Most breast cancer survivors (BCS) are not meeting recommended physical activity guidelines. Here, we report the effects of the Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) behavior change intervention on physical activity, aerobic fitness, and quality of life (QoL). We randomized 222 post-primary treatment BCS to the 3-month intervention (BEAT Cancer) or usual care (UC). BEAT Cancer combined supervised exercise, face-to-face counseling, and group discussions with tapering to home-based exercise. Assessments at baseline, immediately post-intervention (month 3; M3), and 3 months post-intervention (month 6; M6) included accelerometer and self-reported physical activity, submaximal treadmill test, and QoL [Functional Assessment of Cancer Therapy (FACT)-Breast scale]. Adjusted linear mixed-model analyses demonstrated significant effects of BEAT Cancer compared to UC on weekly minutes of ≥moderate intensity physical activity at M3 by accelerometer [mean between group difference (M) = +41; 95 % confidence interval (CI) = 10–73; p = 0.010] and self-report (M = +93; CI = 62–123; p < 0.001). Statistical significance remained at M6 for self-reported physical activity (M = +74; CI = 43–105; p < 0.001). BEAT Cancer participants were significantly more likely to meet physical activity recommendations at both time points [accelerometer M3 adjusted odds ratio (OR) = 2.2; CI = 1.0–4.8 and M6 adjusted OR = 2.4; CI = 1.1–5.3; self-report M3 adjusted OR = 5.2; CI = 2.6–10.4 and M6 adjusted OR = 4.8; CI = 2.3–10.0]. BEAT Cancer significantly improved fitness at M6 (M = +1.8 ml/kg/min; CI = 0.8–2.8; p = 0.001) and QoL at M3 and M6 (M = +6.4; CI = 3.1–9.7; p < 0.001 and M = +3.8; CI = 0.5–7.2; p = 0.025, respectively). The BEAT Cancer intervention significantly improved physical activity, fitness, and QoL with benefits continuing 3 months post-intervention.

Resistance exercise is safe and feasible in patients with head and neck cancer receiving radiation; a definitive trial is warranted.

Most breast cancer survivors do not engage in regular physical activity. Our physical activity behavior change intervention for breast cancer survivors significantly improved physical activity and health outcomes post-intervention during a pilot, feasibility study. Testing in additional sites with a larger sample and longer follow-up is warranted to confirm program effectiveness short and longer term. Importantly, the pilot intervention resulted in changes in physical activity and social cognitive theory constructs, enhancing our potential for testing mechanisms mediating physical activity behavior change. Here, we report the rationale, design, and methods for a two-site, randomized controlled trial comparing the effects of the BEAT Cancer physical activity behavior change intervention to usual care on short and longer term physical activity adherence among breast cancer survivors. Secondary aims include examining social cognitive theory mechanisms of physical activity behavior change and health benefits of the intervention. Study recruitment goal is 256 breast cancer survivors with a history of ductal carcinoma in situ or Stage I, II, or IIIA disease who have completed primary cancer treatment. Outcome measures are obtained at baseline, 3 months (i.e., immediately post-intervention), 6 months, and 12 months and include physical activity, psychosocial factors, fatigue, sleep quality, lower extremity joint dysfunction, cardiorespiratory fitness, muscle strength, and waist-to-hip ratio. Confirming behavior change effectiveness, health effects, and underlying mechanisms of physical activity behavior change interventions will facilitate translation to community settings for improving the health and well-being of breast cancer survivors.

Purpose Data from large randomized controlled trials confirming sleep quality improvements with aerobic physical activity have heretofore been lacking for post-primary treatment breast cancer survivors. Our primary purpose for this report was to determine the effects of a physical activity behavior change intervention, previously reported to significantly increase physical activity behavior, on sleep quality in post-primary treatment breast cancer survivors. Methods Post-primary treatment breast cancer survivors (n=222) were randomized to a 3-month physical activity behavior change intervention (BEAT Cancer) or usual care. Self-report (Pittsburgh Sleep Quality Index [PSQI]) and actigraphy (latency and efficiency) sleep outcomes were measured at baseline, 3 months (M3), and 6 months (M6). Results After adjusting for covariates, BEAT Cancer significantly improved PSQI global sleep quality when compared with usual care at M3 (mean between group difference [M] = −1.4; 95% CI = −2.1 to −0.7; p < .001) and M6 (M = −1.0; 95% CI = −1.7 to −0.2; P = .01). BEAT Cancer improved several PSQI subscales at M3 (sleep quality M = −0.3; 95% CI = −0.4 to −0.1; P = .002; sleep disturbances M = −0.2; 95% CI = −0.3 to −0.03; P = .016; daytime dysfunction M = −0.2; 95% CI = −0.4 to −0.02; P = .027) but not M6. A non-significant increase in percent of participants classified as good sleepers occurred. No significant between group difference was noted for accelerometer latency or efficiency. Conclusion A physical activity intervention significantly reduced perceived global sleep dysfunction at 3 and 6 months, primarily due to improvements in sleep quality aspects not detected with accelerometer.

Objectives To determine the effects of the 3-month multicomponent Better Exercise Adherence after Treatment for Cancer (BEAT Cancer) physical activity behavior change intervention on fatigue, depressive symptomatology, and anxiety. Methods Post-primary treatment breast cancer survivors (n=222) were randomized to BEAT Cancer or usual care (UC). Fatigue Symptom Inventory and Hospital Anxiety and Depression Scale were assessed at baseline, post-intervention (month 3; M3), and follow-up (month 6; M6). Potential demographic, medical, and psychosocial moderators were assessed at baseline. Results Adjusted linear mixed-model analyses demonstrated significant effects of BEAT Cancer versus UC on fatigue intensity (M3 mean between group difference [M] = −0.6; 95% confidence interval [CI] = −1.0 to −0.2; effect size [d] = −0.32; p =.004), fatigue interference (M3 M = −0.8; CI = −1.3 to −0.4; d = −0.40; p < .001), depressive symptomatology (M3 M = −1.3; CI = −2.0 to −0.6; d = −0.38; p < .001), and anxiety (M3 M = −1.3; CI = −2.0 to −0.5; d = −0.33; p < .001). BEAT Cancer effects remained significant at M6 for all outcomes (all p values < .05; d = −0.21 to -.35). Clinically meaningful effects were noted for fatigue intensity, fatigue interference, and depressive symptomatology. Conclusions BEAT Cancer reduces fatigue, depressive symptomatology, and anxiety up to 3 months post-intervention in post-primary treatment breast cancer survivors. Further study is needed to determine sustainable methods for disseminating and implementing the beneficial intervention components.