Addressing Physical Activity Needs of Survivors by Developing a Community-Based Exercise Program: LIVESTRONG® at the YMCA

Heston, Ann-Hilary; Schwartz, Anna L.; Justice-Gardiner, Haley; Hohman, Katherine H.

doi:10.1188/15.cjon.213-217

Cited by 51 publications

(77 citation statements)

References 9 publications

(15 reference statements)

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“…Finally, a significant gap in preventive health behavior education and support could be addressed, again with minimal burden on survivorship clinic resources, through community‐based programs. Currently, adult survivors are offered free or subsidized survivorship‐focused exercise programs through LIVESTRONG at the YMCA . Although presently no specific CCS programs have been developed, survivorship clinics serving large metropolitan regions should consider developing relationships with these programs to develop appropriate exercise resources for child, adolescent, and young adult survivors.…”

Section: Resultsmentioning

confidence: 99%

Perceptions of changes in clinical, informational, and supportive relationships after end of treatment among parents of young childhood cancer survivors

2019

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Background Parents of childhood cancer patients experience changes in relationships with their health‐care team as the child transitions from treatment to long‐term survivorship (LTS). These changes may affect parent receptivity of survivorship‐health–related programs, yet little is known about the experience of changing clinical relationships for parents as treatment ends and children transition into LTS. Methods In‐depth, semistructured interviews were conducted with 20 English‐speaking parents of childhood cancer survivors less than 13 years old who were greater than 1‐year posttreatment. Audiotaped, transcribed interview content was analyzed using emergent themes grouped and refined in a process of multistaged constant comparison. Results There was a consensus among parents regarding the emotional stressors of the period immediately after the end of treatment. Regardless of positive or negative recollection of treatment, parents commonly viewed their health‐care team with affection and this period as one of stability and security. Transitioning off treatment was viewed as a severe disruption of the security of weekly, treatment‐related contact with nurses, nurse practitioners, physician's assistants, and physicians. LTS was generally viewed as presenting lower levels, but new types of stress as new, psychosocial late effects were seen to emerge. Clinical needs shifted to prevention and late‐effect management. Conclusion Parents of young childhood cancer survivors experience a similar emotional trajectory from treatment to transitioning off treatment and into LTS. This period is seen by parents as uniquely distressing because it represents a disruption of the hard‐won safety represented by regular clinical relationships.

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Section: Resultsmentioning

confidence: 99%

Perceptions of changes in clinical, informational, and supportive relationships after end of treatment among parents of young childhood cancer survivors

2019

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“…Referring patients to existing community-based programs (e.g. LIVESTRONG at the YMCA 106 and Silver Sneakers 107 ) may complement physical functioning improvements gained through clinic-based rehabilitation. Given the results showing larger effect size in studies that used cognitive behavior counseling, providing cognitive behavioral interventions to supplement existing community-based programs may further improve outcomes.…”

Section: Discussionmentioning

confidence: 99%

Effect of Home- and Community-Based Physical Activity Interventions on Physical Function Among Cancer Survivors: A Systematic Review and Meta-Analysis

Swartz

Lewis

Lyons

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective We reviewed randomized trials to examine the effect of home and community-based physical activity interventions on physical functioning among cancer survivors based on the most prevalent physical function measures. Data Sources Five electronic databases—Medline Ovid, Pubmed, CINAHL, Web of Science, and PsychINFO—were searched from inception to March 2016 for relevant articles. Study Selection Search terms included: community-based interventions, physical functioning, and cancer survivors. A reference librarian trained in systematic reviews conducted the final search. Detail protocol is registered on PROSPERO (www.crd.york.ac.uk/prospero/) CRD42016036730. Data Extraction Four reviewers evaluated eligibility and two reviewers evaluated methodological quality. Data were abstracted from studies that used the most prevalent physical function measurement tools—Medical Outcomes Study Short Form-36, Late Life Function and Disability Instrument, European Organisation for the Research and Treatment of Cancer Quality-of-Life Questionnaire, and six minute walk test. Random or fixed effects models were conducted to obtain overall effect size per physical function measure. Data Synthesis Fourteen studies met inclusion criteria and were used to compute standardized mean differences using inverse variance statistical method. The median sample size was 83 participants. The majority of the studies were conducted among breast cancer survivors (n = 7). The interventions produced short-term positive effects on physical functioning with overall effect sizes ranging from small (0.17, 95% CI: 0.07, 0.27) to medium (0.45, 95% CI: 0.23, 0.67). Community-based interventions that met in groups and used behavioral change strategies produced the largest effect sizes. Conclusions Home and community-based physical activity interventions may be a potential tool to combat functional deterioration among aging cancer survivors. More studies are needed among other cancer types using clinically relevant objective functional measures (e.g., gait speed) to accelerate translation into the community and clinical practice.

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“…Examples of such training courses designed by professionals with cancer exercise expertise include ACSM/ACS Certified Cancer Exercise Trainer (https://www.acsm.org/get-stay-certified/get-certified/specialization/cet) and CanRehab cancer exercise specialist courses (http://www.canrehab.co.uk/fitness-workshops/). This skilled workforce is relatively inexpensive and accessible compared with physical or occupational therapists or clinical exercise physiologists . If neither is available, or if a patient is sufficiently mentally and physically able to participate in “regular” community exercise, directing patients to the most appropriate exercise opportunities (called “signposting” in the United Kingdom) can be an effective way of providing access to a wide range of generic activities in the community.…”

Section: Types Of Programmingmentioning

confidence: 99%

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

Schmitz

Campbell

Stuiver

et al. 2019

CA A Cancer J Clinicians

500

465

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Multiple organizations around the world have issued evidence‐based exercise guidance for patients with cancer and cancer survivors. Recently, the American College of Sports Medicine has updated its exercise guidance for cancer prevention as well as for the prevention and treatment of a variety of cancer health‐related outcomes (eg, fatigue, anxiety, depression, function, and quality of life). Despite these guidelines, the majority of people living with and beyond cancer are not regularly physically active. Among the reasons for this is a lack of clarity on the part of those who work in oncology clinical settings of their role in assessing, advising, and referring patients to exercise. The authors propose using the American College of Sports Medicine's Exercise Is Medicine initiative to address this practice gap. The simple proposal is for clinicians to assess, advise, and refer patients to either home‐based or community‐based exercise or for further evaluation and intervention in outpatient rehabilitation. To do this will require care coordination with appropriate professionals as well as change in the behaviors of clinicians, patients, and those who deliver the rehabilitation and exercise programming. Behavior change is one of many challenges to enacting the proposed practice changes. Other implementation challenges include capacity for triage and referral, the need for a program registry, costs and compensation, and workforce development. In conclusion, there is a call to action for key stakeholders to create the infrastructure and cultural adaptations needed so that all people living with and beyond cancer can be as active as is possible for them.

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Addressing Physical Activity Needs of Survivors by Developing a Community-Based Exercise Program: LIVESTRONG® at the YMCA

Cited by 51 publications

References 9 publications

Perceptions of changes in clinical, informational, and supportive relationships after end of treatment among parents of young childhood cancer survivors

Perceptions of changes in clinical, informational, and supportive relationships after end of treatment among parents of young childhood cancer survivors

Effect of Home- and Community-Based Physical Activity Interventions on Physical Function Among Cancer Survivors: A Systematic Review and Meta-Analysis

Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer

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