The primary purpose of this proposed 5-year hybrid effectiveness and implementation study is to evaluate the relative benefit from, and implementation of an Alberta wide clinic-to-community-based cancer and exercise model of care - the Alberta Cancer Exercise (ACE) Program. The investigators hypothesize that the strategy will improve the physical well-being and QoL of survivors (on and off cancer treatment) while preventing the development of secondary cancers.
A total of 2500 adult cancer survivors will be enrolled in the 5-year study. The investigators will build capacity by expanding ACE training and programming to sites beyond the large urban centers. The investigators plan for implementation in 7 Alberta YMCAs and/or City Recreation facilities within 3 years, as well as to formally establish partnerships within AHS to build further capacity across the province within existing AHS programming (e.g., CancerControl Rehab Services, Alberta Healthy Living Program and Primary Care Network). Virtual and supported home-based options will be available as an alternative. Eligible and consenting participants will be screened for exercise safety, and following fitness testing will be triaged to appropriate exercise programming in their home or community. The exercise intervention will take place at the survivor's home, YMCAs and municipal fitness centres across the province. The supported home-based and community-based exercise program will be administered by exercise specialists who have undergone the ACE Cancer and Exercise: Training for Fitness Professionals course. Survivors will take part in a combination of aerobic, resistance, balance, and flexibility exercises delivered in a circuit-type class setting or group personal training format, twice weekly for an 8-to-12-week period. Effectiveness outcomes include physical fitness, physical activity, quality of life, and healthcare utilization. These outcomes are known factors associated with the secondary prevention of cancer. The RE-AIM framework will be used to evaluate program reach, effectiveness, adoption, implementation and maintenance. The Alberta Quality Matrix for Health will serve as a framework to inform program sustainability beyond the funding period. Through this research, the investigators will better understand the effectiveness of the ACE program, and evaluate processes to support future implementation and sustainability.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
2,570
Exercise sessions will include a combination of aerobic, resistance, balance, and flexibility exercises delivered in a circuit-type class setting or group personal training format.
University of Calgary/ Tom Baker Cancer Centre
Calgary, Alberta, Canada
University of Alberta & Cross Cancer Institute
Edmonton, Alberta, Canada
Physical Activity Minutes Per Week
Change in number of participants meeting Guidelines for Physical Activity of 150 minutes per week of moderate intensity exercise
Time frame: Baseline to One-year
Aerobic Endurance
Change in 6 minute walk test distance (metres)
Time frame: Baseline to One-year
Quality of Life Cancer Specific
Change in Functional Assessment of Cancer Therapy General Scale
Time frame: Baseline to One year
General Health-related Quality of Life
Change in Rand Short Form (SF)-36
Time frame: Baseline to One-year
Fatigue
FACT-Fatigue subscale
Time frame: Baseline to One-year
Upper extremity grip strength
Change in hand-grip dynamometry (kg)
Time frame: Baseline to One-year
Functional performance test
Change in sit-to-stand (number in 30 seconds)
Time frame: Baseline to One-year
Upper extremity flexibility
Change in active shoulder flexion range of motion (degrees)
Time frame: Baseline to One-year
Lower extremity flexibility
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Change in sit-and-reach test (cm)
Time frame: Baseline to One-year
Balance
Change in one legged stance test (seconds)
Time frame: Baseline to One-year
Cost-effectiveness evaluation
EQ-5D questionnaire
Time frame: Baseline to One-year
Exercise adherence
Adherence to exercise programming (attendance at sessions)
Time frame: Baseline to 12-weeks
Body Composition
Change in BMI
Time frame: Baseline to One-year
Waist and hip measurements
Change in waist and hip circumference (cm) and change in waist-to-hip ratio
Time frame: Baseline to One-year
Program implementation and evaluation
RE-AIM: program reach, effectiveness, adoption, implementation and maintenance
Time frame: Baseline to One-year
Adverse events
Adverse event rates
Time frame: Baseline to One-year