Health and Energy Through Active Living Every Day After Cancer Intervention for Cancer Survivors
Condition: Quality of Life; Cognitive Decline; Fatigue; Sleep; Anxiety; Depression
MeSH terms: Cognitive Dysfunction
Study type: Interventional

Summary: 
      The purpose of the Health and Energy through Active Living Every Day (HEALED) intervention,
      is to examine the effect of a web-based intervention on changes in device-measured physical
      activity (light and moderate-to-vigorous intensity aerobic) and sedentary behavior. The
      purpose of this study is intended for survivors of a cancer with a 5-year survival (at Stage
      I, II, and III) of at least 45% that has a strong level of evidence for association with
      physical inactivity according to the 2018 PA Guidelines Advisory Committee Report (breast,
      colon, endometrium, kidney, bladder, multiple myeloma). In line with social cognitive theory
      behavior change techniques, participants will be provided information and skills necessary to
      be more physically active and less sedentary after a cancer diagnosis. New materials will be
      disseminated biweekly through a website open only to participants, and include at-home
      exercise demonstration videos, research news, discussion boards, success stories,
      infographics for exercise recommendations, etc.
    

Detailed description: 
      By 2026, there will be approximately 20.3 million cancer survivors in the U.S., and this
      population is expected to grow with improved cancer survival rates. Cancer survivors
      experience a myriad of side effects following treatment, including fatigue, decreased muscle
      mass, balance issues, decreased cognitive function, and an increased risk of comorbidities.
      Observational studies and randomized controlled trials suggest that physical activity (PA) is
      a safe and effective non-pharmacologic option for improving some of these side effects.
      Despite the evidence, it is estimated that at least 75% of cancer survivors do not meet PA
      guidelines. Interventions tailored for survivors may increase PA, but there are gaps in the
      literature regarding the most effective methods. Further, there are several cancers
      associated with physical inactivity, but most PA interventions focus on breast cancer.
      Additionally, many existing interventions require in-person meetings, are very
      resource-intensive, and may not be sustainable. Most physical activity interventions focus on
      the promotion of moderate-vigorous PA, ignoring the importance of decreased sedentary time
      and increased light PA. Accordingly, it is imperative to create more sustainable,
      broad-reaching PA and sedentary behavior interventions that are intended for survivors of
      various physical inactivity-associated cancers. The proposed one-year study will be a
      two-arm, randomized control intervention embedded within the Cancer Prevention Study-3
      (CPS-3), a prospective cohort study of cancer incidence and mortality initiated by the
      American Cancer Society. The proposed Health and Energy through Active Living Every Day
      (HEALED) intervention is intended for survivors of a cancer with an expected 5-year survival
      (at Stage I, II or III) of at least 45% that has a strong level of evidence for association
      with physical inactivity according to the 2018 PA Guidelines Advisory Committee Report
      (breast, colon, endometrium, kidney, multiple myeloma, and bladder). In line with social
      cognitive theory behavior change techniques, participants will be provided information and
      skills necessary to be more physically active and less sedentary after a cancer diagnosis.
      Materials and tools will be updated monthly through a secure website open only to
      participants, and include: at-home exercise demonstration videos, steps leaderboards, goal
      setting tools, Fitbit self-monitoring and syncing capabilities, discussion boards, success
      stories, infographics for exercise recommendations, etc. This intervention will add to the
      very minimal evidence base for PA interventions for diverse cancer survivors in a
      sustainable, broad-reaching manner. Further, the data resulting from this study will provide
      insight towards promotion of the "time-use" approach, which focuses on all of the movement
      behaviors (including sedentary time, light intensity physical activity, and
      moderate-to-vigorous physical activity), which has not yet been used in interventions for
      survivors.
    

Intervention name(s): Physical activity experiment; Balance and flexibility control
Intervention type(s): Behavioral; Behavioral
Intervention description(s): The Physical Activity (PA) group will have access for one year to the PA website to help increase aerobic and strength training activities.; The static Balance and Flexibility (BF) website will include infographics, videos, and articles for participants to view at their leisure around stretching and balance exercises.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The intervention group will have access for one year to a website to help increase aerobic and strength training activities. The control group will have access for one year to a website to help improve balance and flexibility. At the end of the one-year study, each group will get access to the opposite website.
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: cancer; physical activity; sedentary behavior