Most breast cancer survivors do not engage in regular physical activity (PA). Our piloted PA behavior change intervention for breast cancer survivors significantly improved PA and health outcomes post-intervention. Testing in additional sites with longer follow-up is warranted to confirm program effectiveness short and longer term. Importantly, the pilot intervention resulted in changes in PA and social cognitive theory constructs, enhancing our potential for testing mechanisms mediating PA behavior change. Therefore, we propose a multi- center, randomized controlled trial enrolling 256 breast cancer survivors with the following study aims: Primary study aim: To examine intervention effectiveness, the primary study aim is to compare the effects of the BEAT Cancer PA behavior change intervention to usual care on short and longer term PA adherence among breast cancer survivors. We hypothesize that, compared with usual care, the intervention will result in a significant increase in PA adherence post-intervention that will be maintained 3 and 9 months post- intervention. Secondary study aim #1: To better understand the mechanisms of PA behavior change, secondary study aim #1 is to compare the effects of the BEAT Cancer PA behavior change intervention to usual care on social cognitive factors and examine if such changes mediate PA behavior change. We hypothesize that, compared with usual care, the intervention will result in significant improvements in social cognitive factors targeted by the intervention. We also hypothesize that social cognitive factors will mediate the intervention effect on PA with selected factors mediating the intervention effect on self-efficacy and the effect of self-efficacy on PA. Secondary study aim #2: Although the primary focus of this proposal is to achieve and understand PA behavior change, we also aim to compare the short and longer term health effects of the BEAT Cancer PA behavior change intervention when compared with usual care. We hypothesize that, compared with usual care, the intervention will result in significant improvements in fitness, muscle strength, waist-to-hip ratio, quality of life, fatigue, sleep quality, and joint dysfunction. Outcome measures obtained at baseline, 3 months (i.e., immediately post-intervention), 6 months, and 12 months will include accelerometer (PA and sleep), survey (social cognitive factors, quality of life, fatigue, perceived sleep, and joint dysfunction), submaximal treadmill test (fitness), dynamometer (muscle strength), and waist-to-hip ratio. The study aims will be analyzed with mixed-model analysis of variance (ANOVA) with the secondary study aim #1 also utilizing multivariate analysis of variance (MANOVA) and Freedman- Schatzkin difference-in-coefficients test of mediation. Identifying the effects and underlying mechanisms of PA behavior change interventions will facilitate translation to community settings for improving the health and well- being of breast cancer survivors.

Public Health Relevance

It is important to develop programs that successfully assist breast cancer survivors in adapting and maintaining physically active lifestyles. Learning why such programs are able to help survivors exercise more regularly and identifying the health benefits that can be expected from these programs will guide program refinement and translation to clinical and community settings. Such information is expected to improve the health and quality of life while possibly reducing fatigue and risk of cancer recurrence in breast cancer survivors.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project--Cooperative Agreements (U01)
Project #
3R01CA136859-05S1
Application #
8742186
Study Section
Behavioral Medicine, Interventions and Outcomes Study Section (BMIO)
Program Officer
Patrick, Heather A
Project Start
2009-06-10
Project End
2015-04-30
Budget Start
2013-09-30
Budget End
2014-04-30
Support Year
5
Fiscal Year
2013
Total Cost
$943,338
Indirect Cost
$187,160
Name
University of Alabama Birmingham
Department
Nutrition
Type
Schools of Allied Health Profes
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Carter, Stephen J; Hunter, Gary R; McAuley, Edward et al. (2016) Lower rate-pressure product during submaximal walking: a link to fatigue improvement following a physical activity intervention among breast cancer survivors. J Cancer Surviv 10:927-34
Rogers, Laura Q; Courneya, Kerry S; Carter, Stephen J et al. (2016) Effects of a multicomponent physical activity behavior change intervention on breast cancer survivor health status outcomes in a randomized controlled trial. Breast Cancer Res Treat 159:283-91
Rogers, Laura Q; Courneya, Kerry S; Anton, Phillip M et al. (2016) Social Cognitive Constructs Did Not Mediate the BEAT Cancer Intervention Effects on Objective Physical Activity Behavior Based on Multivariable Path Analysis. Ann Behav Med :
Rogers, Laura Q; Courneya, Kerry S; Anton, Philip M et al. (2015) Effects of the BEAT Cancer physical activity behavior change intervention on physical activity, aerobic fitness, and quality of life in breast cancer survivors: a multicenter randomized controlled trial. Breast Cancer Res Treat 149:109-19
Olson, Erin A; Mullen, Sean P; Rogers, Laura Q et al. (2014) Meeting physical activity guidelines in rural breast cancer survivors. Am J Health Behav 38:890-9
Rogers, Laura Q; Fogleman, Amanda; Trammell, Rita et al. (2013) Effects of a physical activity behavior change intervention on inflammation and related health outcomes in breast cancer survivors: pilot randomized trial. Integr Cancer Ther 12:323-35
Guest, D D; Evans, E M; Rogers, L Q (2013) Diet components associated with perceived fatigue in breast cancer survivors. Eur J Cancer Care (Engl) 22:51-9
Rogers, Laura Q; McAuley, Edward; Anton, Philip M et al. (2012) Better exercise adherence after treatment for cancer (BEAT Cancer) study: rationale, design, and methods. Contemp Clin Trials 33:124-37
Rogers, Laura Q; Markwell, Stephen J; Courneya, Kerry S et al. (2011) Physical activity type and intensity among rural breast cancer survivors: patterns and associations with fatigue and depressive symptoms. J Cancer Surviv 5:54-61
Rogers, Laura Q; Markwell, Stephen; Hopkins-Price, Patricia et al. (2011) Reduced barriers mediated physical activity maintenance among breast cancer survivors. J Sport Exerc Psychol 33:235-54

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