 6-month single-arm exercise intervention using printed materials, telephone-based counseling, and pedometers to encourage adherence to exercise guidelines. Participants completed questionnaires evaluating their sleep (PSQI), physical activity (CHAMPS), quality of life (SF-36), and stress (PSS) at baseline and study completion. RESULTS Ninety-five survivors had PSQI data at both time points. Mean age was 57.1 years (range, 25-76). Mean body mass index was 34.3 kg/m2. The majority were non-Hispanic white (75%) and had stage I disease (80%). At baseline, most survivors (61%) had poor sleep quality (PSQI > 5), with 24% reporting fairly or very bad sleep. The majority (63%) slept <7 h/night. At least once during the preceding month, 83% had an episode of daytime dysfunction. A pairwise comparison showed that obese survivors had more sleep disturbances than normal weight survivors (p = 0.029). No other clinicodemographic factors were associated with sleep. In unadjusted analyses, sleep quality significantly improved in women who increased weekly total or moderate/vigorous physical activity (p = 0.004 and p < 0.050, respectively). This association persisted after adjusting for the potential covariates of age, time since diagnosis, obesity status, disease stage, and treatment (p = 0.026). CONCLUSIONS Our data demonstrated that poor sleep is common and detrimental to endometrial cancer survivors. Increasing exercise may improve this dysfunction and should be investigated as part of a prospective study.
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Affiliation(s)
- Shannon D Armbruster
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States.
| | - Jaejoon Song
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Leticia Gatus
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Karen H Lu
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Karen M Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Smith-Miller CA, Berry DC, DeWalt D, Miller CT. Type 2 Diabetes Self-management Among Spanish-Speaking Hispanic Immigrants. J Immigr Minor Health 2018; 18:1392-1403. [PMID: 26547695 DOI: 10.1007/s10903-015-0271-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This article describes the quantitative findings of a mixed-methods study that examined the relationship among knowledge, self-efficacy, health promoting behaviors, and type 2 diabetes self-management among recent Spanish-speaking, limited English proficient immigrants to the US. This population is at risk for both a higher incidence of disease and increased barriers to successful disease management compared to the general US population. Distinguishing aspects of this study compared to the available literature are the comprehensive nature of the data collected, the theoretical component, and the analysis and modeling approach. Social cognitive theory provides the framework for the study design and analysis. An innovative community-based recruiting strategy was used, a broad range of physiological measures related to health were observed, and instruments related to knowledge, self-efficacy, and healthy lifestyle behaviors were administered orally in Spanish to 30 participants. A broad range of statistical analysis methods was applied to the data, including a set of three structural equation models. The study results are consistent with the importance of education, health knowledge, and healthy lifestyle practices for type 2 diabetes self-management. With the usual cautions associated with applying structural equation modeling to modest sample sizes, multiple elements of the posited theoretical model were consistent with the data collected. The results of the investigation of this under-studied population indicate that, on average, participants were not effectively managing their disease. The results suggest that clinical interventions focused on improving knowledge, nutrition, and physical activity, reducing stress, and leveraging the importance of interpersonal relations could be effective intervention strategies to improve self-management among this population.
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Affiliation(s)
- Cheryl A Smith-Miller
- Nursing Quality and Research, University of North Carolina Hospital, Chapel Hill, NC, USA. .,School of Nursing, UNC-CH, Chapel Hill, NC, USA.
| | | | | | - Cass T Miller
- UNC Gillings School of Global Public Health, UNC-CH, Chapel Hill, NC, USA
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Braun A, Portner J, Grainger EM, Hill EB, Young GS, Clinton SK, Spees CK. Tele-Motivational Interviewing for Cancer Survivors: Feasibility, Preliminary Efficacy, and Lessons Learned. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2018; 50:19-32.e1. [PMID: 29325658 PMCID: PMC7333356 DOI: 10.1016/j.jneb.2017.05.352] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 05/07/2017] [Accepted: 05/14/2017] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Determine the feasibility, acceptability, and efficacy of tele-Motivational Interviewing (MI) for overweight cancer survivors. DESIGN Six-month nonrandomized phase 2 clinical trial. SETTING Urban garden and remote platforms. PARTICIPANTS Overweight and obese cancer survivors post active treatment. INTERVENTION Remote tele-MI from a trained registered dietitian nutritionist (RDN). MAIN OUTCOME MEASURES Feasibility, acceptability, and preliminary efficacy. ANALYSIS Groups were stratified as users and nonusers based on tele-MI use. Qualitative survey data and remote MI interaction logs were analyzed for trends. Two-sample t tests were performed to assess pre-post intervention changes in physical activity and dietary behaviors, quality of life, self-efficacy, and clinical biomarkers. RESULTS A total of 29 participants completed the intervention. There were 17 tele-MI users (59%) and 12 nonusers (41%). Users were primarily female (88%), breast cancer survivors (59%), college educated (82%), with a mean age of 58 years. Users set 50% more goals, lost more weight (4.8 vs 2.6 kg), significantly improved quality of life (P = .03), and trended more positively in clinical biomarkers (eg, cholesterol, blood pressure) than did nonusers. CONCLUSIONS AND IMPLICATIONS Findings from this study indicate that tele-MI is a feasible and acceptable intervention for overweight cancer survivors after active therapy. Larger randomized trials are needed to establish efficacy and generalizability to a variety of demographic populations.
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Affiliation(s)
- Ashlea Braun
- Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, Ohio State University College of Medicine, Columbus, OH
| | - James Portner
- Ohio State University College of Social Work, Columbus, OH
| | - Elizabeth M Grainger
- Comprehensive Cancer Center, Ohio State University College of Medicine, Columbus, OH
| | - Emily B Hill
- Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, Ohio State University College of Medicine, Columbus, OH
| | - Gregory S Young
- Center for Biostatistics, Ohio State University College of Medicine, Columbus, OH
| | - Steven K Clinton
- Comprehensive Cancer Center, Ohio State University College of Medicine, Columbus, OH; Department of Internal Medicine, Division of Medical Oncology, Ohio State University College of Medicine, Columbus, OH
| | - Colleen K Spees
- Medical Dietetics and Health Sciences, School of Health and Rehabilitation Sciences, Ohio State University College of Medicine, Columbus, OH; Comprehensive Cancer Center, Ohio State University College of Medicine, Columbus, OH.
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Hughes DC, Cox MG, Serice S, Baum G, Harrison C, Basen-Engquist K. Using rating of perceived exertion in assessing cardiorespiratory fitness in endometrial cancer survivors. Physiother Theory Pract 2017; 33:758-765. [PMID: 28820332 PMCID: PMC6087665 DOI: 10.1080/09593985.2017.1357150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
For cancer survivors, who also often present with co-existing health conditions, exercise testing is often performed using submaximal protocols incorporating linear heart rate response for estimating the cardiorespiratory capacity and assessing exercise tolerance. However, use of beta-blocker medications, during sub-maximal protocols based on linear HR response can be problematic. Rating of perceived exertion (RPE), which takes into account an individual's overall perception of effort, can be used as a complementary tool that does not rely solely on the heart rate response to increased workload. We compared heart rate response (VO2HR) and self-rating of perceived exertion (VO2RPE) in a graded submaximal exercise test (GXT) in 93 endometrial cancer survivors. The results of the GXT were stratified according to whether participants were taking beta-blocker (BB) medications or not (non-BB). Among non-BB participants, there was no difference between the mean VO2HR and the mean VO2RPE estimates of cardiorespiratory capacity (mlO2//kg/min) (20.4 and 19.3, respectively; p = 0.166). Among BB participants, the mean VO2HR approached significant difference than the mean VO2RPE (21.7 mlO2//kg/min and 17.6 mlO2//kg/min, respectively; p = 0.087). Bland-Altman plots for both methods showed a proportional bias for the non-BB group; but not the BB group. Our results suggest that sub-maximal protocols based on Borg's Rating of Perceived exertion (RPE) produce differing results from sub-maximal protocols based on HR response when applied to clinical population taking BB medications. Using RPE instead of HR for participants on BB medications may be a better method for assessing the exercise tolerance for estimating the cardiorespiratory capacity in sub-maximal exercise testing.
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Affiliation(s)
- Daniel C. Hughes
- Institute for Health Promotion Research, University of Texas Health Science Center – San Antonio, 7411 John Smith Dr., Suite 1000, San Antonio, TX 78229
| | - Matthew G. Cox
- Adult and Child Consortium for Health Outcomes Research and Delivery Science University of Colorado
| | - Susan Serice
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
| | - George Baum
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
| | - Carol Harrison
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
| | - Karen Basen-Engquist
- Department of Behavioral Science, University of Texas, M.D. Anderson Cancer Center
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Scruggs S, Mama SK, Carmack CL, Douglas T, Diamond P, Basen-Engquist K. Randomized Trial of a Lifestyle Physical Activity Intervention for Breast Cancer Survivors: Effects on Transtheoretical Model Variables. Health Promot Pract 2017. [PMID: 28627254 DOI: 10.1177/1524839917709781] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examined whether a physical activity intervention affects transtheoretical model (TTM) variables that facilitate exercise adoption in breast cancer survivors. Sixty sedentary breast cancer survivors were randomized to a 6-month lifestyle physical activity intervention or standard care. TTM variables that have been shown to facilitate exercise adoption and progress through the stages of change, including self-efficacy, decisional balance, and processes of change, were measured at baseline, 3 months, and 6 months. Differences in TTM variables between groups were tested using repeated measures analysis of variance. The intervention group had significantly higher self-efficacy ( F = 9.55, p = .003) and perceived significantly fewer cons of exercise ( F = 5.416, p = .025) at 3 and 6 months compared with the standard care group. Self-liberation, counterconditioning, and reinforcement management processes of change increased significantly from baseline to 6 months in the intervention group, and self-efficacy and reinforcement management were significantly associated with improvement in stage of change. The stage-based physical activity intervention increased use of select processes of change, improved self-efficacy, decreased perceptions of the cons of exercise, and helped participants advance in stage of change. These results point to the importance of using a theory-based approach in interventions to increase physical activity in cancer survivors.
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Affiliation(s)
- Stacie Scruggs
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Cindy L Carmack
- 1 The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Tommy Douglas
- 3 The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Pamela Diamond
- 3 The University of Texas Health Science Center at Houston, Houston, TX, USA
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Fitz E, Warner J, Braun A, Hill E, Wolf K, Spees C. Development, Implementation, and Evaluation of Evidence-Based Cooking Videos for Cancer Survivors. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2017; 49:525-526.e1. [PMID: 28442283 DOI: 10.1016/j.jneb.2017.03.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/16/2017] [Accepted: 03/19/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Emily Fitz
- Medical Dietetics and Health Sciences, The Ohio State University College of Medicine, Columbus, OH
| | - Jim Warner
- Food and Nutrition, Nutrition Services, Wexner Medical Center, The Ohio State University, Columbus, OH
| | - Ashlea Braun
- Medical Dietetics and Health Sciences, The Ohio State University College of Medicine, Columbus, OH
| | - Emily Hill
- Medical Dietetics and Health Sciences, The Ohio State University College of Medicine, Columbus, OH
| | - Kay Wolf
- Medical Dietetics and Health Sciences, The Ohio State University College of Medicine, Columbus, OH
| | - Colleen Spees
- Medical Dietetics and Health Sciences, The Ohio State University College of Medicine, Columbus, OH; Comprehensive Cancer Center, The Ohio State University, Columbus, OH.
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Song J, Karlsten M, Yamal JM, Basen-Engquist K. Health-related quality of life factors associated with completion of a study delivering lifestyle exercise intervention for endometrial cancer survivors. Qual Life Res 2017; 26:1263-1271. [PMID: 27796772 PMCID: PMC8409014 DOI: 10.1007/s11136-016-1441-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 10/20/2022]
Abstract
PURPOSE The aim of this study was to examine associations between participants' quality of life and study completion. This is a secondary analysis of an exercise intervention study for endometrial cancer survivors. METHODS We considered data for one-hundred post-treatment endometrial cancer survivors from a single-arm, six-month longitudinal exercise study. Participants received a home-based intervention consisting of exercise recommendations and telephone counseling sessions to encourage adherence. In addition to monitoring adherence to physical exercise recommendations, participants completed multiple psychological assessments, including health-related quality of life. Associations between study completion and health-related quality of life factors were analyzed using generalized additive models, to allow for possibly nonlinear associations. RESULTS Measures of bodily pain contributed to the odds of study completion in a nonlinear way (p = 0.025), suggesting that improvements in these factors were associated with study completion, especially for individuals reporting very high levels of pain. In addition, association between participants' levels of anxiety and study completion showed an inverse U-shaped relation: Whereas increase in anxiety was associated with higher odds of completion for individuals with low anxiety score (0-4), increase in anxiety contributed to lower odds of study completion for individuals with anxiety scores of approximately 5-10 (p = 0.035). CONCLUSIONS Results from this study indicate that baseline health-related quality of life factors may be associated with study completion in exercise intervention studies. In order to increase study completion rates, individually tailored study strategies may be prepared based on the baseline quality of life responses.
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Affiliation(s)
- Jaejoon Song
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler St., Floor 4, FCT4.5009, Houston, TX, 77030, USA.
- Department of Biostatistics, School of Public Health, University of Texas Health Science Center, Houston, TX, USA.
| | - Melissa Karlsten
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - José-Miguel Yamal
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Pickens Academic Tower, 1400 Pressler St., Floor 4, FCT4.5009, Houston, TX, 77030, USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Sari S, Muller AE, Roessler KK. Exercising alcohol patients don't lack motivation but struggle with structures, emotions and social context - a qualitative dropout study. BMC FAMILY PRACTICE 2017; 18:45. [PMID: 28330457 PMCID: PMC5363022 DOI: 10.1186/s12875-017-0606-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 02/28/2017] [Indexed: 12/17/2022]
Abstract
BACKGROUND Exercise is an important component of a healthy lifestyle, the development of which is a relapse prevention strategy for those with alcohol use disorder. However, it is a challenge to create exercise interventions with a persistent behavioural change. The aim of this qualitative study was to investigate perceived barriers to participation in an exercise intervention among alcohol use disorder patients, who dropped out of the intervention program. Furthermore, this study aims to propose possibilities for a better practice of future intervention studies based on the participants' experiences and suggestions. METHODS Qualitative interviews with 17 patients who dropped out from an exercise intervention in an outpatient treatment centre about their experiences and reasons for dropping out. Social cognitive theory informed the development of the interview guides and systematic text condensation was used for analysis. RESULTS Analysis revealed three central themes: 1) Structural barriers described as the type of exercise and the timing of the intervention, 2) Social barriers described as need for accountability and unsupportive relations, and 3) Emotional barriers described as fear, guilt and shame, and negative affect of the intervention on long term. CONCLUSIONS Future exercise interventions should include socio-psychological support during the first weeks, begin shortly after treatment initiation instead of concurrently, and focus on garnering social support for participants in both the intervention context and among their existing network in order to best reduce barriers to participation. TRIAL REGISTRATION This study was retrospectively registered at Current Controlled Trials ISRCTN74889852 on 11 July 2013.
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Affiliation(s)
- Sengül Sari
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.,Unit of Clinical Alcohol Research (UCAR), Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Ashley Elizabeth Muller
- Norwegian Centre for Addiction Research (SERAF), Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kirsten K Roessler
- Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark.
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36
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Zhaoyang R, Martire LM, Sliwinski MJ. Morning self-efficacy predicts physical activity throughout the day in knee osteoarthritis. Health Psychol 2017; 36:568-576. [PMID: 28277696 DOI: 10.1037/hea0000479] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the within-day and cross-day prospective effects of knee osteoarthritis (OA) patients' self-efficacy to engage in physical activity despite the pain on their subsequent physical activity assessed objectively in their natural environment. METHOD Over 22 days, 135 older adults with knee OA reported their morning self-efficacy for being physically active throughout the day using a handheld computer and wore an accelerometer to measure moderate activity and steps. RESULTS Morning self-efficacy had a significant positive effect on steps and moderate-intensity activity throughout that day, above and beyond the effects of demographic background and other psychosocial factors as well as spouses' support and social control. The lagged effect of morning self-efficacy on the next day's physical activity and the reciprocal lagged effect of physical activity on the next day's self-efficacy were not significant. Positive between-person effects of self-efficacy on physical activity were found. CONCLUSIONS Future research should aim to better understand the mechanisms underlying fluctuations in patients' daily self-efficacy, and target patients' daily self-efficacy as a modifiable psychological mechanism for promoting physical activity. (PsycINFO Database Record
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Armbruster SD, Song J, Bradford A, Carmack CL, Lu KH, Basen-Engquist KM. Sexual health of endometrial cancer survivors before and after a physical activity intervention: A retrospective cohort analysis. Gynecol Oncol 2016; 143:589-595. [PMID: 27678296 PMCID: PMC5116408 DOI: 10.1016/j.ygyno.2016.09.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 09/12/2016] [Accepted: 09/14/2016] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Sexual dysfunction is common in endometrial cancer survivors (ECS). Our group previously tested a six-month exercise intervention in ECS. We performed a secondary analysis to determine intervention's impact on sexual health. METHODS We studied 100 post-treatment Stage I-IIIa sedentary ECS who participated in a non-controlled, single-arm, home-based exercise intervention utilizing telephone counseling, printed material, and pedometers. Quality-of-life and physical activity measures were collected at baseline and six months. Sexual function (SF) and sexual interest (SI) scores were extracted from the QLACS questionnaire. RESULTS Baseline SF and SI were lower in survivors with less than a four-year college degree (P<0.001). Baseline SI was higher in survivors who were married or living with a significant other (P=0.012). No significant differences in SF or SI were observed based on obesity status, race, time since diagnosis, or treatment type. Post-intervention, mean SF score improved (P=0.002), 51% of participants had improved SI, and 43% had improved SF. When controlled for age and time since diagnosis, a one-hour increase in weekly physical activity was associated with a 6.5% increased likelihood of improved SI (P=0.04). Increased physical activity was not associated with improved SF. CONCLUSIONS Although causation cannot be determined in this study, the correlation between receipt of an exercise intervention and improved sexual health for ECS is a novel finding. This finding suggests a role for physical activity as a strategy to improve the sexual health of ECS, which our group is examining in a larger prospective study.
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Affiliation(s)
- Shannon D Armbruster
- Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
| | - Jaejoon Song
- Departments of Biostatistics, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Andrea Bradford
- Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Cindy L Carmack
- Departments of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Karen H Lu
- Departments of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
| | - Karen M Basen-Engquist
- Departments of Behavioral Science, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA
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Atienza AA, Serrano KJ, Riley WT, Moser RP, Klein WM. Advancing Cancer Prevention and Behavior Theory in the Era of Big Data. J Cancer Prev 2016; 21:201-206. [PMID: 27722147 PMCID: PMC5051595 DOI: 10.15430/jcp.2016.21.3.201] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 08/22/2016] [Accepted: 08/22/2016] [Indexed: 11/23/2022] Open
Abstract
The era of “Big Data” presents opportunities to substantively address cancer prevention and control issues by improving health behaviors and refining theoretical models designed to understand and intervene in those behaviors. Yet, the terms “model” and “Big Data” have been used rather loosely, and clarification of these terms is required to advance the science in this area. The objectives of this paper are to discuss conceptual definitions of the terms “model” and “Big Data”, as well as examine the promises and challenges of Big Data to advance cancer prevention and control research using behavioral theories. Specific recommendations for harnessing Big Data for cancer prevention and control are offered.
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Endrighi R, Basen-Engquist K, Szeto E, Perkins H, Baum G, Cox-Martin M, MacIntyre JM, Waters AJ. Self-reported and automatic cognitions are associated with exercise behavior in cancer survivors. Health Psychol 2016; 35:824-8. [PMID: 27505202 DOI: 10.1037/hea0000385] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Physical activity is beneficial for cancer survivors, but exercise participation is low in this population. It is therefore important to understand the psychological factors underlying exercise uptake so that more effective interventions can be developed. Social-cognitive theory constructs such as outcome expectancies predict exercise behavior, but self-report measures have several limitations. We examined the associations between implicit (automatic) cognitions and exercise behavior and self-efficacy in endometrial cancer survivors. METHOD This was a longitudinal study to examine predictors of exercise behavior in female endometrial cancer survivors who all received an exercise intervention. Participants (N = 100, mean age of 57.0) completed questionnaires to assess self-report exercise-related measures (outcome expectancy and attitudes about and identification with exercise) and reaction time (RT) tasks to assess implicit exercise cognitions (expectancy accessibility, implicit attitudes about exercise, and implicit self-identification with exercise) at baseline and at 2, 4, and 6 months at follow-up. Exercise behavior was measured using accelerometers and self-report. Data were analyzed using linear mixed models. RESULTS Expectancy accessibility was associated with exercise duration independent of the corresponding self-report measure. Exercise implicit attitudes and self-identification were prospectively associated with exercise self-efficacy only after adjustment for the corresponding self-report measures and baseline self-efficacy. Self-report measures were also associated with study outcomes. CONCLUSIONS Both self-reported cognitions and implicit cognitions may be useful to identify individuals at risk of failing to exercise. Individuals so identified might be provided with a different or more intensive intervention. The data also suggest cognitive targets for intervention. (PsycINFO Database Record
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Affiliation(s)
| | | | - Edwin Szeto
- Department of Medical and Clinical Psychology
| | | | - George Baum
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center
| | - Matthew Cox-Martin
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center
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Pu J, Hou H, Ma R. Direct and Indirect Effects of Self-efficacy on Depression: The Mediating Role of Dispositional Optimism. CURRENT PSYCHOLOGY 2016. [DOI: 10.1007/s12144-016-9429-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Gill E, Goldenberg M, Starnes H, Phelan S. Outdoor adventure therapy to increase physical activity in young adult cancer survivors. J Psychosoc Oncol 2016; 34:184-99. [PMID: 26939742 DOI: 10.1080/07347332.2016.1157718] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Despite the health benefits of physical activity (PA), limited research has examined PA interventions in young adult cancer survivors (YACS). This study used a two-group parallel design to examine the effects of a 7-day outdoor adventure camp vs. waitlist control on PA levels among YACS. Secondary aims examined effects on sedentary behavior and PA correlates. METHODS 50 camp and 66 control participants were assessed at baseline, end of camp, and 3 months. RESULTS Intent-to-treat analyses indicated that, relative to baseline, camp participants had significantly (p = 0.0001) greater increases in PA than controls during camp (+577 vs. +9 minutes/week) and 3 months post-camp (+133 vs. -75 minutes/week, p = 0.001). Camp participants also reported significantly greater improvements in TV viewing (p = 0.001), hours sitting (p = 0.001), PA variety (p = 0.0001), barriers to PA (p = 0.007), and enjoyment of structured activities (p = 0.04) during camp but not 3 months post-camp. CONCLUSION A week-long outdoor adventure therapy camp increased PA levels during camp and 3 months after camp termination, although effects were attenuated over time. IMPLICATIONS FOR CANCER SURVIVORS Outdoor adventure therapy camps may increase PA and its correlates in YACS, but future research should explore methods to promote sustained PA after camp termination.
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Affiliation(s)
- Elizabeth Gill
- a Kinesiology Department , California Polytechnic State University , San Luis Obispo , CA , USA
| | - Marni Goldenberg
- b Recreation, Parks, and Tourism Administration Department , California Polytechnic State University , San Luis Obispo , CA , USA
| | - Heather Starnes
- a Kinesiology Department , California Polytechnic State University , San Luis Obispo , CA , USA
| | - Suzanne Phelan
- a Kinesiology Department , California Polytechnic State University , San Luis Obispo , CA , USA
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Klusmann V, Musculus L, Sproesser G, Renner B. Fulfilled Emotional Outcome Expectancies Enable Successful Adoption and Maintenance of Physical Activity. Front Psychol 2016; 6:1990. [PMID: 26779095 PMCID: PMC4701923 DOI: 10.3389/fpsyg.2015.01990] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 10/05/2015] [Indexed: 11/13/2022] Open
Abstract
Although outcome expectancies are regarded as key determinants of health behavior change, studies on the role of their degree of fulfillment in long-term activity changes are lacking. This study investigated the impact of (un-)fulfilled outcome expectancies (OE) on (un-)successful attempts to increase physical activity, assuming that disengagement is the logical consequence of perceived futility. Participants (n = 138) of a longitudinal cohort study with three measurement waves were assigned to eight different groups according to a staging algorithm of their self-reported, 1-year-long physical activity behavior track. Stages were validated by objective changes in objective fitness, e.g., Physical Working Capacity (PWC). Social cognitive variables, self-efficacy, proximal and distal OE, and fulfillment of OE, were assessed via self-report. Discriminant analyses revealed that OE fulfillment was the predominant predictor for differentiating between successful and unsuccessful behavior change. Amongst OE, proximal OE concerning emotional rewards, in conjunction with action self-efficacy, further improved discriminatory power. OE adjustment warranting hedonic rewards appears to be a crucial mechanism as it facilitates long-term changes through interventions aimed at increasing physical activity rates. Theoretical models might benefit by including the concept of fulfilled expectations acting in terms of feedback loops between volitional and motivational processes.
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Affiliation(s)
- Verena Klusmann
- Department of Psychology, Psychological Assessment and Health Psychology, University of Konstanz Konstanz, Germany
| | - Lisa Musculus
- Department of Psychology, Psychological Assessment and Health Psychology, University of KonstanzKonstanz, Germany; Department of Psychology, German Sport University CologneCologne, Germany
| | - Gudrun Sproesser
- Department of Psychology, Psychological Assessment and Health Psychology, University of Konstanz Konstanz, Germany
| | - Britta Renner
- Department of Psychology, Psychological Assessment and Health Psychology, University of Konstanz Konstanz, Germany
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Hughes DC, Tirado-Gomez M, Vallejo L, Gonzalez V, Treviño-Whitaker RA, Villanueva G, Basen-Engquist K. Comparing determinants of physical activity in Puerto Rican, Mexican-American, and non-Hispanic white breast cancer survivors. SPRINGERPLUS 2015; 4:416. [PMID: 26295015 PMCID: PMC4532692 DOI: 10.1186/s40064-015-1190-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Accepted: 07/29/2015] [Indexed: 12/11/2022]
Abstract
Purpose Physical activity (PA) has a myriad of benefits for breast cancer survivors, including a reduced risk of cancer recurrence. Latinas are less physically active than are women in the general population and little is known about Latina breast cancer survivors’ levels of PA or their beliefs related to PA. We conducted a survey of 50 Puerto Rican (PR), 50 Mexican-American (MA) and 50 non-Hispanic white (NHW) breast cancer survivors to investigate similarities and differences in PA and social cognitive theory (SCT) constructs associated with PA. Methods We collected information on current PA using the Godin Leisure Time Exercise Questionnaire (GLTEQ); comorbidities; anthropometric measures of body mass index [BMI (kg/m2)] and waist-to-hip (W:H) ratio; and SCT measures, including exercise self-efficacy, exercise barriers self-efficacy, modeling and social support from friends and family. Descriptive statistics, one-way analysis of variance of differences between groups and regression models of the predictors of PA were performed. Results Survivors from the three groups were similar in age (M = 56.8, SD = 11.0), BMI (M = 29.0, SD = 5.7) and co-morbidity (M = 2.09, SD = 1.69). Survivors differed in PA (p < 0.001), self-efficacy (p = 0.05), modeling (p = 0.03) and social support from family (p = 0.05). Social support from family member and exercise barriers self-efficacy were predictors of PA. Conclusions Consistent with published studies, Hispanic breast cancer survivors self-report that they are less physically active than are non-Hispanic whites. SCT variables associated with PA differ among Hispanic subgroups and non-Hispanic whites. Further research is warranted in order to understand determinants of physical activity for specific ethnic breast cancer survivors.
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Affiliation(s)
- Daniel C Hughes
- Institute for Health Promotion Research, The University of Texas Health Science Center at San Antonio, 7411 John Smith Drive, Suite 1000, San Antonio, TX 78229 USA
| | | | - Liliana Vallejo
- Department of Behavioral Science, The University of Texas M.D. Anderson Cancer Center, Houston, USA
| | - Velda Gonzalez
- The University of Puerto Rico Cancer Center, San Juan, Puerto Rico
| | - Rose A Treviño-Whitaker
- Institute for Health Promotion Research, The University of Texas Health Science Center at San Antonio, 7411 John Smith Drive, Suite 1000, San Antonio, TX 78229 USA
| | - Gabriela Villanueva
- Institute for Health Promotion Research, The University of Texas Health Science Center at San Antonio, 7411 John Smith Drive, Suite 1000, San Antonio, TX 78229 USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas M.D. Anderson Cancer Center, Houston, USA
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Feasibility of a lifestyle intervention for overweight/obese endometrial and breast cancer survivors using an interactive mobile application. Gynecol Oncol 2015; 137:508-15. [PMID: 25681782 DOI: 10.1016/j.ygyno.2014.12.025] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Revised: 12/19/2014] [Accepted: 12/20/2014] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The study aimed to assess a one-month lifestyle intervention delivered via a web- and mobile-based weight-loss application (app) (LoseIt!) using a healthcare-provider interface. METHODS Early-stage overweight/obese (body mass index [BMI]≥25kg/m(2)) cancer survivors (CS) diagnosed in the past three years, and without recurrent disease were enrolled and received exercise and nutrition counseling using the LoseIt! app. Entry and exit quality of life (FACT-G) and Weight Efficacy Lifestyle Questionnaire (WEL) measuring self-efficacy were measured along with anthropometrics, daily food intake, and physical activity (PA) using the app. RESULTS Mean participant age was 58.4±10.3years (n=50). Significant reductions (p<0.0006) in anthropometrics were noted between pre- and post-intervention weight (105.0±21.8kg versus 98.6±22.5kg); BMI (34.9±8.7kg/m(2) versus 33.9±8.4kg/m(2)); and waist circumference (108.1±14.9cm versus 103.7±15.1cm). A significant improvement in pre- and post-intervention total WEL score was noted (99.38±41.8 versus 120.19±47.1, p=0.043). No significant differences were noted in FACT-G, macronutrient consumption, and PA patterns. CONCLUSION These results indicate that a lifestyle intervention delivered via a web- and mobile-based weight-loss app is a feasible option by which to elicit short-term reductions in weight. Though these results parallel the recent survivors of uterine cancer empowered by exercise and healthy diet (SUCCEED) trial, it is notable that they were achieved without encumbering significant cost and barrier-access issues (i.e. time, transportation, weather, parking, etc.).
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Cox M, Carmack C, Hughes D, Baum G, Brown J, Jhingran A, Lu K, Basen-Engquist K. Antecedents and mediators of physical activity in endometrial cancer survivors: Increasing physical activity through steps to health. Health Psychol 2015; 34:1022-32. [PMID: 25642840 DOI: 10.1037/hea0000188] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Research has shown that physical activity (PA) has a positive effect on cancer survivors, including improving quality of life, improving physical fitness, and decreasing risk for cancer recurrence in some cancer types. Theory-based intervention approaches have identified self-efficacy as a potential mediator of PA intervention. This study examines the temporal relationships at 4 time points (T1-T4) between several social-cognitive theory constructs and PA among a group of endometrial cancer survivors receiving PA intervention. METHOD A sample of 98 sedentary women who were at least 6 months posttreatment for endometrial cancer were given interventions to increase their PA. We tested whether modeling, physiological somatic sensations, and social support at previous time points predicted self-efficacy at later time points, which in turn would predict PA at later time points. RESULTS Results indicated that, as physiological somatic sensations at T2 decreased, self-efficacy at T3 increased, which led to an increase in PA at T4. This suggests that self-efficacy is a significant mediator between physiological somatic sensations and PA. Exploratory follow-up models suggest that model fit can be improved with the addition of contemporaneous effects between self-efficacy and PA at T3 and T4, changing the timing of the mediational relationships. CONCLUSION Physiological somatic sensations appear to be an important construct to target to increase PA in this population. Self-efficacy appeared to mediate the relationship between physiological somatic sensations and PA, but the timing of this relationship requires further study. (PsycINFO Database Record
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Affiliation(s)
- Matthew Cox
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center
| | - Cindy Carmack
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center
| | - Daniel Hughes
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center
| | - George Baum
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center
| | - Jubilee Brown
- Department of Gynecological Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center
| | - Anuja Jhingran
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center
| | - Karen Lu
- Department of Gynecological Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center
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Patients' Outcome Expectations Matter in Psychological Interventions for Patients with Diabetes and Comorbid Depressive Symptoms. COGNITIVE THERAPY AND RESEARCH 2015; 39:307-317. [PMID: 25983355 PMCID: PMC4424270 DOI: 10.1007/s10608-014-9667-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study examined whether patients’ expectations of treatment outcome predict treatment completion, homework compliance, and depressive symptom improvement in cognitive behavior therapy (CBT) and mindfulness-based cognitive therapy (MBCT). Study participants were patients with diabetes and comorbid depressive symptoms who were randomized to 8 sessions of either CBT (n = 45) or MBCT (n = 46), both individually delivered. The results showed that high outcome expectations were predictive of post-treatment depressive symptoms in CBT and MBCT, but not of early and mid-treatment symptoms. Patients’ outcome expectations predicted treatment completion in CBT and MBCT as well as homework compliance in MBCT. Homework compliance did not mediate the association between patients’ outcome expectations and post-treatment depressive symptom improvement. The findings do not support the hypothesis that patients’ expectations have an immediate impact on patients’ mental state and partially support the notion that patients are less involved in treatment when they hold low expectations for improvement.
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Basen-Engquist K, Carmack C, Brown J, Jhingran A, Baum G, Song J, Scruggs S, Swartz MC, Cox MG, Lu KH. Response to an exercise intervention after endometrial cancer: differences between obese and non-obese survivors. Gynecol Oncol 2014; 133:48-55. [PMID: 24680591 PMCID: PMC3979927 DOI: 10.1016/j.ygyno.2014.01.025] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 01/15/2014] [Accepted: 01/16/2014] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The objective of this paper is to describe baseline differences between obese and non-obese endometrial cancer survivor in anthropometrics, exercise behavior, fitness, heart rate and blood pressure, and quality of life, and to analyze whether the effect of a home-based exercise intervention on these outcomes differed for obese and non-obese participants. METHODS One hundred post-treatment Stage I-IIIa endometrial cancer survivors participated in a single arm 6month study in which they received a home-based exercise intervention. Cardiorespiratory fitness, anthropometrics, and exercise behavior were measured every two months, and quality of life (QOL) and psychological distress were measured at baseline and 6months. RESULTS Adjusting for potential confounders, at baseline obese survivors had poorer cardiorespiratory fitness (p=.002), higher systolic blood pressure (p=.018), and lower physical functioning (p<.001) and ratings of general health (p=.002), and more pain (p=.037) and somatization (.002). Significant improvements were seen in exercise behavior, resting heart rate, systolic blood pressure, and multiple QOL domains over the course of the intervention. Obese survivors had less improvement in exercise behavior and cardiorespiratory fitness than non-obese survivors, but there were no differences with regard to improvements in QOL and stress. CONCLUSIONS Home based exercise interventions are beneficial to endometrial cancer survivors, including those whose BMI is in the obese range. While obese survivors have lower levels of physical activity and fitness, they experienced similar activity, fitness, quality of life and mental health benefits. Exercise should be encouraged in endometrial cancer survivors, including those who are obese.
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Affiliation(s)
- K Basen-Engquist
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, USA.
| | - C Carmack
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, USA
| | - J Brown
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, USA
| | - A Jhingran
- Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, USA
| | - G Baum
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, USA
| | - J Song
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, USA
| | - S Scruggs
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, USA
| | - M C Swartz
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, USA
| | - M G Cox
- Department of Behavioral Science, University of Texas MD Anderson Cancer Center, USA
| | - K H Lu
- Department of Gynecologic Oncology and Reproductive Medicine, University of Texas MD Anderson Cancer Center, USA
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McCarroll ML, Armbruster S, Frasure HE, Gothard MD, Gil KM, Kavanagh MB, Waggoner S, von Gruenigen VE. Self-efficacy, quality of life, and weight loss in overweight/obese endometrial cancer survivors (SUCCEED): a randomized controlled trial. Gynecol Oncol 2013; 132:397-402. [PMID: 24369301 DOI: 10.1016/j.ygyno.2013.12.023] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Revised: 12/11/2013] [Accepted: 12/15/2013] [Indexed: 12/12/2022]
Abstract
OBJECTIVE More patient-centered programming is essential for endometrial cancer (EC) survivors needing to lose weight to reduce cardiovascular disease risk (CVD). The purpose of this study was to improve self-efficacy (SE) and quality of life (QOL) using a lifestyle intervention program designed for weight loss. METHODS Overweight and obese early-stage EC survivors, n = 75, were randomized into two groups: 1) Survivors of Uterine Cancer Empowered by Exercise and Healthy Diet (SUCCEED), a six-month lifestyle intervention or 2) a usual care group (UC). Participants completed the Weight Efficacy Lifestyle Questionnaire (WEL) to assess SE and the Functional Assessment of Cancer Therapy-General (FACT-G) to measure QOL, and their body mass index (BMI) was calculated at baseline, 3, 6, and 12 months. Mixed, repeated-measures ANCOVA models with baseline covariates were employed using SPSS 20.0. RESULTS Positive effects in every WEL domain, including the total score, were statistically significant in the SUCCEED group versus the UC group. A linear regression model demonstrated that, if BMI decreased by 1 unit, the total WEL score increased by 4.49 points. Significant negative correlations were found in the total WEL score and a change in BMI of R = -0.356 (p = 0.006). Between-group differences in the FACT-G were significant from baseline in the fatigue domain at three months (p = .008) and in the physical domain at six months (p = .048). No other significant differences were found. CONCLUSION Overall, this study shows promise for targeted interventions to help improve SE, thus improving BMI.
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Affiliation(s)
| | | | - H E Frasure
- Department of Obstetrics and Gynecology, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
| | | | - K M Gil
- Summa Health System, Akron, OH, USA
| | - M B Kavanagh
- Department of Nutrition, Case Western Reserve University, Cleveland, OH, USA
| | - S Waggoner
- Department of Obstetrics and Gynecology, University Hospitals, Case Western Reserve University, Cleveland, OH, USA
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