A remotely delivered, peer-led intervention to improve physical activity and quality of life in younger breast cancer survivors

Abstract

Younger breast cancer survivors (YBCS) consistently report poorer quality of life (QOL) than older survivors. Increasing physical activity (PA) may improve QOL, but this has been understudied in YBCS. This single arm pilot study evaluated the feasibility and acceptability of a 3-month, peer-delivered, remote intervention to increase PA and improve QOL in YBCS. Data were collected from October 2019 – July 2020. Participants (n = 34, 43.1 ± 5.5 years old, 46 ± 34.4 months post-diagnosis, BMI = 30.2 ± 7.4 kg/m2) completed six video sessions with a trained peer mentor; self-monitored PA with a Fitbit activity tracker; and interacted with a private Fitbit Community for social support. At baseline, 3-and 6-months, participants completed QOL questionnaires and PA was measured through accelerometer (moderate-to-vigorous PA [MVPA]) and self-report (strength and flexibility). A parallel mixed-methods approach (qualitative interviews and quantitative satisfaction survey at 3-months) explored intervention feasibility and acceptability. One-way repeated-measures ANOVAs examined impacts on PA and QOL at 3-and 6-months. The intervention was feasible as evidenced by efficient recruitment, high retention, and adherence to intervention components. Remote delivery, working with a peer mentor, and using Fitbit tools were highly acceptable. From baseline to 3-months, participants increased time spent in objectively measured MVPA, strength, and flexibility exercises, and reported meaningful improvements to body image, fatigue, anxiety, and emotional support. A fully remote, peer-to-peer intervention is an acceptable and promising strategy to increase PA and improve QOL in YBCS. Refinements to the intervention and its delivery should be further assessed in future studies, toward the goal of disseminating an evidence-based, scalable intervention to the growing number of YBCS.Trial registration Prospectively registered as NCT04064892.

Exercise and Quality of Life in Patients Undergoing Active Breast Cancer Treatment. Comparison of Three Modalities of a 24-Week Exercise Program.

“…These factors make home-based exercise, streaming-based programs a resource to consider in exercise recommendation. Therefore, it is an alternative to offer guided and supervised exercise programs to a larger population, as confirmed by other researchers (26,27).…”

“…Our results may be more related to changes in family and social dynamics after diagnosis than to the benefits of exercise prescription. Most research has been conducted in breast cancer survivors who have completed their oncologic treatment and have experienced life changes after cancer (2,5,9,10,12,13,26).…”

Exercise and Quality of Life (QoL) in Patients Undergoing Active Breast Cancer Treatment—Comparison of Three Modalities of a 24-Week Exercise Program—A Randomized Clinical Trial

“…These factors make home-based exercise and streaming-based programs resources to consider in exercise recommendation. Therefore, it is an alternative to offer guided and supervised exercise programs to a larger population, as confirmed by other researchers [ 30 , 31 ]. Furthermore, it should be noted that the average age of the patients is younger than expected, so the results may be different in an older population in the real world.…”

“…One of the inclusion criteria was prescription by the oncologist; Due to this, the patient profile we receive does not correspond to the average of cancer patients. Currently, about 80% of patients with breast cancer are individuals aged > 50, while at the same time, more than 40% are those more than 65 years old [ 31 ].…”

Advances in the care of breast cancer survivors

“…Remotely delivered physical activity programs for breast cancer survivors have also emerged separately or in concert with weight loss programs, and early results have shown their feasibility and acceptance in both older rural and young breast cancer survivors 270271. Interventions supporting these programs include the use of video enabled exercise sessions, web based education, wearable devices/accelerometers, and certified instruction or peer coaching.…”