Development of an exercise adherence program for breast cancer survivors with cancer-related fatigue—an intervention mapping approach

Abstract

Purpose Cancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors (BCS), with severe impact on quality of life. CRF can be reduced through exercise, but conversely, is also a barrier to exercising. The aim of this article was to apply the intervention mapping protocol (IMP) to develop an exercise adherence intervention for BCS with CRF. Method The program was developed using the IMP, which consists of six steps. Based on the data from focus group interviews and literature review, we produced a logic model of change.Results Two performance objectives (survivors adopt and maintain exercise and survivors cope with fatigue) and 17 change objectives were generated. Also, we designed theory-based methods of change, and strategies for practical application. A structured program plan that includes intervention content and methods, ranges, and program data was proposed. Finally, an implementation and evaluation plan was developed. ConclusionThe IMP provided a useful framework to systematically plan an exercise adherence program. This study resulted in a theory and practice-based exercise adherence program, based on behavioral change theories, and practice-based knowledge that fits the needs of BCS with CRF.

We have the program, what now? Development of an implementation plan to bridge the research-practice gap prevalent in exercise oncology

“…IM is relevant for already developed evidence-based practices, but need a plan to be adopted, implemented, and maintained in a real-world setting [ 15 ]. While the process has been applied as a component of overall program development in exercise oncology [ 18 ], the implementation tasks have not been comprehensively described; however, the protocol has shown promise in other disciplines [ 19 ]. There are five specific tasks involved in this iterative process and each is guided by input from a stakeholder advisory group (SAG) (Table 1 ).…”

Comparison of fatigue and fatigability correlates in Korean breast cancer survivors and differences in associations with anxiety, depression, sleep disturbance, and endocrine symptoms: a randomized controlled trial

“…This follow-up study employed a two-armed, prospective, RCT design. This study was performed to identify the effects of an exercise adherence intervention called BLESS (Better Life after cancer, Energy, Strength, and Support) [ 17 ] at one-year follow-up and assess the effects of long-term exercise on survivors’ fatigue and fatigability, as well as factors related to anxiety, depression, sleep disturbance, and endocrine symptoms in the participants.…”

“…Also, after the end of the program, we made an effort to minimize attrition and maximize exercise adherence for both groups by providing special activities (e.g., candle making, calligraphy sessions, and other activities) at the four follow-up measurement points. The BLESS protocol has been thoroughly described by Kim et al (2019) [ 17 ].…”

We have the program, what now? Development of an implementation strategy to bridge the research-practice gap prevalent in exercise oncology

“…IM is relevant for evidence-based practices that have already been developed, but need a plan to be adopted, implemented, and maintained in a real-world setting [15]. While the process has been applied as a component of overall program development in exercise oncology [18], the implementation tasks have not been comprehensively described; however, the protocol has shown promise in other disciplines [19]. There are ve speci c tasks involved in this iterative process and each is guided by input from a stakeholder advisory group (SAG) ( Table 1).…”