bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of an electronic implementation method of an evidence-based exercise intervention among testicular cancer survivors (TCS).
Authors: Fung Chunkit , Peckham Jennifer , Porto Michelle , Lin Po-Ju , Sahasrabudhe Deepak M. , Guancial Elizabeth A. , Ky Bonnie , Storozynsky Eugene , Janelsins Michelle Christine , Heckler Charles E. , Bruckner Lauren B. , Mohile Supriya Gupta , Mustian Karen Michelle 
Published: March 2017

161 Background: Cardiovascular (CV) disease results in significant morbidity among TCS. The effects of exercise on mitigating these late effects remain unknown in this population. Exercise for Cancer Patients (EXCAP) is a self-directed, individually tailored intervention that has been shown to improve CV fitness in cancer patients. We conducted a randomized phase II feasibility study of a novel electronic implementation method (mHealth) of EXCAP. Methods: We developed mHealth-EXCAP that integrates data from a wearable digital activity tracker (DAT) into a patient’s electronic medical record (EMR), allowing providers to monitor and adjust EXCAP prescriptions via a patient-centered virtual portal. We randomized TCS ( < 69 yr at diagnosis, any treatments, not in active or maintenance stage of exercise behavior) into 3 study arms: Arm 1 (mHealth-EXCAP), Arm 2 (EXCAP) and Arm 3 (usual care). Both Arm 1 and 2 completed a 12 week EXCAP program with the goal of 12,000 daily steps and daily resistance exercises and Arm 1 has integration of mHealth. Arm 3 received a TCS care plan that encourages exercises. Results: 52 TCS were screened (23 ineligible; 12 declined), 17 consented and 13 (80.9%) completed study (3 withdrew; 1 lost to follow up) as of May 31, 2016. Median age (yr) was 34 (Arm 1; n = 6), 52 (Arm 2; n = 3), and 48 (Arm 3; n = 4). In Arm 1, 83% TCS wore DAT and synced daily step data to EMR > 90% of days. Further, EXCAP prescriptions were adjusted via EMR portal on average 5 times over 12 weeks for each TCS and their weekly daily step goals were met 73% of the time. The number of daily steps recorded by DAT and those synced from DAT to EMR differed by a mean of 1.5% steps (±1.8). Median baseline number of daily steps were 5,432 (Arm 1), 6,737 (Arm 2), and 5,875 (Arm 3) and increased by 6,161, 1,742, and 1,921 respective steps, with only Arm 1 (50% TCS) achieving > 12,000 daily steps at study completion. On average, TCS in Arm 1 and 2 performed resistance exercises 15 minutes a day/2 times a week and 34 minutes a day/3 times a week, respectively. Conclusions: mHealth-EXCAP is feasible to implement among TCS and may decrease sedentary behavior. Ongoing research will examine its effects on CV risk factors and cardiopulmonary function.
Factors and barriers associated with changes in physical activity after cancer diagnosis.
Authors: Romero Sally A. D. , Li Qing Susan , Mao Jun J. 
Published: March 2017

162 Background: Cancer patients experience a variety of symptoms (e.g., pain, fatigue) that can impact their ability to maintain physical activity (PA) levels. The objectives of this study were to examine factors associated with decreased levels of PA following cancer diagnosis and to identify barriers to PA. Methods: We recruited cancer patients from one urban academic medical center and 11 affiliated community hospitals to participate in a cross-sectional study. We conducted chi-square tests and multivariate logistic regression models to examine patient demographics, clinical characteristics and self-reported barriers associated with decrease in PA levels since cancer diagnosis. Results: Among 662 participants, mean age (SD) was 59.9 (11.6) years. The majority were female (65%), White (81%), and overweight/obese (65%). Common cancer types were breast (32%), lung/thoracic (15%), and hematological (15%), 53% had non-metastatic disease, and 53% were > 12 months post-cancer diagnosis. The majority received chemotherapy (88%), radiation (53%), and/or surgery (53%). Since their cancer diagnosis, 499 (75%) participants reported decreasing their PA levels, 16% maintained, and 4% increased their PA levels. In multivariate analyses, decreased PA levels were significantly associated with receiving chemotherapy [Adjusted Odds Ratio (AOR) 3.54, 95% CI 2.06-6.06] and having metastatic disease (AOR 1.64, 95% CI 1.07-2.52). For barriers to PA, the most common were fatigue (78%), pain (71%), difficulty getting motivated (68%) and difficulty remaining disciplined (65%). In bivariate analyses, the presence of symptoms (i.e., pain, nausea, fatigue, treatment side effects, or surgical complications), difficulty getting motivated, difficulty remaining disciplined, and sadness were significantly associated (p < 0.05) with decreasing PA levels. Conclusions: The majority of cancer patients, especially those who received chemotherapy and those with advanced disease, decreased their PA levels since cancer diagnosis. In addition, physical and psychological barriers exist that influence PA levels. Interventions targeting these barriers are needed to promote maintenance of PA levels throughout the cancer continuum.
Building a healthy body after cancer: Results of a focus group with young adult survivors to inform an intervention for exercise after treatment.
Authors: Kimball Brittany , Asiedu Gladys , Thompson Carrie A. 
Published: March 2017

164 Background: Adolescent and young adult (AYA) cancer survivors have distinctive and often unmet needs, may lead long lives after treatment, and are a population for whom targeted health supports are limited. Exercise in particular has become increasingly recognized as a vital part of cancer survivors’ health needs, yet, little is known about what interventions would be most appropriate for this population. This ongoing study reports early data on barriers and facilitators to exercise in AYA lymphoma survivors. Methods: We conducted a focus group with five young adult lymphoma survivors. Participants completed questionnaires to assess quality of life, exercise habits, and knowledge about evidence for exercise after cancer treatment. Charts were abstracted for demographic and treatment-related details. The focus group was audio recorded and transcribed. Data is being analyzed thematically to generate applied findings and identify areas for action. Results: Participants were 24-35 years old, 60% male, and an average of 2.97 years from the time of diagnosis. All reported some form of physical activity, with 80% active and 20% moderately active. Preliminary analysis identified fatigue, weight gain, and lack of time as barriers to exercise. Participants identified fatigue particularly in the early survivorship period, and discussed the issue of non-cancer survivor peers not relating with or recognizing fatigue after treatment. 100% of participants reported that someone from their doctor’s office had talked with them about exercise, but indicated during the focus group that this recommendation did not motivate them to exercise. Other themes revolve around the relationship between healthy diet and physical activity. In terms of an intervention, survivors were interested in activity trackers and fitness apps, exercise variety, and fitness groups targeted specifically for AYA survivors. Conclusions: Fatigue, weight gain, and time are barriers to exercise for AYA survivors. Interventions that incorporate fitness tracking technology, provide variety, and/or include other AYA survivors may be successful in this unique population.
The long-term benefits of the LIVESTRONG at the YMCA program.
Authors: Ratterman Erin L , Standage Kelly , Beaupin Lynda M. 
Published: March 2017

167 Background: Up to 35% of cancer survivors report physical dysfunction. Exercise programs are beneficial for cancer survivors, yet adherence to exercise long-term remains a challenge. This study examines the efficacy of the Livestrong at the YMCA Program on the physical function of cancer survivors and its influence on habitual exercise. Methods: This retrospective study analyzed data from 158 participants between 2013-16. Each 12-week program consisted of two 1.5 hour sessions per week led by YMCA trainers with LIVESTRONG certification. Sessions included group exercises and education on nutrition and healthy eating, yoga and meditation. Demographic forms completed upon enrollment and Functional Assessments performed at the beginning and close of each 12-week program were analyzed. The demographic data was compiled to produce aggregate characteristics and matched Functional Assessments scores were used to determine changes in each measure over the course of the program. Data analysis included who obtained YMCA membership and continued to have active membership. Results: Matched pre- and post-program Functional Assessments and demographic data were available for 112 participants (71%). Thirty-four percent were over 65 years of age, 94% Caucasian, 52% had breast cancer, and 55% completed treatment within the past two years. We observed improvements in all measures within the Functional Assessment, including upper and lower body strength, flexibility, balance, and 6-minute walk test. Thirty-nine percent are currently YMCA members, and 78% of those have checked into the YMCA within the last 3 months. A post-program potluck dinner is hosted and attendance from prior participants is over 50%. Participant feedback indicates that the program promotes socialization and peer support among cancer survivors. Conclusions: Similar to other exercise programs, the Livestrong at the YMCA program improves physical function scores. Nearly 40% of participants maintain a YMCA membership and over 75% of these members continue to exercise at the YMCA. Promotion of peer support and education on healthy lifestyle behaviors by the Livestrong at the YMCA program may have an impact on the long-term adherence to exercise among cancer survivors.
Introducing medical students to survivorship care through an elective oncology summer program.
Authors: McKillip Ryan Patrick , Hahn Olwen Mary , Rosenberg Carol A. , Olopade Olufunmilayo I. , Arora Vineet M , Golden Daniel William 
Published: March 2017

17 Background: Advancing the quality of cancer care requires that physicians be trained in survivorship care. An oncology seminar series was designed and implemented for first year medical students (MS1s) to improve their knowledge of oncologic disciplines, including survivorship care, by educating them about these disciplines from both a research and clinical perspective. Methods: In 2015 and 2016, MS1s at a single US medical school were invited to participate in the Scholars in Oncology-Associated Research (SOAR) summer program, which included a series of 10 lectures to provide a general survey of how clinical care, basic sciences, and social sciences apply to oncology as a multidisciplinary specialty. Lectures included topics specific to cancer genetics, medical, surgical, and radiation oncology, hospice/palliative medicine, and survivorship care. The students also attended a multidisciplinary tumor board and had the opportunity to shadow a pharmacist, radiation therapist, or palliative care advanced practice nurse. Students completed self-assessments of their understanding of oncology and its related disciplines before and after SOAR. Likert-type scores were 1=not at all, 2=somewhat, 3=moderately, 4=quite, and 5=extremely and are reported as median [interquartile range]. Results: Twenty-seven students successfully completed SOAR. Thirty-three pre- and 25 post-assessments were completed. Student self-reported understanding of oncology as a clinical discipline (2[2-3] vs. 4[4-4] p<.01) and as a research discipline (2[2-3] vs. 4[4-4] p<.01) improved after SOAR. Student understanding of survivorship care as a clinical discipline (1[1-2] vs. 3[2-4] p<.01) and as a research discipline (1[1-1] vs. 2.5[2-3] p<.01) also improved. All students indicated they would be "quite" or "extremely" likely to recommend SOAR to future students. Conclusions: A structured didactic introduction to oncology, SOAR, was successfully piloted. MS1s report improved understanding of oncology and survivorship care as clinical and research disciplines. Additional curricular content is required during subsequent years to further improve student understanding of oncology and survivorship care.
Patient and family caregiver perceptions of a cancer-related in-home Reiki experience.
Authors: Alhawatmeh Hossam , Chen Yea-Jyh , Radziewicz Rosanne M. 
Published: March 2017

174 Background: Complementary care modalities are needed for residential patients and family caregivers, in addition to traditional cancer treatments, to effectively alleviate associated symptoms. Reiki is one of the biofield energy modalities which is generally known to provide non-invasive, non-pharmacological, and beneficial relaxation. It has been commonly practiced to cancer patients in clinical and cancer support facilities. However, little is known about providing Reiki at home especially by informal caregivers. This study aims to describe and understand the perceptions of an in-home Reiki practice as experienced by patients with cancer and their family caregivers. Research Question: What are the perceptions of patients and caregivers of their experiences with an in-home Reiki practice? Methods: A descriptive phenomenological approach (Husserl) was used to explore the perceptions of cancer patients and family caregivers of an in-home Reiki practice through narratives of six dyads of participants; six patients with active cancer and six family caregivers were interviewed. Participants were recruited at three sites in Northeast Ohio. Participants’ narratives were analysed according to Colaizzi’s thematic analysis method. Bracketing, peer debriefing, and external audits were performed to enhance the trustworthiness of findings. Results: Seven major themes were identified: 1) exchange of emotional energies, 2) sensory experiences of energy exchange, 3) physical symptom relief, 4) detachment from stressful circumstances, 5) restoration of spiritual wellbeing, 6) recognition of a valued technique, and 7) lifestyle accommodation. Conclusions: Study participants perceived that in-home Reiki was a beneficial self-care practice that improved the health of patients with cancer. An understanding of patient and caregiver perceptions of Reiki practice in home settings may lead to the development of stand practice and guidelines for a successful patient–caregiver intervention, suitable for a daily schedule or lifestyle. Further study is needed to understand the process underlying in-home Reiki in connection with health outcomes related to cancer.
Creating an integrative survivorship program within a conventional medical culture within a lean economic environment.
Authors: Lawrence Francinne , Reeves Brandon 
Published: March 2017

177 Background: The Institute of Medicine report, From Cancer Patient to Cancer Survivor: Lost in Transition (2005) identified gaps in services for cancer patients upon completion of their initial phase of treatment. In response to these needs, the Commission on Cancer (CoC) (2015) defined survivorship as an official phase of treatment along the cancer care continuum. This case study examined the process of developing an integrative survivorship program that introduces complementary health approaches within a conventional oncology setting using limited financial resources. Methods: A case study design was applied to examine using complementary health approaches as the foundation of a newly implemented cancer survivorship program. A regional CoC accredited community was the research site. Data was collected from: empirical literature, a self-report inventory completed by participants, and archival data and was interpreted using the logic model framework. Results: Findings revealed that using a survivorship model with complementary health approaches as its foundation within a conventional cancer treatment facility resulted in positive outcomes for cancer survivors. Seven core concepts were identified as significant to the process of developing an integrative program. Findings also showed that using a volunteer-staffed program was an effective implementation plan within a lean economic environment. Additionally, this case demonstrated that complementary components resulted in self-reported improvements among cancer survivors in mood, pain, social connectedness, stress, fatigue, and coping capacity. Conclusions: Within this case study, there were seven elements significant to the process of successfully developing and implementing an integrative survivorship program within a conventional medical cancer setting. A cancer survivorship program that integrates complementary health approaches within a conventional cancer treatment facility appears efficacious in assisting cancer survivors in addressing long-term and late-onset side effects of cancer treatment. Using a volunteer-staffed program model was effective for implementing the program within a lean economic environment.
Awareness among patients with cancer of the harms of continued smoking.
Authors: Eng Lawson , Alton Devon , Che Jiahua , Song Yuyao , Su Jie , Farzanfar Delaram , Mohan Rahul , Krys Olivia , Yoannidis Tom , Milne Robin , Brown M Catherine , Vennettilli Ashlee , Hope Andrew J. , Howell Doris , Jones Jennifer M. , Selby Peter , Xu Wei , Goldstein David Paul , Giuliani Meredith Elana , Liu Geoffrey 
Published: March 2017

179 Background: Smoking cessation is becoming an integral part of cancer survivorship. To help improve survivorship education, clinicians need an understanding of patient knowledge of the harms of continued smoking. Methods: Patients with various cancer subtypes were surveyed with respect to self-awareness of the harms of continued smoking on cancer outcomes. Multivariable logistic regression models assessed factors associated with the level of awareness. Results: Among 985 patients, 23% smoked at diagnosis; 34% quit > 1 year prior to diagnosis; 25% had lung, 30% had head and neck cancers; 77% received curative therapy. Many patients reported being unaware that smoking can negatively impact cancer surgery (65%), radiation (74%), chemo outcomes (64%), treatment efficacy (70%), cancer prognosis (54%) and second primary development (52%). Among all patients, those smoking at diagnosis were significantly more likely to be unaware of radiation (aOR = 1.73, 95% CI [1.16-2.57]) and chemo (aOR = 2.10 [1.17-3.79]) toxicities, cancer prognosis (aOR = 1.63 [1.16-2.29]) and second primary risk (aOR = 1.61 [1.14-2.26]). Those with poorer health status were more likely unaware of effects on prognosis (aOR = 1.56 [1.18-2.08]) and second primaries (aOR = 1.54 [1.14-2.08]). Patients with non-tobacco related cancers (non-TRCs) were more likely unaware smoking impacts cancer surgery (aOR = 1.45 [1.04-2.04]) and radiation (aOR = 1.37 [1.01-1.85]). Among smokers at diagnosis, those with non-TRCs (aOR = 4.00 [1.45-11.11]) were more likely unaware smoking can impact chemo outcomes. Awareness was not associated with stage, second-hand smoke exposure, cessation or interest in a smoking cessation program (SCP), but was associated with patients believing that a SCP would be beneficial to their health (aORs = 2.33-4.35, P < 0.03). Among smokers at diagnosis, believing that a SCP is beneficial (51%) was associated with both interest in an in-patient (aOR = 4.65 [2.15-10.03]) and ambulatory (aOR = 4.08 [2.14-7.79]) SCP. Conclusions: Many cancer patients were unaware of the harms of continued smoking; mainly smokers at diagnosis and those with non-TRCs. Patient education should focus on emphasizing awareness, which may help improve patient interest in smoking cessation.
A randomized control trial (RCT) of an online, symptom self-management curriculum (Reimagine) among breast cancer survivors.
Authors: Smith Sophia Kustas , MacDermott Kristin , Amarasekara Sathya 
Published: March 2017

182 Background: Chronic pain, depression, and fatigue are common effects resulting from the cancer experience (e.g., disease, treatment); new interventions are needed. Reimagine is an online symptom self-management program that teaches coping skills. This presentation will report on the impact of Reimagine on key health outcomes. Methods: Adult breast cancer survivors with chronic pain were recruited from the Susan Love Army of Women volunteer registry. Consenting participants were randomized 1:1 to the treatment or usual care condition and completed surveys at Baseline and 18 weeks (post-intervention). Treatment arm participants accessed content online; required activities included viewing online videos, attending online group meetings, and completing cognitive reframing exercises. Surveys were administered via REDCap to assess for pain severity and interference (primary outcome), depression, fatigue, and program satisfaction. An independent-samples t-test was conducted to compare change in pain, depression, and fatigue outcomes in treatment and usual care conditions. Results: Participants (n = 91) were: mean age 56.4 ± 8.8 years; 99% female; 94% white; 67% married; 46% employed; mean time since diagnosis 7.9 ± 6.4 years; and 89% were in remission or cured of their breast cancer. There was a significant difference in the change in depression scores for treatment (M = -1.7, SD = 4.7) and usual care (M = 0.3, SD = 3.8) conditions; t (82) = -2.1, p = 0.035. Difference in the change in fatigue scores was significant for treatment (M = 4.8, SD = 9.1) and usual care (M = 1.2, SD = 6.6) conditions; t (84) = 2.1, p = .038. No significant differences were found in the change in pain outcomes for treatment and usual care conditions (p > .05). Most treatment arm participants (94%) would recommend Reimagine to others and 85% felt more resilient at study completion. Conclusions: These results suggest that Reimagine has an effect on depression and fatigue symptoms for breast cancer survivors. Additional research is recommended with larger and more diverse samples. Trial (NCT02465892) was funded by Pfizer, Inc. Clinical trial information: NCT02465892.