It is well established that structured moderate to vigorous physical activity (i.e., aerobic and resistance exercise) improves many physical and psychosocial health outcomes for cancer survivors. However, it is estimated that less than half of cancer survivors are achieving the cancer-specific exercise guidelines. Interventions that are supervised, and include theory-based behavior change strategies are effective for increasing moderate to vigorous physical activity (MVPA) among cancer survivors; but following an intervention, many survivors return to previously inactive, or insufficiently active lifestyles. To achieve the many benefits associated with MVPA or ?exercise?, cancer survivors must not only adopt or begin a program, but also be able to maintain these PA levels long-term. In addition to individual behavior change strategies, interpersonal, and environmental support for PA can extend the success of PA interventions. This can be achieved by increasing the accessibility of tailored, evidence-informed cancer-specific exercise programs at community-based locations. Thus, we propose to engage in a research-practice partnership to deliver an adaptive PA maintenance intervention for cancer survivors. In the R21 phase, we will examine acceptability of maintenance intervention components, and conduct a needs assessment for intervention delivery at three- community partner locations. In the R33 phase, we will utilize an adaptive intervention design to determine the optimal level of support needed to maintain PA following a community-based exercise program. We will enroll cancer survivors who are not currently achieving aerobic and resistance exercise guidelines in a three-month, supervised, group-based exercise and PA behavior change program at one of three community fitness facilities. Upon completion of the program, participants will be encouraged to continue exercising during a three-month free-living follow-up period, during which time there will be no active intervention. After this follow- up period, exercise levels will be assessed. Those who are not achieving aerobic and resistance exercise guidelines for cancer survivors will be classified as ?incomplete responders? and randomized to one of two subsequent interventions: (a) monthly PA behavior change discussion sessions, or (b) monthly PA behavior change discussion sessions plus bi-weekly, exercise sessions. Responders will be randomized to either: (c) no further intervention, or (d) monthly PA behavior change discussion sessions. After three-months of the subsequent PA maintenance intervention, exercise levels will be assessed again (i.e., 6-months after completion of the initial exercise program). This project is significant because it aims to develop a tailored approach to enhancing PA maintenance, by identifying non-responders and providing them with the additional support necessary to engage in MVPA long-term. Delivering the intervention in community-based facilities will increase potential for scalability and widespread dissemination. Findings from this study will prepare our team to test this intervention in a full-scale adaptive trial, powered for efficacy.

R21CA256656

2021-09-01

2023-08-31