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Breast Cancer Research and Treatment
Published in: Breast Cancer Research and Treatment 2/2015

01-01-2015 | Review

Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors

Authors: Shirley M. Bluethmann, Sally W. Vernon, Kelley Pettee Gabriel, Caitlin C. Murphy, L. Kay Bartholomew

Published in: Breast Cancer Research and Treatment | Issue 2/2015

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Abstract

Research has shown that recent post-treatment breast cancer survivors face significant challenges around physical activity as they transition to recovery. This review examined randomized controlled trials targeting physical activity behavior change in breast cancer survivors <5 years post-treatment and described (1) characteristics of interventions for breast cancer survivors as well as (2) effect size estimates for these studies. A systematic search was conducted following PRISMA guidelines with Medline, PubMed, PsycINFO, CINAHL, and Scopus databases. Data were abstracted for primary intervention strategies and other details (e.g., setting, duration, theory use). A subgroup analysis was conducted to assess intensity of exercise supervision/monitoring and intervention effectiveness. The search produced 14 unique behavior intervention trials from the US and abroad published 2005–2013. The mean sample size was 153 participants per study. All interventions included moderate-intensity activities plus various behavioral change strategies. Most interventions were partially or entirely home based. The overall standardized mean difference was 0.47 (0.23, 0.67) with p < 0.001. Most interventions were effective in producing short-term behavior changes in physical activity, but varied greatly relative to intervention strategies and intensity of supervision/monitoring. Highly structured interventions tended to produce larger behavior change effects overall, but many larger effect sizes came from interventions supported by phone counseling or e-mail. We observed that ‘more’ may not be better in terms of direct supervision/monitoring in physical activity behavior interventions. This may be important in exploring less resource-intensive options for effective behavior change strategies for recent post-treatment survivors.
Literature
1.
Hewitt M, Greenfield S, Stovall E (2005) From cancer patient to cancer survivor: lost in transition. National Academies Press, Washington
2.
Ganz PA (2009) Quality of care and cancer survivorship: the challenge of implementing the institute of medicine recommendations. J Oncol Pract 5:101–105PubMedCentralPubMedCrossRef
3.
Rock CL, Doyle C, Demark-Wahnefried W et al (2012) Nutrition and physical activity guidelines for cancer survivors. CA 62(4):242–274
4.
Physical Activity and Public Health (2007) Updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Circulation 116:1081–1093CrossRef
5.
6.
Schmitz KH, Holtzman J, Courneya KS et al (2005) Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev 14:1588–1595CrossRef
7.
McNeely ML, Campbell KL, Rowe BH et al (2006) Effects of exercise on breast cancer patients and survivors: a systematic review and meta-analysis. CMAJ 175:34–41PubMedCentralPubMedCrossRef
8.
Underwood JM, Townsend JS, Stewart SL et al (2012) Surveillance of demographic characteristics and health behaviors among adult cancer survivors: behavioral risk factor surveillance system, United States, 2009. US Department of Health and Human Services, Centers for Disease Control and Prevention
9.
Smith SG, Chagpar AB (2010) Adherence to physical activity guidelines in breast cancer survivors. Am Surg 76:962–965PubMed
10.
Sabiston CM, Brunet J (2012) Reviewing the benefits of physical activity during cancer survivorship. Am J Lifestyle Med 6:167–177CrossRef
11.
Speck RM, Courneya KS, Masse LC et al (2010) An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv 4:87–100PubMedCrossRef
12.
Schmitz K (2011) Physical activity and breast cancer survivorship. Recent Results Cancer Res 186:189–215PubMedCrossRef
13.
Ferrer RA, Huedo-Medina T, Johnson BT et al (2011) Exercise interventions for cancer survivors: a meta-analysis of quality of life outcomes. Ann Behav Med 41:32–47PubMedCentralPubMedCrossRef
14.
Alfano CM, Molfino A, Muscaritoli M (2013) Interventions to promote energy balance and cancer survivorship Interventions to promote energy balance and cancer survivorship: European and North American priorities for research and care. Cancer (0008543X) 119:2143–2150
15.
McNeely ML, Campbell K, Ospina M et al (2010) Exercise interventions for upper-limb dysfunction due to breast cancer treatment. Cochrane Database Syst Rev 6:005211
16.
Rabin C (2009) Promoting lifestyle change among cancer survivors: when is the teachable moment? Am J Lifestyle Med 3:369–378CrossRef
17.
Glanz K, Bishop DB (2010) The role of behavioral science theory in development and implementation of public health interventions. Annu Rev Public Health 31:399–418PubMedCrossRef
18.
Moher D, Liberati A, Tetzlaff J et al (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269PubMedCrossRef
19.
Lipsey MW, Wilson DB (2001) Practical meta-analysis. Sage Publications, Thousand Oaks
20.
Ligibel JA, Meyerhardt J, Pierce JP et al (2011) Impact of a telephone-based physical activity intervention upon exercise behaviors and fitness in cancer survivors enrolled in a cooperative group setting. Breast Cancer Res Treat 132:205–213PubMedCentralPubMedCrossRef
21.
Spark LC, Reeves MM, Fjeldsoe BS et al (2013) Physical activity and/or dietary interventions in breast cancer survivors: a systematic review of the maintenance of outcomes. J Cancer Surviv 7:74–82PubMedCrossRef
22.
Hedges LV (1982) Statistical methodology in meta-analysis. ERIC Clearinghouse, Princeton
23.
24.
25.
26.
27.
Kim SH, Shin MS, Lee HS et al (2011) Randomized pilot test of a simultaneous stage-matched exercise and diet intervention for breast cancer survivors. Oncol Nurs Forum 38:E97–E106PubMedCrossRef
28.
Greenlee HA, Crew KD, Mata JM et al (2013) A pilot randomized controlled trial of a commercial diet and exercise weight loss program in minority breast cancer survivors. Obesity 21:65–76PubMedCrossRef
29.
Holmes MD, Chen WY, Feskanich D et al (2005) Physical activity and survival after breast cancer diagnosis. JAMA 293:2479–2486PubMedCrossRef
30.
Hatchett A, Hallam JS, Ford MA (2013) Evaluation of a social cognitive theory-based email intervention designed to influence the physical activity of survivors of breast cancer. Psychooncology 22:829–836PubMedCrossRef
31.
Daley AJ, Crank H, Saxton JM et al (2007) Randomized trial of exercise therapy in women treated for breast cancer. J Clin Oncol 25:1713–1721PubMedCrossRef
32.
Rogers LQ, Hopkins-Price P, Vicari S et al (2009) A randomized trial to increase physical activity in breast cancer survivors. Med Sci Sports Exerc 41:935–946PubMedCrossRef
33.
Matthews CE, Wilcox S, Hanby CL et al (2007) Evaluation of a 12-week home-based walking intervention for breast cancer survivors. Support Care Cancer 15:203–211PubMedCrossRef
34.
Pinto BM, Frierson GM, Rabin C et al (2005) Home-based physical activity intervention for breast cancer patients. J Clin Oncol 23:3577–3587PubMedCrossRef
35.
Pinto BM, Papandonatos GD, Goldstein MG (2013) A randomized trial to promote physical activity among breast cancer patients. Health Psychol 32:616–626PubMedCrossRef
36.
Basen-Engquist K, Taylor CL, Rosenblum C et al (2006) Randomized pilot test of a lifestyle physical activity intervention for breast cancer survivors. Patient Educ Couns 64:225–234PubMedCrossRef
37.
Bloom JR, Stewart SL, D’Onofrio CN et al (2008) Addressing the needs of young breast cancer survivors at the 5 year milestone: can a short-term, low intensity intervention produce change? J Cancer Surviv 2:190–204PubMedCrossRef
38.
Irwin ML, Cadmus L, Alvarez-Reeves M et al (2008) Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial. Cancer 112:2593–2606PubMedCrossRef
39.
Saarto T, Penttinen HM, Sievanen H et al (2012) Effectiveness of a 12-month exercise program on physical performance and quality of life of breast cancer survivors. Anticancer Res 32:3875–3884PubMed
40.
Latka RN, Alvarez-Reeves M, Cadmus L et al (2009) Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: the Yale exercise and survivorship study. J Cancer Surviv 3:148–157PubMedCrossRef
41.
Vallance JK, Courneya KS, Plotnikoff RC et al (2007) Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol 25:2352–2359PubMedCrossRef
42.
Prochaska JO, Velicer WF (1997) The transtheoretical model of health behavior change. Am J Health Promot 12:38–48PubMedCrossRef
43.
44.
Hayden HA (2003) Validation of the telephone and in-person interview versions of the 7-Day PAR. Med Sci Sports Exerc 35:801–809CrossRef
45.
Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci (Journal canadien des sciences appliquees au sport) 10:141
46.
Stewart AL, Mills KM, King AC et al (2001) CHAMPS physical activity questionnaire for older adults: outcomes for interventions. Med Sci Sports Exerc 33:1126–1141PubMedCrossRef
47.
Murphy SL (2009) Review of physical activity measurement using accelerometers in older adults: considerations for research design and conduct. Prev Med 48:108–114PubMedCrossRef
48.
Ottenbacher AJ, Day RS, Taylor WC et al (2011) Exercise among breast and prostate cancer survivors-what are their barriers? J Cancer Surviv 5(4):413–419PubMedCentralPubMedCrossRef
49.
Rogers LQ, Vicari S, Courneya KS (2010) Lessons learned in the trenches: facilitating exercise adherence among breast cancer survivors in a group setting. Cancer Nurs 33:E10–E17PubMedCentralPubMedCrossRef
50.
Demark-Wahnefried W, Morey MC, Sloane R et al (2012) Reach out to enhance wellness home-based diet-exercise intervention promotes reproducible and sustainable long-term improvements in health behaviors, body weight, and physical functioning in older, overweight/obese cancer survivors. J Clin Oncol 30:2354–2361PubMedCentralPubMedCrossRef
51.
Ottenbacher AJ, Day RS, Taylor WC et al (2012) Long-term physical activity outcomes of home-based lifestyle interventions among breast and prostate cancer survivors. Support Care Cancer 20(10):2483–2489PubMedCentralPubMedCrossRef
52.
Spence RR, Heesch KC, Brown WJ (2010) Exercise and cancer rehabilitation: a systematic review. Cancer Treat Rev 36:185–194PubMedCrossRef
53.
54.
Eakin EG, Lawler SP, Vandelanotte C et al (2007) Telephone interventions for physical activity and dietary behavior change: a systematic review. Am J Prev Med 32:419–434PubMedCrossRef
55.
Goode AD, Reeves MM, Eakin EG (2012) Telephone-delivered interventions for physical activity and dietary behavior change: an updated systematic review. Am J Prev Med 42:81–88PubMedCrossRef
56.
Marcus BH, Williams DM, Dubbert PM et al (2006) Physical activity intervention studies: what we know and what we need to know: a scientific statement from the American Heart Association Council on nutrition, physical activity, and metabolism (Subcommittee on Physical Activity); council on cardiovascular disease in the young; and the interdisciplinary Working Group on Quality of Care and Outcomes Research. Circulation 114:2739–2752PubMedCrossRef
57.
Gustafson DH, McTavish FM, Stengle W et al (2005) Reducing the digital divide for low-income women with breast cancer: a feasibility study of a population-based intervention. J Health Commun 10:173–193PubMedCrossRef
58.
Penttinen H, Nikander R, Blomqvist C et al (2009) Recruitment of breast cancer survivors into a 12-month supervised exercise intervention is feasible. Contem Clin Trials 30:457–463CrossRef
59.
Nikander R, Sievanen H, Ojala K et al (2012) Effect of exercise on bone structural traits, physical performance and body composition in breast cancer patients—a 12-month RCT. J Musculoskelet Neuronal Interact 12:127–135PubMed
60.
61.
Daley AJ, Crank H, Mutrie N et al (2007) Determinants of adherence to exercise in women treated for breast cancer. Eur J Oncol Nurs 11:392–399PubMedCrossRef
62.
Vallance JK, Courneya KS, Plotnikoff RC et al (2008) Maintenance of physical activity in breast cancer survivors after a randomized trial. Med Sci Sports Exerc 40:173–180PubMedCrossRef
63.
Pinto BM, Rabin C, Papandonatos GD et al (2008) Maintenance of effects of a home-based physical activity program among breast cancer survivors. Support Care Cancer 16:1279–1289PubMedCentralPubMedCrossRef
64.
Rabin CS, Pinto BM, Trunzo JJ et al (2006) Physical activity among breast cancer survivors: regular exercisers vs participants in a physical activity intervention. Psychooncology 15:344–354PubMedCrossRef
65.
Demark-Wahnefried W, Aziz NM, Rowland JH et al (2005) Riding the crest of the teachable moment: promoting long-term health after the diagnosis of cancer. J Clin Oncol 23:5814–5830PubMedCentralPubMedCrossRef
66.
Bartholomew LK, Parcel GS, Kok G et al (2011) Planning health promotion programs: an intervention mapping approach. Jossey-Bass, San Francisco
67.
French SD, Green SE, O’Connor DA et al (2012) Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci 7:38PubMedCentralPubMedCrossRef
68.
Michie S, Prestwich A (2010) Are interventions theory-based? Development of a theory coding scheme. Health Psychol 29:1PubMedCrossRef
69.
White SM, McAuley E, Estabrooks PA et al (2009) Translating physical activity interventions for breast cancer survivors into practice: an evaluation of randomized controlled trials. Ann Behav Med 37:10–19PubMedCrossRef
70.
Troiano RP, Berrigan D, Dodd KW et al (2008) Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc 40:181PubMedCrossRef
71.
Sallis JF, Cervero RB, Ascher W et al (2006) An ecological approach to creating active living communities. Annu Rev Public Health 27:297–322PubMedCrossRef
72.
Weaver KE, Palmer N, Lu L et al (2013) Rural-urban differences in health behaviors and implications for health status among US cancer survivors. Cancer Causes Control 24:1481–1490PubMedCentralPubMedCrossRef
Metadata
Title
Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors
Authors
Shirley M. Bluethmann
Sally W. Vernon
Kelley Pettee Gabriel
Caitlin C. Murphy
L. Kay Bartholomew
Publication date
01-01-2015
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 2/2015
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-014-3255-5

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