improving exercise capacity with a
4. controlled oral word association

This test has three parts (letters). Examiner*: "I am going to say a letter of the alphabet, and I want you to say as quickly as* you can all of the words that you can think of that begin with that letter. You may say any words at all, except proper names such as the names of people or places. So you would not say 'Rochester' or 'Robert'. Also, do not use the same word again with a different ending, such as 'Eat,' and 'Eating.' "For example, if I say 'S,' you could say 'son', 'sit,' 'shoe,' or 'slow.' Can you think of other words beginning with the letter 's'?"
- Wait for the patient to give a word. If it is a correct response, say *"good"*, and ask for another word beginning with the letter "s". If a second appropriate word is given, proceed to the test itself.  
- If the patient gives an inappropriate word on either occasion, correct the patient, and repeat the instructions. If the patient then succeeds, proceed to the test.  
- If the patient fails to respond, repeat the instruction. If it becomes clear that the patient does not understand the instructions or cannot associate, stop the procedure, and indicate the reason(s) on the scoring sheet.  
- If the patient has succeeded in giving two appropriate words beginning with the demonstration letter, say:
Examiner: *"That is fine. Now I am going to give you another letter and again you say all of* the words beginning with that letter that you can think of. Remember, no names of people or places, just ordinary words. Also, if you should draw a blank, I want you to keep on trying until the time limit is up and I *say STOP."* "You will have a minute for each letter. The first letter is '___'" (see scoring sheet). **Allow exactly one minute for each letter**
- If the patient discontinues before the end of the time period, encourage him/her to try to think of more words.  
- If he/she is silent for 15 seconds, repeat the basic instruction and the letter (e.g., "Tell me all the words you can think of that begin with a "c").  
- No extension on the time limit is made in the event that instructions are repeated. - Continue the evaluation with the remaining two letters, allowing one minute for each.  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
.  
Examiner*: Remember, no names of people or places, just ordinary words. Also, if you should* draw a blank, I want you to keep on trying until the time limit is up and I say STOP. You will have a minute for each letter. "The next letter is '___'" (see scoring sheet).
improving exercise capacity with a
recording and scoring

- The record sheet provides lines on which the patient's responses can be entered (e.g., write in the word that is said by the patient). If his/her speed of word production is too fast to permit verbatim recording, a "+" should be entered to indicate a correct response and try to write an abbreviated version. When time permits complete the abbreviation.  
- Incorrect responses either should not be recorded or, if recorded, should be struck through with a line.  
- If the patient provides more responses than there are lines on the record sheet, write in the margins.  
- Count all the correct responses. The number of correct words should be indicated below each column on the recording sheet and on the summary data form that is sent to the CCCWFU.
improving exercise capacity with a
comments on scoring

- Note: It can be helpful for the first several patients and for patients known to be fast with their word production to tape record the session for transcription at a later time.  
- The instructions include a specific prohibition against giving proper names or different forms of the same word. Therefore, inflections of the same word *(e.g., eat-eating; mouse-mice;* loose-loosely; ran-run-runs) are not considered correct responses.  
- Patients often give both a verb and a word derived from the verb or adjective *(e.g., fun-funny;*
sad-sadness). These are not considered correct responses. On the other hand, if the word refers to a specific object *(e.g., foot-footstool; hang-hanger),* it would be counted as a correct answer.  
- Many words have two or more meanings *(e.g., foot; can; catch; hand)*. A repetition of the word is acceptable IF the patient definitely indicates the alternative meaning to you.  
- Slang terms are OK if they are in general use. - Foreign words *(for example, pasta; passé; lasagna)* can be counted as correct if they can be considered part of that relevant language, the criterion being their listing in a standard dictionary of that language. All incorrect and repeated responses MUST be crossed out with one single line, initialed and dated. Additionally, all duplicate entries that have been verified to have different meanings must be marked "ok", initialed and dated. Refer to the descriptions above for guidelines for acceptability. Add the total number of correct responses in each column and input the totals where indicated on the COWA worksheet.  
- If the test is discontinued or omitted, please mark this on the bottom of the test form and indicate the reason.  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
. controlled oral word association

"C" "F" "L"  
| _________________________   | ________________________   | ______________________   |
|-----------------------------|----------------------------|--------------------------|
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |
| _________________________   | ________________________   | ______________________   |  
"C" Total: ________________ "F" total: ________________ "L" Total: _____________
Adapted and reproduced by special permission of the publisher, Psychological Assessment Resources, Inc. 16204 North Florida Avenue, Lutz, Florida 33549, from the Multilingual Aphasia Examination by Arthur L. Benton, PhD, Kerry de S. Hamsher, PhD, and Abigail Sivan, PhD, Copyright 1978 by PAR, Inc. Further reproduction is prohibited without permission from PAR, Inc.  
| __ Month   | Site:   | Date:   | Patient Initials:   | Patient ID:   | CRA:   |
|------------|---------|---------|---------------------|---------------|--------|  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
4. digit span 4. digit

Digits Backward
- Administer the digit spans in order
- Do not repeat a span once read.  
- Administer both spans of the same length regardless of how the participant performs.  
- Say the digits at a rate of 1 digit about every 1 sec. - Use a monotonic voice; without inflections at the end Examiner: "Now I am going to say some numbers, but this time when I stop I want you say them backwards. For example, if I say 7-1-9, what would you say?"
- If the participant responds correctly (9-1-7), say, **That's right,"** and proceed to Item 1. - If the participant fails the example, say: "No, you would say 9-1-7. I said 7-1-9, so to say it backwards you would say 9-1-7. Now try these numbers. Remember, you are to say them backwards 3-4-8."
- Whether the participant succeeds or fails with the second example (3-4-8), proceed to Item 1. Give no help on this second example or any of the items that follow.  
- Discontinue after failure on **both trials of any item.**
Scoring: Each span is scored '0' or '1'. Give 1 point if the participant passes the trial; and no points if the participant fails the trial. Only discontinue test when participant has failed both trials of the same span length (e.g., 5a. and 5b.).  
DIGIT SPAN TEST--- **BACKWARD**  
| Item   | Digit span                    | Score (0 or 1)   |
|--------|-------------------------------|------------------|
| 1a.    | 2 - 4                         |                  |
| 1b.    | 5 - 7                         |                  |
| 2a.    | 6 - 2 - 9                     |                  |
| 2b.    | 4 - 1 - 5                     |                  |
| 3a.    | 3 - 2 - 7 - 9                 |                  |
| 3b.    | 4 - 9 - 6 - 8                 |                  |
| 4a.    | 1 - 5 - 2 - 8 - 6             |                  |
| 4b.    | 6 - 1 - 8 - 4 - 3             |                  |
| 5a.    | 5 - 3 - 9 - 4 - 1 - 8         |                  |
| 5b.    | 7 - 2 - 4 - 8 - 5 - 6         |                  |
| 6a.    | 8 - 1 - 2 - 9 - 3 - 6 - 5     |                  |
| 6b.    | 4 - 7 - 3 - 9 - 1 - 2 - 8     |                  |
| 7a.    | 9 - 4 - 3 - 7 - 6 - 2 - 5 - 8 |                  |
| 7b.    | 7 - 2 - 8 - 1 - 9 - 6 - 5 - 3 |                  |  
Wechsler Adult Intelligence Scale-Third Edition. Copyright © 1997 by Harcourt Assessment, Inc. Reproduced with permission. All rights reserved.  
| __ Month   | Site:   | Date:   | Patient Initials:   | Patient ID:   | CRA:   |
|------------|---------|---------|---------------------|---------------|--------|  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
. 5. hopkins verbal learning

- HVLT-R 'Part B - Delayed Recall' should be administered approximately 20 minutes after Part A of the HVLT-R.
improving exercise capacity with a
examiner "do you remember that

- Check the box on the corresponding line of the HVLT-R worksheet for each word the patient accurately recalls.  
- If a word is said that is not in the list (*referred to as an, "intrusion"*), do not write that word on the form and say nothing to the patient about the word not being on the list.  
- There is no time limit for each recall trial. However, if the patient does not produce any words for 10-15 seconds, ask the patient if he/she can remember any more words.  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
. hopkins verbal learning test

| Check words correctly recalled   | Delayed Recall   |    |
|----------------------------------|------------------|----|
|                                  | LION             | ¨  |
|                                  | EMERALD          | ¨  |
|                                  | HORSE            | ¨  |
|                                  | TENT             | ¨  |
|                                  | SAPPHIRE         | ¨  |
|                                  | HOTEL            | ¨  |
|                                  | CAVE             | ¨  |
|                                  | OPAL             | ¨  |
|                                  | TIGER            | ¨  |
|                                  | PEARL            | ¨  |
|                                  | COW              | ¨  |
|                                  | HUT              | ¨  |  
Adapted and reproduced by special permission of the publisher, Psychological Assessment Resources, Inc. 16204 North Florida Avenue, Lutz, Florida 33549, from the Hopkins Verbal Learning Test-Revised by Jason Brandt, PhD and Ralph H.B. Benedict, PhD,
Copyright 1991, 1998, 2001 by PAR, Inc. Further reproduction is prohibited without permission from PAR, Inc.  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
part c - hvlt-r delayed

Examiner: "Now I'm going to read a longer list of words to you. Some of them are words from the original list, and some are not. After I read each word, I'd like you to say "Yes" if it was on the original list or "No" if it was not. Was [word] on the list?"
- Read the words from the top of the columns down.  
- Check either the "Y" (Yes) or "N" (No) box next to each word to indicate the patient's response.  
- Guessing is allowed.  
- If the test is discontinued or omitted, please mark this on the bottom of the test form and indicate the reason.  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
hopkins verbal learning test (f1)--part

Check either "Y" or "N" for each word  
HORSE ¨ ¨ **balloon** ¨ ¨ house* ¨ ¨ **boat** ¨ ¨  
HUT ¨ ¨ **dog*** ¨ ¨  
TENT ¨ ¨ **HOTEL** ¨ ¨  
ruby* ¨ ¨ **coffee** ¨ ¨  
OPAL ¨ ¨ **scarf** ¨ ¨  
EMERALD ¨ ¨ **apartment*** ¨ ¨  
Mountain ¨ ¨ COW ¨ ¨  
CAVE ¨ ¨ **LION** ¨ ¨  
TIGER ¨ ¨ **PEARL** ¨ ¨  
SAPPHIRE ¨ ¨ **penny** ¨ ¨ cat* ¨ ¨ **diamond*** ¨ ¨  
Adapted and reproduced by special permission of the publisher, Psychological Assessment Resources, Inc. 16204 North Florida Avenue, Lutz, Florida 33549, from the Hopkins Verbal Learning Test-Revised by Jason Brandt, PhD and Ralph H.B. Benedict, PhD, Copyright 1991, 1998, 2001 by PAR, Inc. Further reproduction is prohibited without permission from PAR, Inc.  
| Y   | N   | Y   | N   |
|-----|-----|-----|-----|  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
. data summary sheet 1.

(TO BE SCORED AT COORDINATING CTR) 2. Trail Making Test Part A Time: _____ min. ____ sec Highest circle connected: ______
Errors: _____________
Part B Time: ____ min ____sec Highest circle connected: ______ Errors: _____________ 3. Controlled Oral Word Association Test Letter 1 Word Total _____
Letter 2 Word Total _____
Letter 3 Word Total _____
4. **Digit Span**
(TO BE SCORED AT COORDINATING CTR)
improving exercise capacity with a
5. hvlt-r delayed & recognition

(TO BE SCORED AT COORDINATING CTR)  
| __ Month   | Site:   | Date:   | Patient Initials:   | Patient ID:   | CRA:   |
|------------|---------|---------|---------------------|---------------|--------|  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
appendix k body composition assessments

- Patient should be instructed to not hold their breath.  
- The measuring tape should be secure but not tight. - The area being measured can be found by placing the hands on the waist and moving them downward until the top curve of the hip bone can be felt.  
- Place the tape measure around the top of the hip curve and wrap around at the level of the belly button. (This may not be the same level as the top of the pants.)
Record this measurement in inches below:  
_________ inches  
  
  
- Record height and weight: ________height (inches) __________weight (kg)
improving exercise capacity with a
peripheral edema evaluation

Does the patient have peripheral edema? Yes / No  
| __ Month   | Site:   | Date:   | Patient Initials:   | Patient ID:   | CRA:   |
|------------|---------|---------|---------------------|---------------|--------|  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
appendix l physical activity program

Please circle the number below that best describes your feeling **about each statement.** PART I.  
1. **I liked the physical activity program overall.**
0 Not At All 1 A Little Bit 2 Somewhat 3 Quite A Bit 4 Very Much 2. **The physical activity program was helpful to me.**
0 Not At All 1 A Little Bit 2 Somewhat 3 Quite A Bit 4 Very Much 3. **I plan to continue to practice physical activity.**
0 Not At All 1 A Little Bit 2 Somewhat 3 Quite A Bit 4 Very Much 4. I plan **to start or continue to practice another type of physical activity.**
0 Not At All 1 A Little Bit 2 Somewhat 3 Quite A Bit 4 Very Much 5. **The physical activity program had an impact on my physical function.**
0 Not At All 1 A Little Bit 2 Somewhat 3 Quite A Bit 4 Very Much 6. **The physical activity program had an impact on my mental health.**
0 Not At All 1 A Little Bit 2 Somewhat 3 Quite A Bit 4 Very Much 7. **The interventionist made physical activity enjoyable.**
0 Not At All 1 A Little Bit 2 Somewhat 3 Quite A Bit 4 Very Much Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
PART II.  
1. What did you like best about participating in this study and the physical activity program?  
2. What **did you like least about participating in this study and the physical activity**
program?  
3. What did you learn from participating in the physical activity program? 4. What other suggestions would you make to improve this program? 5. **Please share any other thoughts and comments about your participation in the**
physical activity program. (Feel free to use additional space below or on the back of this page if you would like.)
6. **May we contact you about participating in future studies?**
Yes If yes, E-mail No Phone Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
appendix m health education program

Please circle the number below that best describes your feeling **about each statement.** PART I.  
8. I liked the educational **program overall.**  
0  
Not At All  
1  
A Little Bit  
2  
Somewhat  
3  
Quite A Bit  
4  
Very Much  
9. The educational **program was helpful to me.**  
0  
Not At All  
1  
A Little Bit  
2  
Somewhat  
3  
Quite A Bit  
4  
Very Much  
10. **I plan to continue to practice what I learned.**  
0  
Not At All  
1  
A Little Bit  
2  
Somewhat  
3  
Quite A Bit  
4  
Very Much  
11. **The educational program was a valuable use of my time.**  
0  
Not At All  
1  
A Little Bit  
2  
Somewhat  
3  
Quite A Bit  
4  
Very Much  
12. The interventionist made learning about health **enjoyable.**
0 Not At All 1 A Little Bit 2 Somewhat 3 Quite A Bit 4 Very Much Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
.  
PART II.  
1. What did you like best about participating in **this study and the health education**
program?  
2. What did you like least about participating in this study and the health education program?  
3. What did you learn from participating in the education **program?** 4. What other suggestions would you make to improve this program? 5. **Please share any other thoughts and comments about your participation in the**
health education **program. (Feel free to use additional space below or on the back** of this page if you would like.)
6. **May we contact you about participating in future studies?**
Yes If yes, E-mail No Phone Page 100 of 114 Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
appendix n the q-pro shared

QPRO offers the following services:
- Community-based study recruitment and engagement  
.  
- Qualitative research methodological expertise and infrastructure - Patient-reported outcomes measurement consultation
We will utilize the Q-PRO Shared Resource to provide methodological expertise for qualitative research. This expertise applies to all areas of qualitative inquiry including the design and selection of methods, selection and recruitment of study sample, data collection, management of textual data, and data analysis. Additionally, Q-PRO offers assistance with proposal writing as it pertains to qualitative methodology, progress report and presentation development, manuscript development, and team- specific training and mentoring in collecting and analyzing qualitative data. Q-PRO also provides support facilitating the dissemination of research findings to the community. Personnel The Q-PRO Developing Shared Resource is co-directed by two faculty members and staffed by a Senior Research Associate and a full-time Program Manager. Q-PRO co-directors engage other qualified faculty on a per-project basis when external expertise is needed. The co- directors were chosen to lead this developing shared resource based on complementary areas Q-PRO Developing Shared Resource services are provided through the CCCWFUHS and are housed in the Department of Social Sciences and Health Policy. For this study, the QPRO resources will be available to Dr. Lucas for evaluating participant feedback to identify issues with the exercise mediated physical activity intervention.  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
appendix o - fact-b questionnaire

Have you ever been diagnosed with **breast Cancer? Yes / No** If the participant responds "No," continue to the next questionnaire.  
Below is a list of statements that other people with your illness have said are important**. Please circle or** mark one number per line to indicate your response as it applies to the past 7 days.  
| PHYSICAL WELL-BEING      | Not                                                                              | A little   | Som   |    |    |    |
|--------------------------|----------------------------------------------------------------------------------|------------|-------|----|----|----|
| at all                   | bit                                                                              | e            |       |    |    |    |
| what                     | Quite                                                                            | Very       |       |    |    |    |
| a bit                    | much                                                                             |            |       |    |    |    |
| GP1                      | I have a lack of energy                                                          | 0          | 1     | 2  | 3  | 4  |
|                          |                                                                                  |            |       |    |    |    |
| GP2                      | I have nausea                                                                    | 0          | 1     | 2  | 3  | 4  |
|                          |                                                                                  |            |       |    |    |    |
| GP3                      | Because of my physical condition, I have trouble  meeting the needs of my family | 0          | 1     | 2  | 3  | 4  |
|                          | 0                                                                                | 1          | 2     | 3  | 4  |    |
|                          |                                                                                  |            |       |    |    |    |
| GP5                      | I am bothered by side effects of treatment                                       | 0          | 1     | 2  | 3  | 4  |
|                          | 0                                                                                | 1          | 2     | 3  | 4  |    |
|                          |                                                                                  |            |       |    |    |    |
| GP7                      | I am forced to spend time in bed                                                 | 0          | 1     | 2  | 3  | 4  |
| SOCIAL/FAMILY WELL-BEING | Not                                                                              | A little   | Som   |    |    |    |
| at all                   | bit                                                                              | e            |       |    |    |    |
| what                     | Quite                                                                            | Very       |       |    |    |    |
| a bit                    | much                                                                             |            |       |    |    |    |
| GS1                      | I feel close to my friends                                                       | 0          | 1     | 2  | 3  | 4  |
|                          |                                                                                  |            |       |    |    |    |
| GS2                      | I get emotional support from my family                                           | 0          | 1     | 2  | 3  | 4  |
|                          |                                                                                  |            |       |    |    |    |  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
GS3 I get support from my friends
................................................................................  
0 1 2 3 4 GS4 My family has accepted my illness
................................................................................  
0 1 2 3 4  
GS5 I am satisfied with family communication about my  
illness  
................................................................................  
0 1 2 3 4  
GS6 I feel close to my partner (or the person who is my  
main support)  
................................................................................  
0 1 2 3 4  
GS7 I am satisfied with my sex life  
................................................................................  
0 1 2 3 4  
| GS5   | I am satisfied with family communication about my  illness                                                                                                                     |
|-------|--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| GS6   | I feel close to my partner (or the person who is my  main support)                                                                                                             |
| Q1    | Regardless of your current level of sexual activity,  please answer the following question. If you prefer not  to answer it, please mark this box and go to the  next section. |
| GS7   | I am satisfied with my sex life                                                                                                                                                |  
Please circle or mark one number per line to indicate your response as it applies to the past 7 days.  
GE1 I feel sad  
.................................................................................  
0 1 2 3 4  
GE2 I am satisfied with how I am coping with my illness  
.................................................................................  
0 1 2 3 4  
| EMOTIONAL WELL-BEING   | Not  at all                                         |
|------------------------|-----------------------------------------------------|
| GE1                    | I feel sad                                          |
| GE2                    | I am satisfied with how I am coping with my illness |
| GE3                    | I am losing hope in the fight against my illness    |
| GE4                    | I feel nervous                                      |
| GE5                    | I worry about dying                                 |
| GE6                    | I worry that my condition will get worse            |  
GE3 I am losing hope in the fight against my illness  
.................................................................................  
0 1 2 3 4  
GE4 I feel nervous  
.................................................................................  
0 1 2 3 4  
GE5 I worry about dying  
.................................................................................  
0 1 2 3 4  
GE6 I worry that my condition will get worse  
.................................................................................  
0 1 2 3 4  
| Som ewhat       | Quite   | Very   |
|-------|---------|--------|
| a bit | much    |        |  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)  
| FUNCTIONAL WELL-BEING   | Not                                                | A little   |
|-------------------------|----------------------------------------------------|------------|
| at all                  | bit                                                |            |
| GF1                     | I am able to work (include work at home)           |            |
| GF2                     | My work (include work at home) is fulfilling       |            |
| GF3                     | I am able to enjoy life                            |            |
| GF4                     | I have accepted my illness                         |            |
| GF5                     | I am sleeping well                                 |            |
| GF6                     | I am enjoying the things I usually do for fun      |            |
| GF7                     | I am content with the quality of my life right now |            |  
| Som ewhat       | Quite   | Very   |
|-------|---------|--------|
| a bit | much    |        |  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
Please circle or mark one number per line to indicate your response as it applies to the past 7 days.  
| ADDITIONAL CONCERNS   | Not                                                                                | A little   | Som   |    |    |    |
|-----------------------|------------------------------------------------------------------------------------|------------|-------|----|----|----|
| at all                | bit                                                                                | e            |       |    |    |    |
| what                  | Quite                                                                              | Very       |       |    |    |    |
| a bit                 | much                                                                               |            |       |    |    |    |
| B1                    | I have been short of breath                                                        | 0          | 1     | 2  | 3  | 4  |
|                       |                                                                                    |            |       |    |    |    |
| B2                    | I am self-conscious about the way I dress                                          | 0          | 1     | 2  | 3  | 4  |
|                       |                                                                                    |            |       |    |    |    |
| B3                    | One or both of my arms are swollen or tender                                       | 0          | 1     | 2  | 3  | 4  |
|                       |                                                                                    |            |       |    |    |    |
| B4                    | I feel sexually attractive                                                         | 0          | 1     | 2  | 3  | 4  |
|                       |                                                                                    |            |       |    |    |    |
| B5                    | I am bothered by hair loss                                                         | 0          | 1     | 2  | 3  | 4  |
|                       |                                                                                    |            |       |    |    |    |
| B6                    | I worry that other members of my family might  someday get the same illness I have | 0          | 1     | 2  | 3  | 4  |
|                       |                                                                                    |            |       |    |    |    |
| B7                    | I worry about the effect of stress on my illness                                   | 0          | 1     | 2  | 3  | 4  |
|                       |                                                                                    |            |       |    |    |    |
| B8                    | I am bothered by a change in weight                                                | 0          | 1     | 2  | 3  | 4  |
|                       |                                                                                    |            |       |    |    |    |
| B9                    | I am able to feel like a woman                                                     | 0          | 1     | 2  | 3  | 4  |
|                       |                                                                                    |            |       |    |    |    |
| P2                    | I have certain parts of my body where I experience  pain                           | 0          | 1     | 2  | 3  | 4  |  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
Appendix P - **PALS Home-Based Testing Kit**
improving exercise capacity with a
pals home-based testing kit

This document contains both instructions for the participant who will perform the tests, and for the testing assistant who will use the camera app on the Samsung Android device to film each of the tests for scoring purposes.  
Participant Instructions To begin with, please check the package you received to make sure it contains the following items.  
Package Contents 1. Instruction booklet (can also be emailed beforehand). 2. 1 x Android device. 3. 1 x Camry Grip strength dynamometer. 4. 1 x 15m length rope (marked in 1m increments). 5. 2 x weighted markers for securing ends of 15m rope.  
.  
  
Other Equipment Needed 6. A flat area of the home without obstructions to complete balance tests. The back of a chair, a table, or a shelf at about hip height is recommended if you need to catch your balance.  
7. A flat area for set-up and completion of the 4-meter and 6-minute walk test (15-20 meters/
50-70 feet).  
8. Standard dining room-type chair for chair stand test (17-19" in height). 9. Your own smartphone device with the following app installed 6WT (IOS) or
(Android).  
Important Notes:
10.*Before you begin, please be aware that participant safety is more important than any* test outcome. Please let the research team know about any conditions including fatigue and concerns related to balance that may make the completion of some of the following exercise tests unsafe.  
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.  
11.Please have the person who *is helping you to conduct these tests, become familiar* with the Android device. Specifically, they will need to be able to operate the camera/video app found on the home screen.  
12.We would like you to complete all the tests in one attempt. The total time taken to complete the full battery of tests should be between 40-60 minutes.  
13.*One of the walking tests will be completed at a usual walking pace (4m walk), while* the other is done as fast as you can without running (6MWT).  
14.Please complete the following tests in the stated order. It is important to be adequately recovered for the start of each test.  
Test Order 1. Balance tests - **Steady App** (If your balance test results show you have a low risk for a fall
[≤40/100], you may continue to the rest of the tests.)
2. 4-meter walk test. 3. **Chair stand test.** (You may rest after this test, until such time as you feel you have regained your breath and can talk normally.)
4. Grip strength test. 5. 6-minute walk test.
improving exercise capacity with a
balance test - steady app

The Steady App is designed to evaluate your balance and determine your fall risk before continuing with the rest of the physical tests. The App can be found on the Home screen of the Samsung device you received in your package. Find a firm, safe, flat area to complete the balance tests. A room with a table or shelf at about hip height can be used for support should you feel it may be necessary to catch your balance. You may also stand behind the chair you will use for some of the remaining tests. Do not do this test on a soft surface like grass, or a thick carpet.  
1. Open the Steady App 2. When prompted, insert your test subject number (if not sure ask the research team)  
  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
.  
  
  
3. Follow the audio instructions on the device as it talks you through 4 separate balance tests, each taking approximately 30 seconds to complete.  
4. When the tests have finished, you will be provided with a fall risk score. If your score is ≤40, you may continue with the rest of the tests.
improving exercise capacity with a
general testing assistant instructions

Once the participant has completed the balance tests using the Steady app, if low risk for a fall, they will then perform the remaining physical tests. The Camera app, located on the home screen of the Samsung Android device will be used to film the participant completing each test. The position you will stand in is slightly different for filming each test so check the specific instructions for each test section before you start. With the Camera app open, you will see a smaller red dot to the left of the large white dot in a bar across the bottom of the screen. This is how you will start the video.  
1. To film the participant performing each test, make sure both you and they are ready to begin.  
2. Hold the phone in the vertical position. Make sure you can clearly see the participant in the frame of the camera before starting the test.  
3. Start with your finger on the red dot and release the button as you start to count down "3, 2, 1, GO". You will begin each test that you film with the same instructions for consistency. Note: Do not press the button as you say GO *as there will be a* slight delay at the start of the video and it is important to capture the beginning of the test.  
4. To end the test, press the white dot (*with a smaller black* square) in the middle of the bar across the bottom of the screen.  
5. Before you perform any of the tests, practice filming a few short clips.  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
set up for the 4-meter

First, find a level unobstructed area to complete the 6-minute walk test. This can be a driveway, the edge of the road/street outside your home (if not too busy), an open parking area (ideally towards the perimeter, where it is not too busy). The space chosen should be safe and firm. Do not complete this test on a soft, uneven surface like a lawn or a busy sidewalk where you will be interrupted.  
1. Hook the loops at the ends of the 15m rope onto the weighted markers in the test kit.  
2. Place the weighted anchors (marked with orange crosses) in a straight line until the slack is removed from the rope. Be careful to not overstretch the rope.  
3. Place a chair perpendicular (at a right angle) to the marker at the end of the walking course (close to position A). Make sure the chair does not obstruct the walking course. You will use this same chair for the sit-to stand tests (chair stands) and to provide you with somewhere to sit should you become fatigued or should you need a break during the walking test.  
4. You will also perform the grip strength tests while seated in this chair.
improving exercise capacity with a
4-meter walk test

The test will require you to walk at a usual pace for a distance of 4 meters. You will complete 2 sets (repeats) of this test.  
Testing Assistant Position and Instructions As the person filming the test you will want to stand in line with the end marker the participant will walk towards. This will be opposite position A. From this vantage point, you will follow the participant until they walk past the marker at the end of the rope. To film the test:
5. Open the camera app on the Samsung device. 6. Make sure the participant is fully viewable in the frame of the screen. 7. Ask the participant to slowly walk towards the marker at the end of the rope and make sure you can follow them through the 4m course.  
  
  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
.  
  
8. When you are ready, have the participant start with their toes just behind the 4th mark
(position B) from the end of the rope.  
9. Remind the participant to walk at a normal/usual pace and to not stop or slow down before reaching the end of the rope.  
10.Place your finger on the red dot and release as you start to say "3, 2, 1, GO". 11.Repeat the test. 12.Open the gallery app on the phone and make sure both tests are filmed.  
Participant Instructions Start with the toes of your feet placed at position B, in line with the 4th mark from the end of the  
 rope (4 meters) facing the marker at position A. When both the  
 participant and the person who is videoing the test are ready, have the person filming, start the test with "3, 2, 1, GO." On GO walk towards and past position A, in line with the marker at the end of the rope. Walk at a normal pace and do not stop or slow down before reaching the end of the rope. Return to the starting position (Position B) and repeat the test for a second time.
improving exercise capacity with a
chair stand test

The goal of this test is to complete as many chair stands as possible in 30 seconds, but be sure to stand up completely and return to a seated position with a straight spine each time. See images below for the start and stop positions of each chair stand.  
  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
testing assistant position and instructions.

As the person filming the test you will want to stand perpendicular to the participant so you have the same view as in the picture above. From this vantage point, you will film the participant for approximately 35 seconds (this allows for the capture of the exact position of the participant at 30 seconds after the test starts).
improving exercise capacity with a
to film the test

1. Open the camera app on the Samsung device. 2. Make sure the participant is fully viewable in the frame of the screen. 3. Ask the participant to slowly stand up from seated and make sure they have correct form. 4. When you are ready, have the participant start with their arms crossed and hands placed on their shoulders.  
5. Remind the participant to stand upright completely before returning to the seated position. 6. Place your finger on the red dot and release as you start to say "3, 2, 1, GO". 7. After 35 seconds press the white dot and say **"STOP"** loudly to end the test. 8. Open the gallery app on the phone and make sure the test was filmed.
improving exercise capacity with a
participant instructions

1. Start seated toward the front edge of the chair with your feet shoulder-width and positioned behind your knees, and arms folded across your chest (see start stop positions in picture above).  
2. You may complete one practice trial, and ask for any corrective feedback as necessary.  
3. When both the participant and the person who is videoing the test are ready, have the person filming, start the test with "3, 2, 1, GO." After they say 'GO,' you will stand all the way up, and return to the original seated position.  
4. Repeat the stands as many times as you can until you hear the assistant say **STOP!** 5. You may stop the test early if you become very tired or short of breath during the repeated chair stands.  
6. End your test by returning to the seated position.
improving exercise capacity with a
grip strength test

The goal of this test is to measure your upper body strength.  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
improving exercise capacity with a
testing assistant instructions

It is not necessary to film or photograph this test.  
Participant Instructions 1. To begin with, turn on the device. 2. Find the user-number you have been designated by pressing the up or down arrows and press start. (check with research team contact if you are unsure of your number).  
3. Start in the seated position, with your feet hip-width apart, ankles vertically below your knees (see picture at right).  
4. Sit upright with the shoulders vertically over your hips. The elbow should be tucked in at the side, falling on a line approximately halfway between your shoulder and your hips.  
5. Bend the elbow to 90 degrees so your forearm is parallel to the tops of the thighs.  
6. Hold the grip dynamometer in your dominant hand, so that your thumb is pointing directly up towards the sky. The screen of the device should be facing away from the palm of your hand.  
7. When you are ready, squeeze the grip handles as tightly as you can, maintaining the position you started in. Repeat 3 times, recording the value for each test.  
8. You may rest for up to 1 minute between each of the 3 attempts. 9. Switch to the other arm and repeat 3 times.
improving exercise capacity with a
6-minute walk test

The goal of this test is to walk as fast, but safely, as you can without running for a period of 6 minutes.
improving exercise capacity with a
testing assistant position and instructions

As the person filming the test you will want to stand in line with the midpoint of the rope about 6-8 feet back from the rope. From this vantage point, you can follow the participant as they walk alongside the rope and around the markers at each end. To film the test:  
  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
1. Open the camera app on the Samsung device. 2. Have the participant start with their toes in line with a marker at the end of the rope (position A) facing the other end of the rope.  
3. Make sure the participant is fully viewable in the frame of the screen. 4. Practice starting the test with "3, 2, 1, GO", filming as the participant slowly walks one length of the course.  
5. Open the gallery app and make sure you are capturing the video accurately as they move around the course.  
6. Open the Camera app and remind the participant to walk as fast a pace as possible without running and to not stop or slow down before you ask them to **STOP**.  
7. Place your finger on the red dot and release as you start to say "3, 2, 1, GO". 8. You may tell the participant each minute that has passed. 9. Film the test for 6 minutes and a few seconds (approximately 5 seconds), waiting for the participant to complete the length of the course they are on before telling them to stop.  
10.Open the gallery app on the phone and make sure the test was filmed.
improving exercise capacity with a
participant instructions

1. Start with your feet placed at position A on the diagram facing the opposite marker.  
 2. Find the 6WT App on your own device and open it to the screenshot to the right.  
3. When the participant and person who is videoing the test are ready, have the person filming start the test with "3, 2, 1, GO." On GO start the test on your own device (press the play icon) and place it into your pocket. It will automatically stop when the test is over.  
4. Walk as fast but as safely as possible towards and around the marker at the end of the rope.  
5. Continue walking until the person filming the test says STOP.  
  
Improving Exercise Capacity with a Tailored Physical Activity Intervention in Lymphoma and Breast Cancer Patients Undergoing Treatment - An addendum to NIH R01CA167821 "Early Imaging Detection of CV Injury after Cancer" Comprehensive Cancer Center of Wake Forest University (CCCWFU - \#99112)
You have completed you tests, well done. If you are tired or unsteady on your feet take a few moments to rest. If you are thirsty make sure to hydrate following your tests.