Breast Cancer and Resistance Exercise Program

Study Overview
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Brief Summary
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The goal of the study is to test the feasibility and acceptability of a supervised, online-delivered, individualized, physical activity program in a sample of post-active treatment breast cancer survivors. The proposed intervention will use a 2-arm randomized controlled trial study design to compare a 12-week resistance-based physical activity program to an attention control (i.e., printed individualized physical activity program) group on feasibility, acceptability and changes in strength as measured by 10 repetition maximum (10RM). Both groups will wear accelerometers. The main hypothesis is that participants randomized to the intervention arm will rate the online-delivered physical activity program as feasible and acceptable compared to attention control participants. The overall rationale is that delivering a physical activity intervention online may increase uptake of the intervention, which may lead to maintained physical activity behavior and associated health benefits. The primary outcomes are feasibility as measured by participant retention and acceptability as measured by adherence to physical activity program (recorded by physical activity log). Secondary outcomes include changes in strength as measured by 10RM, objectively measured physical activity levels as measured by the accelerometer, satisfaction, physical functioning and health-related quality of life. Additionally, a select number of participants will be invited for an interview to talk about their experiences in the program, motivation and barriers to exercise. Interview description: Participants will complete one-on-one interviews with the PI or research staff over videoconferencing software (Rutgers Zoom). The interview will be 45 to 60 minutes in duration and audio recorded using the record meeting function. Prior to the interview, participants will consent to being audio recorded. The recording will be stored on Box (a HIPAA compliant cloud drive). A transcript of the audio will be generated using the audio transcript function on Rutgers Zoom and transcribed by a third party to ensure accuracy.

Detailed Description
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The project will use a 2-arm randomized controlled trial study. The intervention will include a 12, weekly, supervised, online-delivered, individualized resistance-based exercise program. The attention control arm will include a printed, individualized resistance-based physical activity program. A total of 50 breast cancer survivors will be recruited from Rutgers Cancer Institute of New Jersey (CINJ) and randomized to one of two study arms. The intervention arm will test the feasibility and acceptability of the intervention compared to the control arm, which will receive a printed or digital copy of an individualized physical activity program. Participants from both arms will receive an accelerometer (ActiGraph GT3X+), resistance bands (TheraBand®), and additional free weights (if required). Outcome measures will be assessed at baseline (pre-intervention), Week 12 (post-intervention) and Week 24 (follow-up). Data collection will occur both in-person and online. Data will be both objective (10RM, functional strength, physical activity measured by accelerometers, physical function assessments, and attendance) and subjective (self-reported physical activity program adherence, satisfaction, physical activity levels, health-related quality of life, and exercise and barrier self-efficacy). Additionally, participants will complete one-on-one interviews with the PI or research staff over videoconferencing software (Rutgers Zoom). The interview will be 45 to 60 minutes in duration and participants will be asked to discuss their experiences in the program.

Official Title
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Breast Cancer and Resistance Exercise Program (B-REP): A Feasibility and Acceptability Trial

Conditions
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Breast Cancer, Resistance Training

Intervention / Treatment
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* Behavioral: Online-delivered physical activity intervention.
* Behavioral: Printed, individualized resistance-based physical activity program.


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: aged 18 years and older self-identify as Black or African American or Afro-Latina/e a confirmed diagnosed of breast cancer < 10 years prior to study start does not have a concurrent cancer diagnosis have completed active treatment > 6 months prior to study commencement (hormonal therapy is acceptable) who are inactive, defined as engaging in < 30 minutes of moderate-to-vigorous physical activity per day for 3 days per week are able to exercise safely as per physical activity safety screening questionnaire, Get Active Questionnaire read and understand English h) have regular access to an internet-connected device with a video camera. Exclusion Criteria: respiratory, joint, or cardiovascular problems precluding physical activity as per physical activity safety screening questionnaire metastatic disease planned elective surgery during the duration of the intervention and/or follow-up that would interfere with participation (e.g., breast reconstruction surgery) does not have someone to supervise them while they exercised remotely.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Intervention arm<br>Participants will engage in 12, weekly, supervised, exercise sessions using Zoom with the exercise trainer. Once a week, the exercise trainer and participant will each log on to Zoom from their locations to begin the supervised exercise session. The exercise trainer will record all sessions. Sessions will be 30 to 45 minutes long and be structured as follows: review of previous session and an opportunity to ask questions; 5-minute warm-up; 20- to 25-minute workout; 5- to10-minute cool down and reminder of next session and/or data collection time period. Supervised sessions will be scheduled once a week over the 12-week intervention. Participants will be expected to complete their resistance-based physical activity program for an additional 1-2 days a week as per the intervention schedule to meet as physical activity guidelines. The exercise trainer will track participant attendance. During the session, participants must have another person in the same location in case of an emergency. | Behavioral: Online-delivered physical activity intervention.<br>* Participants randomized to the intervention arm will engage in 12, weekly, supervised, exercise sessions using Zoom with the exercise trainer.<br>|
| Other: Control Arm<br>The attention control arm will include a printed, individualized resistance-based physical activity program. Participants randomized to the control arm will be given a printed or digital individualized, resistance-based physical activity program and told to aim to for three exercise sessions per week. Control participants will follow the same measurement schedule as intervention participants. | Behavioral: Printed, individualized resistance-based physical activity program.<br>* Without the supervision of an exercise trainer, participants will be given a printed, individualized resistance-based physical activity program to complete over the course of 12 weeks.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Feasibility (participant retention) | Participant retention at assessment timepoints (attendance and completing assessments) | 14 weeks including pre-intervention and post-intervention questionnaire completion | 
| Acceptability (program adherence) | Adherence to physical activity program/intervention (attendance and exercise logs) | 12 weeks to complete the intervention | 
| Internet Evaluation and Utility Questionnaire | Satisfaction will be measured as participants' experience and perceptions of an internet intervention. Scale values: Not at all, slightly, somewhat, mostly & very. Higher scores are associated with a greater level of satisfaction. | After the 12 week intervention and captured in follow-up questionnaire for intervention arm participants | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 10 Repetition Maximum Test | Changes in strength measured by 10RM assessment | During the baseline assessment, week 12 assessment and week 24 follow up assessment | 
| Godin Leisure Time Exercise Questionnaire | Self-report exercise frequency (times per week) and intensity (mild, moderate, and vigorous). Higher scores indicate that individuals are more active. | During the baseline assessment, week 12 assessment and week 24 follow up assessment | 
| Accelerometer (ActiGraph) | Objective measure of total physical activity levels with intensity and duration (minutes). No scale. | Prior to intervention start and following the Week 12 and week 24 assessments | 
| Senior Fitness Test | Functional assessments including senior fitness test, which includes the 6 minute walk test, chair sit to stand test and arm curl test. Scores are compared to age-matched, national averages. | During the baseline assessment, week 12 assessment and week 24 follow up assessment | 
| Exercise Self-Efficacy Questionnaire | Confidence to exercise over the next three months rated on a scale of 0% to 100% confidence. High scores indicate higher perceived confidence to exercise. | During the baseline assessment, week 12 assessment and week 24 follow up assessment | 
| Barrier Self-Efficacy Questionnaire | Confidence to overcome commonly-reported barriers rated on a scale of 0% to 100%. Higher scores indicated higher perceived confidence to overcome barriers. | During the baseline assessment, week 12 assessment and week 24 follow up assessment | 
| Functional Assessment of Cancer Therapy - Breast Cancer (FACT-B) | Scale measures physical wellbeing, social/family wellbeing, emotional wellbeing and functional wellbeing with items specifically for breast cancer (additional concerns). Scale - Not at all, a little bit, some-what, quite a bit, very much. Higher scores indicate better outcomes. | Completed at baseline assessment, after completion of the intervention at week 12 and at the week 24 follow up | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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online, breast cancer, physical activity, breast neoplasm, resistance exercise, survivor