Peers Promoting Exercise Adoption and Maintenance among Cancer Survivors

描述(由申请者提供)：在癌症幸存者中促进运动接受和维持的同龄人摘要研究环境中的研究表明，在癌症幸存者中采用运动可以改善他们的生活质量、情绪和疲劳。在将这些努力转化为社区环境方面，几乎没有采取什么行动。这种传播对于扩大有效干预措施的范围以改善癌症幸存者的康复和福祉至关重要。我们已经测试了由社区同行志愿者(具体地说，美国癌症协会[ACS]的Reach to Recovery[RTR]志愿者)为乳腺癌幸存者提供的为期3个月的电话锻炼计划的效果。这项基于理论的干预被成功实施，并发现与接触控制条件相比，干预后3个月和6个月的运动量显著增加。干预效果显著，但在6个月时减弱。运动维持对于维持心理社会益处很重要，而且可能会降低癌症复发的风险。维持结果也是将循证行为干预措施转化为实践的基础。因此，在社区组织实施之前，我们建议加强这一干预措施，不仅支持采用锻炼(3个月)，而且通过比较社区组织可以实施的三种循证维护干预措施，支持锻炼12个月。在这项随机对照试验中，在RTR同行志愿者/教练进行了为期3个月的电话锻炼计划后，我们将比较三组：1)REACH Plus(锻炼日志和反馈报告，但不通过电话或短信与教练进行额外联系)，2)REACH Plus电话(每月教练的咨询电话、锻炼日志和反馈报告)，以及3)REACH Plus消息(每月电子邮件/短信、锻炼日志和反馈报告)。总而言之，在第4-9个月，三个小组的参与者将被要求保留锻炼日志，并将获得反馈报告；将通过教练每月的电话(REACH PLUS电话)或电子邮件/短信(REACH PLUS消息)提供扩展支持。我们将招募150名患者，并在基线、3个月、6个月、9个月和12个月时评估运动(主要结果)、疲劳、生活质量和情绪。我们还将进行成本效益分析，为传播工作提供信息。如果建议的试验显示出积极的效果，我们将设计一项在社区环境下在乳腺癌幸存者中采用和维持锻炼的同伴指导方法的传播试验。与提供同伴指导的癌症护理组织合作，可以扩大促进幸存者康复的努力的范围(“扩大”)。

DESCRIPTION (provided by applicant): Peers Promoting Exercise Adoption and Maintenance among Cancer Survivors ABSTRACT Studies in research settings have demonstrated that exercise adoption among cancer survivors can improve their quality of life, mood and fatigue. Little has been done to translate these efforts into a community-setting. Such dissemination is essential to extend the reach of efficacious interventions to improve the recovery and well-being of cancer survivors. We have tested the effects of a 3-month telephone-based exercise program offered by community peer volunteers (specifically, Reach to Recovery [RTR] volunteers of the American Cancer Society [ACS]) to breast cancer survivors. This theory-based intervention was successfully delivered and was found to significantly increase exercise at 3 months (post-intervention) and at 6 months compared to a contact control condition. Intervention effects were significant but attenuated at 6 months. Exercise maintenance is important to sustain psychosocial benefits and may reduce risk for cancer recurrence. Maintenance of outcomes is also fundamental to informing the translation of evidence-based behavioral interventions into practice. Hence, prior to implementation in community-based organizations, we propose to enhance this intervention to support not only the adoption of exercise (3 months) but also its maintenance at 12 months by comparing three evidence-based maintenance interventions that can be implemented by community-based organizations. In this randomized controlled trial, after the 3-month telephone-based exercise program from RTR peer volunteers/coaches, we will compare three groups: 1) Reach Plus (exercise logs and feedback reports but no additional contact with coaches via phone or messages), 2) Reach Plus Phone (monthly counseling calls from coaches, exercise logs and feedback reports), and 3) Reach Plus Messages (monthly email/text messages, exercise logs and feedback reports). In sum, during Months 4-9, participants in the three groups will be asked to keep exercise logs and will be provided feedback reports; extended support will be offered via monthly telephone calls from the coaches (Reach Plus Phone) or email/text messages (Reach Plus Messages). We will enroll 150 patients and assess exercise (primary outcome), fatigue, QOL and mood at baseline, 3, 6, 9 and 12 months. We will also conduct cost-effectiveness analyses to inform dissemination efforts. If the proposed trial demonstrates positive effects, we will design a dissemination trial f a peer mentored approach for exercise adoption and maintenance among breast cancer survivors in a community setting. Partnering with cancer care organizations that offer peer mentoring can expand the reach ("scale up") of efforts to enhance survivors' recovery.