A nurse-led physical activity program including an individualized exercise program using wearable technology and health coaching based on Social Cognitive Theory will be implemented for women surviving cancer. The impact of the nurse-led physical activity program on physical activity level, health-related quality of life and cognitive factors (self regulation, outcome expectation, self efficacy, perceived social support, perceived environment) will be evaluated in the study.
This study protocol describes a randomized controlled trial with parallel group design. Participants will be Breast cancer survivors who aged 18-65, have finished active treatment (surgery, chemotherapy, and/or radiotherapy) in the previous 5 years, no evidence of recurrence and contraindications, and are completing less than 150-minutes of Moderate-Vigorous intensity Physical Activity (MVPA) per week. Participants will be randomly assigned to the intervention and control group. Wearable Technology using Social Cognitive Theory based physical activity program (WATSOCPAP) created for the Intervention Group includes 3 different intervention components: (1) Supervised and individualized exercise plan; (2) Physical activity monitoring with activity tracker; (3) Nurse-led physical activity coaching program. Participants will be administered strengthening and aerobic exercise program, structured and individualized according to the person's individual capacity and needs, under the supervision of a physiotherapist. The activity tracker will provide real-time activity information about daily steps, time spent with MVPA (minutes/day) and sedentary time. The nurse-led physical activity coaching program was planned according to the Social Cognitive Theory (SCT) components such as self-regulation, outcome expectation, social support and perceived environment. WATSOCPAP is a 12-week program that includes text messages, face-to-face and online interviews. The first intervention in this group will begin with a 60-minute face-to-face individual training. After the first interview, text messages will be made according to the Social Cognitive Theory (SCT) components per weeks. Control group will receive standard care. Follow-up questionnaires will be applied by repeating the post-test at the 24th week. In the intervention and control groups, post-test will be applied 12 weeks after the pre-test, and follow-up questionnaires will be applied 24 weeks after the pre-test.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
84
Participants will receive an supervised and individualized exercise plan, activity tracker, and physical activity coaching program based Social Cognitive Theory. Participants will be administered strengthening and aerobic exercise program, structured and individualized according to the person's individual capacity and needs, under the supervision of a physiotherapist. The activity tracker will provide real-time activity information about daily steps, time spent with MVPA (minutes/day) and sedentary time. The nurse-led physical activity coaching program was planned according to the Social Cognitive Theory (SCT) components such as self-regulation, outcome expectation, social support and perceived environment. The interventions will continue with online and the 12-week program will be completed.
Istanbul University-Cerrahpasa
Istanbul, Turkey (Türkiye)
Self Reported Physical Activity
Change in physical activity, as measured by the "International Physical Activity Questionnaire-Short Form", from baseline to 12 and 24 weeks. Participants report frequency of light, moderate and vigorous physical activity, and average duration (minutes/week) bouts for 10 minutes or longer in the last seven days. Scores for light, moderate and vigorous exercise are combined to compute total physical activity minutes/week. Computation of the total score for the short form requires summation of the duration (in minutes) and frequency (days) of walking, moderate-intensity and vigorous-intensity activities. Standard MET (metabolic equivalent) values for activities were established. The 'MET-min/week' value is obtained by multiplying the MET value of each physical activity level with the days and minutes this physical activity is performed every week. The obtained MET value is classified as HEPA active (MET\>3000), minimally active (MET=600-3000), and inactive (MET\<600).
Time frame: Baseline, 12 weeks, 24 weeks
Health Related Quality of Life: EORTC-QLQ-C30
Change in general health-related quality of life, as measured using the The European Organization for Research and Treatment of Cancer (EORTC) developed a cancer-specific core questionnaire (QLQ-C30), from baseline to 12 and 24 weeks. QLQ-C30 is composed of 30 items assessing global perceived health status and QoL. These items are grouped in five functional scales (physical functioning, role functioning, emotional functioning, cognitive functioning, and social functioning); three symptom scales (fatigue, nausea \& vomiting, and pain); six single item scales. Responses are coded on a scale of 0 to 4 where 0 is not at all and 4 is very much. A rise in the functional dimension score and a fall in the symptom dimension score signify an improvement in QoL. High general well-being dimension scores are indicative of a QoL. The computation yields scores for every dimension out of a possible 100, with scores ranging from 0 to 100.
Time frame: Baseline, 12 weeks, 24 weeks
Health Related Quality of Life-Breast Cancer Specified: EORTC-QLQ-BR23
Change in health-related quality of life-Breast Cancer Specified, as measured using the EORTC-QLQ-BR23, from baseline to 12 and 24 weeks. QLQ-BR23 questionnaire has 23 items to assess functional scales (body image), sexual functioning, sexual enjoyment, and future perspective); symptom scales (systemic therapy side effects, breast symptoms, arm symptoms, and upset by hair loss). The total score range of the scale is 0-100. A high quality of life is indicated by a low score in the symptom dimension and a high score in the functional dimension of the scale.
Time frame: Baseline, 12 weeks, 24 weeks
BMI
Change in BMI, as measured objectively with digital scales, from baseline to to 12 and 24 weeks.
Time frame: Baseline, 12 weeks, 24 weeks
Fatigue
Change in fatigue, as measured by the The Functional Assessment of Chronic Illness Treatment-Fatigue Scale (FACIT-F), from baseline to 12 and 24 weeks. The FACIT-F Scale is composed of 13 expressions that measure the fatigue that the patients had in the last seven days.7 The expressions on the scale consist of Likert type question form which is scored between 0 and 4 and con- sists of ''Not at all'', ''A little bit'', ''Somewhat'', ''Quite a bit'', and ''Very much''. The total score range of the scale is 0-52. The higher the scale score, the lower the fatigue level of the patient.
Time frame: Baseline, 12 weeks, 24 weeks
Self-efficacy For Exercise
Change in self-efficacy for exercise, as measured by the The Exercise Self-efficacy Scale, from baseline to 12 and 24 weeks. Responses 18 items, ranging from 0 (cannot do it) to 100 (definitely can do it), are summed, with higher values representing higher efficacy beliefs for exercises.
Time frame: Baseline, 12 weeks, 24 weeks
Outcome Expectations for Exercise
Change in outcome expectations for exercise, as measured by the Multidimensional Outcome Expectations for Exercise Scale, from baseline to 12 and 24 weeks. Responses for three subscales (physical subscale, social subscale, self-evaluative subscale), ranging from 1 (strongly disagree) to 5 (strongly agree), are summed, with higher values representing higher outcome expectations for exercise.
Time frame: Baseline, 12 weeks, 24 weeks
Self-regulation
Change in self-regulation, as measured using by self-report questionnaire, from baseline to 12 and 24 weeks. Responses to two subscales (Exercise goal-setting, Exercise planning and scheduling), ranging from 1 (does not describe) to 5 (describes completely), are averaged to yield two subscales. Higher subscale scores represent higher self-regulation.
Time frame: Baseline, 12 weeks, 24 weeks
Multidimensional Perceived Social Support Scale
Change in social support, as measured by the Multidimensional Perceived Social Support Scale, from baseline to 12 and 24 weeks. Responses for three factors (Family participation, Friend participation, a special person participation), ranging from 1 to 7, are summed, with higher values representing higher perceived social support.
Time frame: Baseline, 12 weeks, 24 weeks
Perceived Environment
Change in perceived environment, as measured using the Physical Activity Neighborhood Environment Scale (PANES) survey, from baseline to 12 and 24 weeks. PANES is a 17-item measure perceived attributes of the neighborhood environment related to physical activity. Concepts assessed by PANES include residential density (1 item), access to destinations (3 items), pedestrian and bicycling facilities (4 items), recreational facilities (1 item), aesthetic qualities (1 item), social environment (1 item), street connectivity (1 item), traffic safety (2 items), crime safety (2 items), and household motor vehicles (1 item). With the exception of the residential density and household motor vehicle questions, items ranging ranging from 1 (strongly disagree) to 5 (strongly agree), as well as don't know or doesn't apply response option.
Time frame: Baseline, 12 weeks, 24 weeks
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