Peers Promoting Exercise Adoption and Maintenance Among Cancer Survivors

Study Overview
=================
Brief Summary
-----------------
Exercise adoption enhances well-being and recovery from breast cancer. Researchers trained American Cancer Society volunteers to provide exercise counseling to breast cancer survivors and the survivors increased their exercise in the short-term. This RCT examines the effects of three maintenance conditions on survivors' exercise participation at longer follow-ups. The cost-effectiveness of the three groups will be examined to guide implementation of this peer mentoring approach in community-based organizations.

Detailed Description
-----------------
The current study, a randomized controlled trial (RCT), represents the next step of the efforts to to extend the research on physical activity to the community setting; community volunteers will deliver the intervention, thereby making physical activity interventions much more accessible to survivors. In partnership with the National American Cancer Society office (Atlanta, GA) and Reach To Recovery (RTR) programs in North Carolina, South Carolina, and Georgia, researchers at the University of South Carolina's College of Nursing will share skills, experience and resources to examine the effects of RTR coaches offering a theoretically-based 3-month exercise program among 150 breast cancer survivors to increase moderate-to-vigorous physical activity (MVPA) followed by self-monitoring (i.e. exercise logs) and feedback reports in Months 4-9 (Reach Plus), monthly phone calls from RTR coaches, self monitoring and feedback reports in Months 4-9 (Reach Plus Message) or weekly email/text messages, self-monitoring and feedback reports in Months 4-9 (Reach Plus Message). In this three group study, researchers will assess survivors' exercise, fatigue, mood, quality of life, and self-reported physical functioning at baseline, 3, 9 and 12 months. The costs of the methods vary and data on costs will be collected to guide the selection of maintenance strategies for dissemination. If the results are promising, researchers will proceed with a dissemination trial wherein the large network of RTR volunteers can expand the scope of their services to benefit breast cancer survivors.

Official Title
-----------------
Peers Promoting Exercise Adoption and Maintenance Among Cancer Survivors

Conditions
-----------------
Breast Cancer

Intervention / Treatment
-----------------
* Behavioral: Reach Plus
* Behavioral: Reach Plus Phone
* Behavioral: Reach Plus Message


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Women aged 21 years or over will be eligible if they: Have been diagnosed in the past 5 years with Stage 0-3 breast cancer. Are able to read and speak English. Are ambulatory. Are sedentary (i.e., do not meet recommendations for moderate-intensity PA [30 minutes/ day or more for at least 5 days/ week] or vigorous-intensity PA [20 minutes/day or more for at least 3 days/week] Are able to walk unassisted. Have access to a telephone. Exclusion Criteria: Women with: More advanced disease (Stage 4). Medical or psychiatric problems (e.g., substance abuse, coronary artery disease, peripheral vascular disease, diabetes, and orthopedic problems) that may interfere with protocol adherence will not be included. Participants will be asked to provide consent for medical chart review to extract disease and treatment variables. Eligible participants will obtain medical clearance from their physicians.

Ages Eligible for Study
-----------------
Minimum Age: 21 Years

Sexes Eligible for Study
-----------------
Female

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Reach Plus<br>In Months 1-3, participants in this group will receive the previously tested telephone counseling for exercise. RTR volunteers or coaches will be asked to contact participants by telephone weekly over 3 months (12 calls). In months 4-9, participants will no longer receive calls from RTR coaches and will be encouraged to use the heart rate monitors and pedometers during exercise. Participants will continue to complete their exercise logs and receive feedback reports from study staff. | Behavioral: Reach Plus<br>* In Months 1-3, participants in this group will receive the previously tested telephone counseling for exercise. RTR volunteers or coaches will be asked to contact participants by telephone weekly over 3 months (12 calls). In months 4-9, participants will no longer receive calls from RTR coaches and will be encouraged to use the heart rate monitors and pedometers during exercise. Participants will continue to complete their exercise logs and receive feedback reports from study staff.<br>|
| Experimental: Reach Plus Phone<br>In Months 1-3, participants in this group will receive the previously tested telephone counseling for exercise. RTR volunteers or coaches will be asked to contact participants by telephone weekly over 3 months (12 calls). In months 4-9, these participants will have the opportunity to continue to receive support calls from their coach. Participants will also continue to complete their exercise logs and receive feedback reports from study staff. | Behavioral: Reach Plus Phone<br>* In Months 1-3, participants in this group will receive the previously tested telephone counseling for exercise. RTR volunteers or coaches will be asked to contact participants by telephone weekly over 3 months (12 calls). In months 4-9, these participants will have the opportunity to continue to receive support calls from their coach. Participants will also continue to complete their exercise logs and receive feedback reports from study staff.<br>|
| Experimental: Reach Plus Message<br>In Months 1-3, participants in this group will receive the previously tested telephone counseling for exercise. RTR volunteers or coaches will be asked to contact participants by telephone weekly over 3 months (12 calls). In months 4-9, participants will receive messages by email or text to motivate, prompt and reinforce continued exercise. Participants will also continue to complete their exercise logs and receive feedback reports from study staff. | Behavioral: Reach Plus Message<br>* In Months 1-3, participants in this group will receive the previously tested telephone counseling for exercise. RTR volunteers or coaches will be asked to contact participants by telephone weekly over 3 months (12 calls). In months 4-9, participants will receive messages by email or text to motivate, prompt and reinforce continued exercise. Participants will also continue to complete their exercise logs and receive feedback reports from study staff.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical Activity | Through interviewer - administered Seven Day Activity Recall & wearing the Actigraph accelerometer (GT3X) | Change at 9 and 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Breast Cancer Quality of life | Assessed via the Functional Assessment of Cancer Therapy Scale - Breast (FACT-B) Sub-scales scored: Physical well-being, social/family well-being, emotional well-being, functional well-being and other breast cancer related statements. | Change at 9 and 12 months | 
| Fatigue | Assessed via the Functional Assessment of Cancer Therapy Scale - Fatigue (FACT-F) | Change at 9 and 12 months | 
| Mood | Assessed via the Profile of Mood States (POMS) | Change at 9 and 12 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Breast cancer, Exercise, Physical activity, Community volunteers, Peer mentors, Peer coaches, Social support, Exercise maintenance