Background: As an overlooked aspect of cancer, survivorship often begs the question of “what's next?” once treatment is complete. Physical activity following treatment has been shown to improve quality of life and decrease rates of recurrence. The MD Anderson Active Living After Cancer Program (ALAC) has recruited over 900 cancer survivors and caregivers since its establishment in 2013. This study seeks to examine how retention rates have changed since the transition to virtual classes due to the COVID-19 pandemic, and whether variables associated with retention differ between in person and virtual classes. Methods: A retrospective study of baseline surveys completed by participants (N=860) through Redcap was conducted, excluding those currently enrolled in ongoing ALAC classes. A chi-square test was performed to determine whether completion rates were significantly different between in person and virtual classes. A bivariate regression model was used to determine whether participant demographics varied between virtual and in person classes, based on insurance status and education level. A logistic regression was performed to investigate whether these factors were predictors of retention in either class. Results: Retention rates significantly differed between virtual (87.91%) and in person classes (77.20%); participants of virtual classes were two times as likely to complete the program compared to their in-person counterparts (P=0.00). Compared to in person classes, uninsured participants comprised a larger proportion of virtual classes, while privately and publicly insured participants comprised a smaller proportion (P=0.014). In both classes, participants who never received a high school diploma or GED constituted the most common education level. Having insurance and completion of some higher education were only weakly associated with retention. Conclusion: Given the success of ALAC since its creation, we are interested in expanding enrollment beyond MD Anderson Cancer Center. This study provides understanding of the benefits and limitations of virtual classes since the rise of COVID-19. Overall, greater retention rates demonstrate the utility of virtual classes. Maintaining a virtual aspect of future ALAC classes, such as a hybrid program, may help improve survivor outreach by identifying potentially overlooked groups. Citation Format: Kendahl Servino, Stacy Mitchell, Che Young Lee, Yue Liao, Karen Basen-Engquist. Predictors of retention rates in the Active Living After Cancer program at MD Anderson Cancer Center: A comparison of classes during and before COVID-19 [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-108.
e24034 Background: Active Living After Cancer (ALAC) is a 12-week evidence-based program funded by the Cancer Prevention and Research Institute of Texas (CPRIT) to provide physical activity and survivorship education to cancer survivors. Given the limited data evaluating the effects of physical activity educational programs in gynecologic cancer survivors, we aim to assess the effects of the ALAC intervention in this patient population. Methods: A retrospective analysis was performed on gynecologic cancer survivors who participated in ALAC from 2017 to 2021. The 12-week ALAC program included weekly meetings (in-person or virtual) led by a facilitator providing physical activity behavioral skills training, leading 10 minutes of exercise, and discussing topics related to cancer survivorship. Surveys and functional testing assessments were collected pre- and post-program which included: The Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) and 30-second sit-to-stand. A patient-reported outcomes survey was used to assess patient perceived benefits and program satisfaction. Results: Thirty-two patients participated in ALAC and 22 completed pre- and post-program assessments. The mean age of participants was 60.2 years (range 50.7-69.7 years) and mean number of classes attended was 8 (range 0-12 classes). Prior cancer diagnoses included 14 cervical, 11 uterine, and 7 ovarian cancers. A significant improvement was seen pre- and post-ALAC in moderate-intensity physical activity minutes (n = 17, 97 vs 252 minutes, p = 0.007) by GSLTPAQ and 30-second sit-to-stand test (n = 16, 12.3 vs 15.8 repetitions, p = 0.003) in our cohort. The post-ALAC patient reported outcome survey (n = 22) revealed improvement in emotional well-being (90%), physical well-being (91%), physical activity level (100%), comfort speaking openly in a group (85%), and willingness to discuss their cancer journey (66%). Overall, 95.3% of participants were satisfied with the ALAC program and 100% of participants would recommend the ALAC program to other cancer survivors. Conclusions: Educational physical activity-based programs like ALAC improve physical functioning and moderate-intensity physical activity in gynecologic cancer survivors. Further studies on the long-term health benefits of structured educational programs which promote active lifestyles in gynecologic cancer survivors are needed in larger patient cohorts.
12013 Background: Physical activity (PA) improves physical functioning and quality of life in cancer survivors, yet few cancer survivors meet recommendations of ≥150 minutes/week of moderate intensity PA. Active Living After Cancer (ALAC) is a community-based program to improve the quality of life of cancer survivors by promoting PA and providing navigation services for survivorship issues. This study evaluates the impact of ALAC on PA, physical functioning, and quality of life in underserved cancer survivors who participated with and without a caregiver. Methods: Cancer survivors were recruited through community organizations to participate in ALAC, which consists of 12 weekly sessions, with or without a caregiver. Participants completed assessments of PA (Godin Leisure Time Exercise Questionnaire), physical functioning (30-sec sit-to-stand test), and quality of life (PROMIS physical and mental health) at baseline and follow-up. Paired samples t-tests were used to assess changes in physical activity, physical functioning and quality of life in cancer survivors and general linear models were used to compare changes between cancer survivors who participated with vs. without a caregiver. Results: Cancer survivors (N = 539; M age = 61.0±11.3 years) were mostly women (92.4%), Hispanic (57.3%) or non-Hispanic Black (21.5%), and medically underserved (85.3%). Most were breast cancer survivors (69.4%), diagnosed with Stage 0-III cancer (91.5%), and participated in ALAC without a caregiver (N = 463, 85.9%). From baseline to follow-up, the percent of cancer survivors meeting PA recommendations increased from 30.3% to 59.6% (Δ = 27.8 score, t= 16.4, p<.001), and the number of sit-to-stand repetitions in a 30-second period increased from 12.4 to 14.3 (Δ = 2.1, t= 8.6, p<.001). Cancer survivors also reported significant improvements in physical (Δ = 0.6, t= 2.4, p=.015) and mental (Δ = 1.0, t= 3.7, p<.001) health-related quality of life. Cancer survivors who participated with a caregiver reported improvements in physical (Δ = 0.7) and mental (Δ = 1.2) health-related quality of life, whereas those who participated without a caregiver reported slight decreases in physical (Δ = -0.2) and mental (Δ = -0.2) health-related quality of life. However, group x time interactions were not statistically significant [physical F(1,412) = 1.9, p=.168; mental F(1,412) = 49.2, p=.061]. Conclusions: Results confirm the effectiveness of ALAC among medically underserved cancer survivors for increasing PA and physical function and suggest that quality of life improvements may be enhanced by participating with a caregiver. Thus, community-based programs should encourage participation with a caregiver when possible to further increase PA, improve cancer survivorship, and reduce cancer health disparities among underserved cancer survivors.
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