Physical Activity among Cancer Survivors Referred for Exercise Training: A Longitudinal Evaluation
Cisneros, Cassidy Allyn
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BACKGROUND: Physical activity (PA) is a crucial component of cancer survivorship care, but the majority of cancer survivors do not meet National Comprehensive Cancer Network (NCCN) guidelines for weekly activity levels. Supervised exercise training is a growing component of clinical survivorship programs, but little is known about their long-term effects. OBJECTIVE: The primary aim of this study was to examine longitudinal changes (up to 12-months) in self-reported physical activity among cancer survivors enrolled in a community survivorship program and referred for exercise training. A second aim focused on evaluating whether quality of life and session attendance were predictive of these changes, and a third aim identified demographic and clinical predictors of exercise program attendance. METHOD: Participants included 158 cancer survivors referred for supervised exercise training through the Fort Worth Program for Community Survivorship at the University of Texas Southwestern Moncrief Cancer Institute. Self-reported physical activity was measured by the International Physical Activity Questionnaire-Short Form (IPAQ-SF), with data gathered at Baseline, plus 3-, 6- and 12-months post-referral. ANALYSIS: Data related to study aims were analyzed using generalized estimating equations (GEE). RESULTS: Significant increases in self-reported physical activity were noted for participants over the 12-month analysis period; increases were noted at each post-baseline assessment. Participants who had normal BMI at baseline, were married, and had more education reported consistently greater physical activity across timepoints. Baseline global quality of life and exercise session attendance were also positively associated with consistently greater physical activity across timepoints. Emotional well-being at baseline and history of secondary cancer or cancer recurrence were both significant predictors of attending at least 12 exercise sessions. DISCUSSION: Results indicate that in general, the cancer survivorship program was effective in promoting physical activity. A pattern of sustained improvement suggests that even though most participants completed their exercise sessions early in the study period, benefits of the training remained for months afterward. Whether benefits are sustainable in less resource-rich settings and with less intensive exercise interventions should be further explored.