IMPROVE, a community-based exercise intervention versus support group to improve functional and health outcomes among older African American and non-Hispanic White breast cancer survivors from diverse socioeconomic backgrounds: Rationale, design and methods

Owusu, Cynthia; Nock, Nora L.; Hergenroeder, Paul; Austin, Kristina; Bennet, Elizabeth; Cerne, Stephen; Moore, Halle C. F.; Petkac, Jean; Schluchter, Mark D.; Schmitz, Kathryn H.; Webb-Hooper, Monica; Atkins, Lindsay; Asagba, Oghenerukeme; Wimbley, Leonard; Berger, Nathan A.

doi:10.1016/j.cct.2020.106001

Cited by 8 publications

(9 citation statements)

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“…The study design and procedures have been described in detail. 18 In brief, the study was a 52-week, 2-arm randomized controlled trial that compared the effectiveness of a 20-week supervised, group-based exercise intervention called IMPROVE followed immediately by 32 weeks of unsupervised exercise and a 20-week supervised support group plus Fitbit (SG+Fitbit) followed immediately by 32 weeks of unsupervised support group (SG) activity. The study was registered at ClinicalTrials.…”

Section: Methodsmentioning

confidence: 99%

A randomized controlled trial of the effect of supervised exercise on functional outcomes in older African American and non‐Hispanic White breast cancer survivors: Are there racial differences in the effects of exercise on functional outcomes?

Owusu

Margevicius

Nock

et al. 2022

Cancer

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BACKGROUND:The objective of this study was to test the hypothesis that exercise would be more effective than a support group plus Fitbit (SG+Fitbit) program in improving functional outcomes in older breast cancer survivors (BCSs) and that race would moderate the exercise effect on outcomes. METHODS: Older African American (AA) and non-Hispanic White (NHW) BCSs were purposively recruited and enrolled into the 52-week randomized controlled trial. The interventions included 20 weeks of supervised moderate-intensity aerobic and resistance training followed by 32 weeks of unsupervised exercise called IMPROVE (n = 108) and a 20-week SG+Fitbit program followed by 32 weeks of unsupervised activity (n = 105). Study outcomes were assessed at 20 and 52 weeks. The primary outcome was the change in Short Physical Performance Battery (SPPB) scores 20 weeks from the baseline between arms. Secondary outcomes included change in the 6-Minute Walk Test (6MWT) in meters 20 weeks from the baseline between arms. General linear regression and multivariable logistic regression analyses were used. RESULTS: The mean age was 71.9 years (SD, 5.9 years), and 44% were AA. SPPB scores did not differ between arms (adjusted difference in mean change, 0.13; 95% CI, -0.28 to 0.55; P = .53). However, the exercise arm (vs the SG+Fitbit arm) improved on the 6MWT (21.6 m; 95% CI, 2.5-40.6 m; P = .03). Race moderated the exercise effect on the 6MWT (adjusted interaction effect, 43.3 m; 95% CI, 6.3-80.2 m; P = .02); this implied that the change in the adjusted mean for the 6MWT at 20 weeks from the baseline was 43.3 m higher in AA exercise participants versus NHW exercise participants. CONCLUSIONS: Combined aerobic and resistance exercise appears to improve physical performance in older BCSs, and the exercise effect might be moderated by race, with AAs appearing to derive larger benefits in comparison with NHWs. Larger studies are warranted to confirm the study findings.

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Section: Methodsmentioning

confidence: 99%

A randomized controlled trial of the effect of supervised exercise on functional outcomes in older African American and non‐Hispanic White breast cancer survivors: Are there racial differences in the effects of exercise on functional outcomes?

Owusu

Margevicius

Nock

et al. 2022

Cancer

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“…The study design and detailed procedures have previously been described elsewhere 23 . In brief, the IMPROVE study was a 2‐arm, randomized controlled trial designed to compare the effectiveness of a group‐based 52‐week exercise intervention (n = 107) versus an attention‐control arm (support group with activity tracking; n = 106).…”

Section: Methodsmentioning

confidence: 99%

“…The study design and detailed procedures have previously been described elsewhere. 23 In brief, the IMPROVE study was a 2-arm, randomized controlled trial designed to compare the effectiveness of a groupbased 52-week exercise intervention (n = 107) versus an attention-control arm (support group with activity tracking; n = 106). The exercise intervention consisted of a 52-week, 3-sessions-per-week, 1-hour-per-session, moderate-intensity, aerobic and resistance group training program designed to achieve 150 minutes of moderate-intensity aerobic activity per week and 90 minutes of resistance training per week.…”

Section: Overview Of Studymentioning

confidence: 99%

“…Details of measures and assessments have previously been described. 23 In brief, after completion of the written informed consent process, study participants were scheduled for a visit to complete baseline assessments in the following order, all on the same day: 1) 8-hour fasting blood draw for biomarker testing, 2) comprehensive geriatric assessment and patient-reported outcomes questionnaires, and 3) body composition measurements. Strength and fitness testing and an assessment for lymphedema were completed at TGP within 1 to 3 days before randomization and at the start of exercise and support group programs.…”

Section: Measurements and Assessmentsmentioning

confidence: 99%

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IMPROVE, a community‐based exercise intervention versus support group to improve functional and health outcomes among older African American and Non‐Hispanic White breast cancer survivors from diverse socioeconomic backgrounds: Recruitment strategies and baseline characteristics

Owusu

Nock

Feuntes

et al. 2021

Cancer

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Background Behavioral intervention studies in older breast cancer survivors, particularly older African American (AA) and socioeconomic status–disadvantaged breast cancer survivors, are lacking. To inform future studies, the authors examined recruitment strategies in older breast cancer survivors who participated in an exercise intervention study. Methods IMPROVE is a randomized trial designed to evaluate a group‐based exercise intervention versus a support group (http://ClinicalTrials.gov identifier, NCT02763228). Participants were aged ≥65 years who had survived stage I through III breast cancer and were within 5 years of treatment completion. Participants were recruited through multiple approaches, including peripheral, linguistic, and constituent‐involving strategies that incorporated the identification of potentially eligible patients from 3 local hospitals and from State of Ohio registries and through direct clinician and community organization referrals. Results Between October 2016 and November 2019, 7487 patients were screened, 4790 were potentially eligible, and 213 were randomized into the study. The eligible:randomization rates were 4.4% overall and 84%, 8%, and 2% for recruitment using direct referrals, hospital registries, and state registries, respectively. The median age of the randomized cohort was 70 years (range, 65‐88 years) and included 44% AA and 44% socioeconomic status–disadvantaged breast cancer survivors. Compared with all registry‐eligible patients, directly referred‐eligible patients were more likely to be AA versus Non‐Hispanic White (41% vs 19%; P = .006), to be contacted successfully (100% vs 33%; P < .0001), and to accept study participation (88% vs 16%; P < .0001). Conclusions Direct referrals appeared to be the most efficient strategy for recruiting AA survivors. Behavioral intervention studies seeking to target older AA and socioeconomic status–disadvantaged breast cancer survivors should include strategies that foster direct referrals to study participation.

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“…Most participants (38.8%) practiced exercise occasionally, i.e., once a week, but a considerable part (33.9%) does 2 to 3 times a week, which is the frequency recommended for most cases. Nevertheless, 17.4% of participants never do physical exercise, which can have a very negative impact on health at so many levels [59][60][61][62]. Regarding active traveling, for example to and from work, most participants (52.2%) do not or do less than half an hour per day, but 33.8% spend between 30 min and 1 h daily in these activities.…”

Section: Lifestylementioning

confidence: 99%

Study of the Influence of Sociodemographic and Lifestyle Factors on Consumption of Dairy Products: Preliminary Study in Portugal and Brazil

Guiné

Florença

Carpes

et al. 2020

Foods

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Sociodemographic characteristics, including regional variations, have been associated with different food consumption patterns. Behavioral factors and lifestyle variables may also contribute to different food dietary trends. In this way, the present study intended to investigate the consumption habits of the most relevant types of dairy products around the world and relate them to sociodemographic factors, for example, age, sex, education and country as well as with some anthropometric and behavioral aspects, for example, body mass index, satisfaction with body weight and exercise or sedentary lifestyles. One other objective of the study was to categorize the lifestyles of the participants, according to measured variables linked with hours of inactivity or exercise, in order to use these as possible differentiating variables for the consumption of dairy products. The study involved a questionnaire survey undertaken on a non-probabilistic convenience sample of participants from Portugal (PT) and Brazil (BR), and participation was voluntary and anonymous. The data analysis involved different statistical techniques: basic statistics, chi-square tests, factor analysis, cluster analysis and tree classification analysis. The results showed that semi skimmed milk is never consumed by about half of the participants (47.4% for PT and 46.7 for BR), and those numbers increase for skimmed (64.8% for PT and 50.9% for BR), chocolate flavored milk (82.6% for PT and 65.6% for BR) and enriched milks (94.8% for PT and 85.3% for BR). Cheeses are also consumed in the two countries by small numbers of people. The number of participants consuming imported cheeses in both countries was particularly low (only 4.0% consume these more than once a week in both countries), suggesting national products may be preferred. It was further observed that those who consume cheese do it seldom (once a week) or sometimes (2–3 times per week). Butter is also consumed by only about half of the adult population (43.8% for PT and 49.5% for BR), but the percentage of those who never consume butter increases for skimmed butter (66.0% for PT and 82.6% for BR) and unsalted butter (70.2% for PT and 69.1% for BR). The consumption of yogurts also follows similar low consumption patterns. The most frequently consumed yogurt types in Portugal are liquid (30.5% consume regularly) and natural yogurts (34.8% consume regularly), while in Brazil the most frequent are creamy fruit pulp yogurt (14.4% consume regularly), liquid (13.7% consume regularly) and Greek type yogurt (10.2% consume regularly). A factor analysis and a cluster analysis established groups according to lifestyles, as follows: 1—Screeners, 2—Exercisers, 3—Travelers and 4—Others. These lifestyles were found to be influential in the consumption of dairy products for all classes of dairy tested: milk, cheese, yogurt and butter. For example, the screeners were found to consume more milk, more butter, more cheese and more yogurt. Additionally, other influential factors were age, sex, education, BMI and satisfaction with body weight. Nevertheless, country was not a meaningfully discriminant variable in relation to the other variables included in the classification analysis. The results concluded that, despite some small differences in the patterns of consumption of dairy products in both countries, the levels of consumption of dairy products are extremely low, for all classes studied (milk, cheese, yogurt or butter). Additionally, it was concluded that some factors are influential on the level of consumption of dairy products, and therefore decision makers can plan their interventions according to the characteristics of the targeted segments of the population, according to lifestyle, age, sex, education, BMI and satisfaction with body weight.

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IMPROVE, a community-based exercise intervention versus support group to improve functional and health outcomes among older African American and non-Hispanic White breast cancer survivors from diverse socioeconomic backgrounds: Rationale, design and methods

Cited by 8 publications

References 86 publications

A randomized controlled trial of the effect of supervised exercise on functional outcomes in older African American and non‐Hispanic White breast cancer survivors: Are there racial differences in the effects of exercise on functional outcomes?

A randomized controlled trial of the effect of supervised exercise on functional outcomes in older African American and non‐Hispanic White breast cancer survivors: Are there racial differences in the effects of exercise on functional outcomes?

IMPROVE, a community‐based exercise intervention versus support group to improve functional and health outcomes among older African American and Non‐Hispanic White breast cancer survivors from diverse socioeconomic backgrounds: Recruitment strategies and baseline characteristics

Study of the Influence of Sociodemographic and Lifestyle Factors on Consumption of Dairy Products: Preliminary Study in Portugal and Brazil

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