Peer Coaching for Physical Activity Promotion among Breast Cancer Survivors: Adapting an Efficacious Intervention to Prepare for Implementation

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Interventions promoting physical activity among cancer survivors improve their functioning, reduce fatigue and offer other benefits for cancer recovery and risk reduction for future cancer. There is a need for interventions that can be implemented on a wide scale. Our 12-week theory-based exercise intervention that was delivered by peer coaches by telephone was efficacious in significantly increasing moderate-to-vigorous physical activity (MVPA) among breast cancer survivors, in randomized controlled trial. The peer coaches from the American Cancer Society’s Reach to Recovery program were trained and supervised to deliver the intervention called Moving Forward Together (MFT) (Pinto, Stein & Dunsiger, 2015). Our goal is to prepare for wider implementation of MFT by adapting an existing web platform (Mentor1to1™) for the intervention and collect key indices to prepare for large scale implementation. The parent grant has two phases: in Phase 1 (completed), we worked with the InquistHealth team to modify Mentor1to1™for the MFT intervention creating webMFT, and in Phase 2, we will conduct a randomized controlled trial in which 10-12 peer coaches will deliver webMFT to 56 breast cancer survivors who will be randomized to receive either webMFT or MVPA Tracking. All study participants will receive a Fitbit activity tracker which they will be asked to wear each week for 12 weeks. webMFT participants, in addition, will receive weekly counseling calls delivered via the web platform. We will examine survivor outcomes (objectively measured MVPA and self-reported fatigue, quality of life, physical functioning and mood) at baseline and 12 weeks and compare groups at 12 weeks. In this supplement, we will: 1) code the webMFT intervention for Behavior Change Techniques (BCTs) that we intend to deliver from coach training materials, using a publicly available taxonomy (Michie et al., 2013). We will advance further and code BCTs that are implemented during intervention delivery by coding BCTs from audio-recordings of counseling calls. We will determine the ratio of implemented BCTs to intended BCTs to predict intervention adherence (number of counseling calls delivered) and survivors’ MVPA minutes/week for 12 weeks, as recorded by Fitbit activity trackers. 2) add measures to assess survivors’ intrapersonal (3 domains of self-efficacy, use of behavior self-regulation strategies, and affective response to physical activity) and intrapersonal variables (social support for exercise) at baseline, 4, 8 and 12 weeks. These theory-based variables, representing levels of the Social-Ecological Model, collected during the intervention phase will be used to predict intervention adherence and survivors’ MVPA minutes/week. Data on BCTs and changes in theoretical constructs at the intra-and interpersonal levels will be analyzed to elucidate the process of behavior change initiation (per NOT-OD-22-140). The results will advance knowledge of designing interventions with BCTs that are effective in motivating cancer survivors to become active and thereby improve their functioning and recovery.