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The Promoting Activity in Cancer Survivors (PACES) trial: a multiphase optimization of strategy approach to increasing physical activity in breast cancer survivors.

ABSTRACT: BACKGROUND:Despite the significant, empirically supported benefits of physical activity, the majority of breast cancer survivors do not meet recommended guidelines for physical activity. A variety of effective strategies to increase physical activity in breast cancer survivors have been identified. However, it is unknown which of these strategies is most effective or how these strategies might be combined to optimize intervention effectiveness. METHODS:The proposed trial uses multiphase optimization strategy (MOST) to evaluate four evidence-based intervention strategies for increasing physical activity in breast cancer survivors. We will enroll 500 breast cancer survivors, age 18 and older, who are 3-months to 5 years post-treatment. Using a full-factorial design, participants will be randomized to receive a combination: 1) supervised exercise, 2) facility access, 3) self-monitoring, and 4) group-based active living counseling. The primary outcome, moderate-to-vigorous physical activity (MVPA) will be measured at baseline, 3 months, and 6 months using an Actigraph GT3X+. To evaluate intervention effects, a linear mixed-effects model will be conducted with MVPA as the outcome and with time (3 months and 6 months) as the within-subjects factor and intervention (i.e., supervised exercise, facility access, self-monitoring, and active living counseling) as the between subjects factor, along with all two-way interactions. DISCUSSION:The purpose of the PACES study is to evaluate multiple strategies for increasing physical activity in breast cancer survivors. Results of this study will provide in an optimized intervention for increasing physical activity in breast cancer survivors. TRIAL REGISTRATION:Clinicaltrials.gov Identifier: NCT03060941 . Registered February 23, 2017.

SUBMITTER: Rethorst CD

PROVIDER: S-EPMC6052597 | biostudies-literature | 2018 Jul

REPOSITORIES: biostudies-literature

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The Promoting Activity in Cancer Survivors (PACES) trial: a multiphase optimization of strategy approach to increasing physical activity in breast cancer survivors.

Rethorst Chad D CD Hamann Heidi A HA Carmody Thomas J TJ Sharp Kendall J KJ Argenbright Keith E KE Haley Barbara B BB Skinner Celette Sugg CS Trivedi Madhukar H MH

BMC cancer 20180718 1

<h4>Background</h4>Despite the significant, empirically supported benefits of physical activity, the majority of breast cancer survivors do not meet recommended guidelines for physical activity. A variety of effective strategies to increase physical activity in breast cancer survivors have been identified. However, it is unknown which of these strategies is most effective or how these strategies might be combined to optimize intervention effectiveness.<h4>Methods</h4>The proposed trial uses mult ...[more]

PMID: 30021554

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Project description:BackgroundPhysical activity (PA) is a safe and effective strategy to help mitigate health challenges associated with breast cancer (BC) survivorship. However, the majority of BC survivors are not meeting the minimum recommended PA (≥150 min of moderate to vigorous intensity). Project MOVE was developed as a model for increasing PA that combined a) Microgrants: funds ($2000) awarded to applicant groups to develop and implement a PA initiative and b) Financial incentives: a reward ($500) for increasing group PA. The purpose of this paper was to provide an exploratory analysis of effectiveness of Project MOVE on PA behavior, PA motivation, and quality of life (QoL) in female BC survivors. The differential outcomes between women meeting and not meeting PA guidelines were also investigated.MethodsThis pre-post test, preliminary trial included groups of adult (18+ years) self-identified female BC survivors, who were post-surgery and primary systemic chemo- and radiation therapy, and living in British Columbia, Canada. PA was assessed by accelerometry. PA motivation and QoL were assessed by self-report. Data were collected at baseline, 6-months, and 12-month time points. Repeated measures mixed ANOVAs were used to test changes in the main outcomes.ResultsA total of 10 groups were awarded microgrants between May 2015 and January 2016. Groups comprised of 8 to 12 women with a total of 87 participants. A statistically significant increase was found between time points on weekly moderate to vigorous PA (p = .012). This was mediated by a significant interaction between those meeting PA guidelines and those not meeting guidelines at baseline by time points (p = .004), with those not meeting guidelines at baseline showing the greatest increase in MVPA. A statistically significant difference across time points was found for intrinsic motivation (p = .02), physical functioning (p < .001), physical health limitations (p = .001), emotional health limitations (p = .023), social functioning (p = .001) and general health (p = .004).ConclusionThese results provide promising support for a unique approach to increasing PA among BC survivors by empowering women and optimizing PA experiences through the use of microgrants and financial incentives.Trial registrationClinicalTrials.gov NCT03548636 , Retrospectively registered June 7, 2018.

Dataset Information

The Promoting Activity in Cancer Survivors (PACES) trial: a multiphase optimization of strategy approach to increasing physical activity in breast cancer survivors.

Publications

The Promoting Activity in Cancer Survivors (PACES) trial: a multiphase optimization of strategy approach to increasing physical activity in breast cancer survivors.

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