A Pilot Study of a Home-Based Motivational Exercise Program for African American Breast Cancer Survivors

Abstract

Introduction. African American breast cancer survivors engage in less physical activity compared with their Caucasian counterparts. There is a need for exercise intervention research that focuses on improving the overall health and longterm survivorship of African American breast cancer survivors, especially because they often have worse outcomes than Caucasian survivors. Study objectives were to determine whether African American participants increase physical activity and explore whether exercise had a positive impact on fitness and health. Methods. African American breast cancer survivors, stage 0 to IIIA, within 2 years of completing primary cancer treatments were recruited for a 16-week home-based aerobic and resistance training exercise pilot study. Outcome measures assessed at baseline and postintervention included physical activity questionnaires and accelerometry, cardiopulmonary function (VO 2peak ) with gas exchange, muscle strength, Selective Functional Movement Assessment, and dual energy X-ray absorptiometry scans for body composition analysis. Assessments for fatigue and quality of life (QOL) were also completed at baseline and postintervention. Motivational interviewing was utilized to determine goals and explore exercise facilitators/barriers. Participants completed weekly exercise logs and received weekly phone calls. Wilcoxon signed rank tests were used to detect significant changes in physical activity and also changes in fitness/health parameters, fatigue, and QOL. Spearman correlation coefficients were used to examine relationships between physical activity and health measures. Results. A total of 17 women enrolled; 13 completed the intervention (76%). Mean age of the participants was 51 years. There was a significant increase in total minutes of weekly physical activity postintervention (M = 271 minutes, SD = 151; P = .001). Significant improvements were found in cardiopulmonary fitness as measured by VO 2peak with a mean increase of 2.03 mL/kg/min (P = .01). Several strength measures significantly increased and also functional movement (P = .005). Positive correlations existed between physical activity and several physical measures, with significant relationships between functional movement and some strength measures (eg, left arm extension: r s = 0.61, P = .002). Total QOL and fatigue scores improved, but neither was significant. Conclusions. The intervention led to increased physical activity. As a result of increased levels of physical activity, improvements on several fitness/health parameters occurred.

The Development and Feasibility of an At-Home, Internet-Based Exercise and Nutrition Education Program in Child Cancer Survivors

“…The current study is in agreement, showing positive trends in physical functioning after implementing exercise for eight weeks. Physical domains that found a positive trend in the current study included physical functioning, role limitations due to physical health, energy/fatigue, pain and general health that parallel other studies investigating the same domains [1,15,27]. In addition, mental domains contributing to a survivor's overall quality of life that showed a positive trend after the eight weeks included role limitations due to emotional health, emotional wellbeing and social functioning.…”

Interventions Promoting Physical Activity in African American Women

“…This review revealed that several studies included a group meeting or educational session. 11,14,17–19,21,24,25,27,32,34,38–40,43–45 Across home-based 18,29,33,40,41 and telephone-based 36 studies, significant and nonsignificant results were reported. Another strategy identified, were phone calls from a peer counselor or research staff member.…”

“…The patient populations across the studies were heterogeneous, and included low-income women 30 , postpartum 31 , pregnant 32 , breast cancer survivors 33–35 , type 2 diabetes 19 , mobility disabilities 36 , and women with high-normal or untreated stage 1 hypertension. 22 Common inclusion criteria included overweight or obesity 15,18,26,32,34,36,37 and sedentary.…”

“…22 Common inclusion criteria included overweight or obesity 15,18,26,32,34,36,37 and sedentary. 17,22,29,31,33,36,38–40 Few studies focused on women who were age 40 or older 19,25 and age 60 or older. 16,17 …”

“…11,20,21,34,41 Several studies did not report using a theory-based intervention however, significant changes in results were reported including an increase in total minutes of physical activity, 33,36,43 increase in steps per day, 31,38 and self-reported energy expenditure. 22 Several concepts identified in the intervention strategies included goal-setting, 11,16,17,20,22,24,26,32,33,36,39–41 reinforcement, 17,32 and problem-solving. 22,26,32,35,36,40,41 Self-monitoring of PA 22,26,32,37,41 and PA barriers 26,36 were identified as intervention strategies.…”