Building a physical activity intervention into clinical care for breast and colorectal cancer survivors in Wisconsin: a randomized controlled pilot trial
Abstract
BACKGROUND: Cancer survivorship care plans (‘care plans’) often recommend an active lifestyle yet are rarely accompanied by programs to help patients enact the prescribed behavior change. As a step towards bridging this gap, this trial tested the feasibility of augmenting care planning with a multi-level physical activity intervention. METHODS: Breast and colorectal cancer survivors were enrolled alongside a self-selected support partner (e.g., spouse, friend). Survivors received a care plan alone (comparison group) versus one augmented with a 12-week physical activity module (intervention group). For the intervention group dyads, both members received a multi-component program including Fitbit trackers, with the survivor’s Fitbit linked to his/her electronic health record (EHR). Treating clinicians received periodic updates regarding the survivors’ physical activity. The primary outcome was ActiGraph-measured physical activity, analyzed using mixed models. Feedback questionnaires were administered to participants and clinicians at 12 weeks. RESULTS: Survivors (n=50) were 54.4±11.2 years of age and 2.0±1.5 years post-diagnosis. Survivors in the intervention group increased moderate-to-vigorous-intensity physical activity (MVPA) by 69±84 min/week vs. a 20±71 min/week decrease in the comparison group (p=.001). Likewise, daily steps increased by 1470±1881 vs. a 398±1751 decrease (P=.002). Among responding clinicians, 100% looked at survivors’ activity data within the EHR at least once and 80% said it provided insight into their patients’ lifestyles. CONCLUSIONS: Augmenting a standard care plan with a multi-level, technology-based intervention increased physical activity among cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS: Technology-based approaches, including activity trackers, can be used by individuals to work towards an active lifestyle after cancer.