Background The benefits of an active lifestyle after a breast cancer diagnosis are well recognized, but the majority of survivors are insufficiently active. The ACTIVATE Trial examined the efficacy of an intervention (use of the Garmin Vivofit 2 activity monitor coupled with a behavioral feedback and goal‐setting session and 5 telephone‐delivered health coaching sessions) to increase moderate to vigorous physical activity (MVPA) and reduce sedentary behavior in breast cancer survivors. Methods This randomized controlled trial recruited 83 inactive, postmenopausal women diagnosed with stage I‐III breast cancer who had completed primary treatment. Participants were randomly assigned to the intervention group or to the control group, and the intervention was delivered over a 12‐week period. MVPA and sedentary behavior were measured with Actigraph and activPAL accelerometers at baseline (T1) and at the end of the intervention (T2). Results Retention in the trial was high, with 80 (96%) of participants completing T2 data collection. At T2, there was a significant between‐group difference in MVPA (69 min/wk; 95% CI = 22‐116) favoring the intervention group. The trial resulted in a statistically significant decrease in both total sitting time and prolonged bouts (≥20 min) of sitting, with between‐group reductions of 37 min/d (95% CI = −72 to −2) and 42 min/d (95% CI = −83 to −2), respectively, favoring the intervention group. Conclusion Results from the ACTIVATE Trial suggest that the use of wearable technology presents an inexpensive and scalable opportunity to facilitate more active lifestyles for cancer survivors. Whether or not such wearable technology‐based interventions can create sustainable behavioral change should be the subject of future research.

WATs are perceived as useful and acceptable interventions by postmenopausal breast cancer survivors. Effective WAT interventions may benefit from taking advantage of the simple features of the trackers paired with other behavioural change techniques, such as specialist counselling, doctor monitoring and peer support, along with simple manual instructions.

Background: The ACTIVATE Trial examined the efficacy of a wearable-based intervention to increase physical activity and reduce sedentary behavior in breast cancer survivors. This paper examines the effects of the intervention on health-related quality of life (HRQoL) and fatigue at 12 weeks (T2; end of intervention) and 24 weeks (T3; follow-up).Methods: Inactive and postmenopausal women who had completed primary treatment for stage I-III breast cancer were randomized to intervention or waitlist control.Physical activity and sedentary behavior were measured by Actigraph and activPAL accelerometers at baseline (T1), end of the intervention (T2), and 12 weeks follow-up (T3). HRQoL and fatigue were measured using the Functional Assessment of Cancer Therapy-Breast (FACT-B) and the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue). Primary intervention effects were evaluated comparing intervention and waitlist group at T2 using repeated measures mixed effects models.Results: Overall, 83 women were randomized and trial retention was high (94%). A 4.6-point difference in fatigue score was observed between groups at T2 (95% CI:1.3, 7.8) indicating improvement in fatigue profiles in the intervention group. In within groups analyses, the intervention group reported a 5.1-point increase in fatigue from

BACKGROUND: High levels of sedentary behavior may negatively affect health outcomes in cancer survivors. A systematic review and meta-analysis was performed to clarify whether postdiagnosis sedentary behavior is related to survival, patient-reported outcomes, and anthropometric outcomes in cancer survivors. METHODS: The Ovid MEDLINE, EMBASE, CINAHL (The Cumulative Index to Nursing and Allied Health Literature), and SPORTDiscus databases were searched from study inception to June 2019. Studies of adults who had been diagnosed with cancer that examined the association between sedentary behavior and mortality, patient-reported outcomes (eg, fatigue, depression), or anthropometric outcomes (eg, body mass index, waist circumference) were eligible for inclusion. Meta-analyses were performed to estimate hazard ratios for the highest compared with the lowest levels of sedentary behavior for all-cause and colorectal cancer-specific mortality outcomes. The ROBINS-E (Risk of Bias in Nonrandomized Studies-of Exposures tool) and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system were used to assess the risk of bias and the strength of evidence, respectively. RESULTS: Thirty-three eligible publications from a total of 3569 identified articles were included in the review. A higher level of postdiagnosis sedentary behavior was associated with an increased risk of all-cause mortality (hazard ratio, 1.22; 95% CI, 1.06-1.41; heterogeneity [I 2 statistic], 33.8%) as well as colorectal cancer-specific mortality (hazard ratio, 1.53; 95% CI, 1.14-2.06; I 2 , 0%). No clear or consistent associations between sedentary behavior and patient-reported or anthropometric outcomes were identified. The risk of bias in individual studies ranged from moderate to serious, and the strength of evidence ranged from very low to low. CONCLUSIONS: Although avoiding high levels of sedentary behavior after a cancer diagnosis may improve survival, further research is required to help clarify whether the association is causal. Cancer 2020;126:861-869. is employed by the University of Wolverhampton as a lecturer and researcher in exercise physiology and has received transport and accommodation costs for presentations about the role of exercise in cancer populations at international conferences as well as research grants to study the effects of exercise on people with or at risk of developing chronic diseases. The remaining authors made no disclosures.

PurposeThe study purpose was to investigate the acceptability and utility of, and preference for, wearable activity trackers (WATs) amongst cancer survivors living in regional and remote areas of Western Australia.MethodsTwenty participants were recruited (Mean age = 63 years, SD = 13) to test two to three trackers from five available models (Fitbit Alta, Garmin Vivofit 2, Garmin Vivosmart, Polar loop 2 and Polar A300). Participants wore each device for two weeks, followed by a one-week washout period between devices. Interviews were conducted with participants to explore user perceptions and experiences. Interview transcripts were analysed using thematic analysis.ResultsFour main themes emerged: (i) Consciousness raising; (ii) Prompts and Feedback; (iii) Accuracy and registry of activities; and, (iv) WAT preferences and features.ConclusionsWATs were acceptable and useful to cancer survivors. WATs increased self-awareness of physical activity, provided real time feedback in relation to step goals, and reinforced progress and efforts towards goals. The aesthetics of the WATs were deemed crucial in determining preference and likelihood of use.Implications for cancer survivorsFuture interventions may do well to have two different WATs available for participants to choose from, according to activity preferences, aesthetic preferences, and display size.