Effects of a multicomponent physical activity behavior change intervention on fatigue, anxiety, and depressive symptomatology in breast cancer survivors: randomized trial

Abstract

Objectives To determine the effects of the 3-month multicomponent Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) physical activity behavior change intervention on fatigue, depressive symptomatology, and anxiety. Methods Post-primary treatment breast cancer survivors (n=222) were randomized to BEAT Cancer or usual care (UC). Fatigue Symptom Inventory and Hospital Anxiety and Depression Scale were assessed at baseline, post-intervention (month 3; M3), and follow-up (month 6; M6). Potential demographic, medical, and psychosocial moderators were assessed at baseline. Results Adjusted linear mixed-model analyses demonstrated significant effects of BEAT Cancer versus UC on fatigue intensity (M3 mean between group difference [M] = −0.6; 95% confidence interval [CI] = −1.0 to −0.2; effect size [d] = −0.32; p =.004), fatigue interference (M3 M = −0.8; CI = −1.3 to −0.4; d = −0.40; p < .001), depressive symptomatology (M3 M = −1.3; CI = −2.0 to −0.6; d = −0.38; p < .001), and anxiety (M3 M = −1.3; CI = −2.0 to −0.5; d = −0.33; p < .001). BEAT Cancer effects remained significant at M6 for all outcomes (all p values < .05; d = −0.21 to -.35). Clinically meaningful effects were noted for fatigue intensity, fatigue interference, and depressive symptomatology. Conclusions BEAT Cancer reduces fatigue, depressive symptomatology, and anxiety up to 3 months post-intervention in post-primary treatment breast cancer survivors. Further study is needed to determine sustainable methods for disseminating and implementing the beneficial intervention components.

Effects of physical activity on psychological well‐being outcomes in breast cancer survivors from prediagnosis to posttreatment survivorship

“…The sample also included a predominantly white, high SES population, possibly due to the requirement of an iPad for participation in this study, thus limiting the generalizability of the results. Despite their high SES, the participants reported similar fatigue, depression, and satisfaction with life scores when compared with other studies . Future studies may consider targeting diverse populations as women of diverse racial/ethnic backgrounds report poorer QoL in comparison with their non‐Latino white counterparts .…”

“…A considerable body of literature has shown that participation in physical activity may improve QoL outcomes in cancer survivors . For example, meta‐analyses have provided consistent evidence of medium to large effects of physical activity on reduced fatigue in BCS .…”

Barriers and facilitators to participating in physical activity for adults with breast cancer receiving adjuvant treatment: A qualitative metasynthesis

“…Physical activity provides a routine for women where they are able to set goals and achieve them. Within the literature, there are numerous studies supporting the use of goal setting to improve health . Self‐regulatory measures, such as goal setting, can be used to increase an individual's physical activity‐related self‐efficacy and perceived behavioural control .…”

Physical Activity and Sleep Quality in Breast Cancer Survivors

“…Randomization evenly distributed baseline anxiety and depressive symptoms between intervention and control groups (i.e., mean Hospital Anxiety and Depression Scale scores were 4.8 vs. 4.7 for depression, p = .80 and 7.0 vs. 7.0 for anxiety, p = .90) yet we did not measure personality disorders that might influence sleep outcomes. Also, several factors associated with sleep in cross-sectional studies (i.e., fatigue, depression, and anxiety) improved with the intervention (29). Longitudinal, multilevel path analyses were beyond the scope of this report yet future studies should consider including such an approach to elucidate the relationships among these variables over time.…”