Skip to main content

Advertisement

SpringerLink
Log in

Adherence to a lower versus higher intensity physical activity intervention in the Breast Cancer & Physical Activity Level (BC-PAL) Trial

  • Published:
Journal of Cancer Survivorship Aims and scope Submit manuscript

Abstract

Purpose

The first aim is to examine adherence to a lower versus higher intensity physical activity (PA) prescription in breast cancer survivors in the Breast Cancer & Physical Activity Level (BC-PAL) Trial. The second aim is to assess associations between baseline characteristics with mean PA adherence in both intervention groups combined.

Methods

Forty-five participants were randomized to a 12-week, home-based lower (300 min/week, 40-59% heart rate reserve (HRR)) or higher (150 min/week, 60-80% HRR) intensity PA intervention, or no intervention/control. Both intervention groups received Polar A360® trackers and were included in this analysis (n=30). Study outcomes assessed on a weekly basis with the Polar A360® activity tracker throughout the intervention included relative adherence to the prescribed PA interventions (% of PA prescription goal met), and the absolute amount of PA time ≥40% of HRR. Baseline predictors of adherence included demographic characteristics, cardiorespiratory fitness, habitual PA and sedentary time, quality of life measures, and motivational variables from the Theory of Planned Behavior. For our primary aim, a linear mixed model was used to assess the effects of randomization group, time (intervention weeks 1-12), and the interaction of these factors on the natural logarithm of PA adherence. For our secondary aim, the association between each baseline predictor with the natural logarithm of mean weekly PA adherence was assessed, with randomization group added as a covariate.

Results

Higher relative time within the prescribed HRR zone was noted in the lower versus higher intensity PA groups (eβ=3.12, 95% CI=1.97, 4.95). No differences in adherence across time were noted. Social support was inversely associated with relative PA time within the prescribed HRR zone (eβ=0.83, 95% CI=0.72, 0.97) and absolute PA time ≥40% of HRR (eβ= 0.82, 95% CI: 0.71, 0.93). Baseline VO2max was inversely associated with relative PA adherence (eβ=0.98, 95% CI=0.95, 0.99). No other baseline measures were associated with PA adherence.

Conclusions

There were no significant changes in absolute PA time ≥40% of HRR across time or between groups. However, the lower intensity PA group averaged over 3 times the relative amount of PA within the prescribed HRR zone compared to the higher intensity PA group. Finally, lower peer support and cardiorespiratory fitness at baseline were associated with higher PA adherence.

Implications for Cancer Survivors

The recent rise in popularity of commercially available activity trackers provides new opportunities to promote PA participation remotely, and these devices can be used to continuously and objectively measure PA levels as an indicator of intervention adherence. Future studies are needed to explore baseline predictors, facilitators, and barriers to sustained activity tracker use to promote PA behavior change and intervention adherence in cancer survivors.

Trial registration

This study was registered at www.clinicaltrials.gov (No. NCT03564899) on June 21, 2018.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):243–74. https://doi.org/10.3322/caac.21142.

    Article  PubMed  Google Scholar 

  2. Kushi LH, Doyle C, McCullough M, Rock CL, Demark-Wahnefried W, Bandera EV, et al. American Cancer Society Guidelines on nutrition and physical activity for cancer prevention: reducing the risk of cancer with healthy food choices and physical activity. CA Cancer J Clin. 2012;62(1):30–67. https://doi.org/10.3322/caac.20140.

    Article  PubMed  Google Scholar 

  3. Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26. https://doi.org/10.1249/MSS.0b013e3181e0c112.

    Article  PubMed  Google Scholar 

  4. American College of Sports Medicine. ACSM’s Guidelines for Exercise Testing and Prescription. 9th ed. Baltimore and Philadelhia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014.

    Google Scholar 

  5. Casla S, Lopez-Tarruella S, Jerez Y, Marquez-Rodas I, Galvao DA, Newton RU, et al. Supervised physical exercise improves VO2max, quality of life, and health in early stage breast cancer patients: a randomized controlled trial. Breast Cancer Res Treat. 2015;153(2):371–82. https://doi.org/10.1007/s10549-015-3541-x.

    Article  PubMed  Google Scholar 

  6. Dieli-Conwright CM, Courneya KS, Demark-Wahnefried W, Sami N, Lee K, Buchanan TA, et al. Effects of aerobic and resistance exercise on metabolic syndrome, sarcopenic obesity, and circulating biomarkers in overweight or obese survivors of breast cancer: a randomized controlled trial. J Clin Oncol Off J Am Soc Clin Oncol. 2018;36(9):875–83. https://doi.org/10.1200/jco.2017.75.7526.

    Article  CAS  Google Scholar 

  7. Lahart IM, Metsios GS, Nevill AM, Kitas GD, Carmichael AR. Randomised controlled trial of a home-based physical activity intervention in breast cancer survivors. BMC Cancer. 2016;16:234. https://doi.org/10.1186/s12885-016-2258-5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Meneses-Echavez JF, Gonzalez-Jimenez E, Ramirez-Velez R. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer. 2015;15:77. https://doi.org/10.1186/s12885-015-1069-4.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, et al. Exercise guidelines for cancer survivors: consensus statement from International Multidisciplinary Roundtable. Med Sci Sports Exerc. 2019. https://doi.org/10.1249/MSS.0000000000002116.

  10. World Health Organization. Adherence to long-term therapies: evidence for action. https://www.who.int/chp/knowledge/publications/adherence_report/en/. Accessed 5 Dec 2020.

  11. Kampshoff CS, van Mechelen W, Schep G, Nijziel MR, Witlox L, Bosman L, et al. Participation in and adherence to physical exercise after completion of primary cancer treatment. Int J Behav Nutr Phys Act. 2016;13(1):100. https://doi.org/10.1186/s12966-016-0425-3.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Courneya KS, Karvinen KH, McNeely ML, Campbell KL, Brar S, Woolcott CG, et al. Predictors of adherence to supervised and unsupervised exercise in the Alberta Physical Activity and Breast Cancer Prevention Trial. J Phys Act Health. 2012;9(6):857–66.

    Article  PubMed  Google Scholar 

  13. Aycinena AC, Valdovinos C, Crew KD, Tsai WY, Mata JM, Sandoval R, et al. Barriers to recruitment and adherence in a randomized controlled diet and exercise weight loss intervention among minority breast cancer survivors. J Immigr Minor Health. 2017;19(1):120–9. https://doi.org/10.1007/s10903-015-0310-1.

    Article  PubMed  Google Scholar 

  14. Pinto BM, Rabin C, Dunsiger S. Home-based exercise among cancer survivors: adherence and its predictors. Psycho-oncology. 2009;18(4):369–76. https://doi.org/10.1002/pon.1465.

    Article  PubMed  PubMed Central  Google Scholar 

  15. De Kruif A, Op Den Kelder-Verstraten I, Derks M, Van Den Berg M, De Vries Y, Kamps L, et al. The perceptions of women with breast cancer during treatment with chemotherapy on changes in weight; a mixed methods approach. Eur J Cancer. 2015;3:S319–S20.

    Article  Google Scholar 

  16. Witlox L, Velthuis MJ, Boer JH, Steins Bisschop CN, Wall EV, Meulen W, et al. Attendance and compliance with an exercise program during localized breast cancer treatment in a randomized controlled trial: the PACT study. PLoS One. 2019;14(5):e0215517. https://doi.org/10.1371/journal.pone.0215517.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Courneya KS, Friedenreich CM, Sela RA, Quinney HA, Rhodes RE. Correlates of adherence and contamination in a randomized controlled trial of exercise in cancer survivors: an application of the theory of planned behavior and the five factor model of personality. Ann Behav Med. 2002;24(4):257–68. https://doi.org/10.1207/s15324796abm2404_02.

    Article  PubMed  Google Scholar 

  18. Cadmus-Bertram L, Marcus BH, Patterson RE, Parker BA, Morey BL. Use of the Fitbit to measure adherence to a physical activity intervention among overweight or obese, postmenopausal women: self-monitoring trajectory during 16 weeks. JMIR mHealth uHealth. 2015;3(4):e96. https://doi.org/10.2196/mhealth.4229.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Nyrop KA, Deal AM, Choi SK, Wagoner CW, Lee JT, Wood WA, et al. Measuring and understanding adherence in a home-based exercise intervention during chemotherapy for early breast cancer. Breast Cancer Res Treat. 2018;168(1):43–55. https://doi.org/10.1007/s10549-017-4565-1.

    Article  CAS  PubMed  Google Scholar 

  20. Hartman SJ, Nelson SH, Weiner LS. Patterns of Fitbit use and activity levels throughout a physical activity intervention: exploratory analysis from a randomized controlled trial. JMIR mHealth uHealth. 2018;6(2):e29. https://doi.org/10.2196/mhealth.8503.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Hardcastle SJ, Jiménez-Castuera R, Maxwell-Smith C, Bulsara MK, Hince D. Fitbit wear-time and patterns of activity in cancer survivors throughout a physical activity intervention and follow-up: exploratory analysis from a randomised controlled trial. PLoS One. 2020;15(10):e0240967. https://doi.org/10.1371/journal.pone.0240967.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Gell NM, Grover KW, Savard L, Dittus K. Outcomes of a text message, Fitbit, and coaching intervention on physical activity maintenance among cancer survivors: a randomized control pilot trial. J Cancer Surviv Res Pract. 2020;14(1):80–8. https://doi.org/10.1007/s11764-019-00831-4.

    Article  Google Scholar 

  23. Maxwell-Smith C, Hince D, Cohen PA, Bulsara MK, Boyle T, Platell C, et al. A randomized controlled trial of WATAAP to promote physical activity in colorectal and endometrial cancer survivors. Psycho-oncology. 2019;28(7):1420–9. https://doi.org/10.1002/pon.5090.

    Article  PubMed  Google Scholar 

  24. Rossi A, Frechette L, Miller D, Miller E, Friel C, Van Arsdale A, et al. Acceptability and feasibility of a Fitbit physical activity monitor for endometrial cancer survivors. Gynecol Oncol. 2018;149(3):470–5. https://doi.org/10.1016/j.ygyno.2018.04.560.

    Article  PubMed  Google Scholar 

  25. Ferrante JM, Devine KA, Bator A, Rodgers A, Ohman-Strickland PA, Bandera EV, et al. Feasibility and potential efficacy of commercial mHealth/eHealth tools for weight loss in African American breast cancer survivors: pilot randomized controlled trial. Transl Behav Med. 2020;10(4):938–48. https://doi.org/10.1093/tbm/iby124.

    Article  PubMed  Google Scholar 

  26. Van Blarigan EL, Chan H, Van Loon K, Kenfield SA, Chan JM, Mitchell E, et al. Self-monitoring and reminder text messages to increase physical activity in colorectal cancer survivors (Smart Pace): a pilot randomized controlled trial. BMC Cancer. 2019;19(1):218. https://doi.org/10.1186/s12885-019-5427-5.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Kenfield SA, Van Blarigan EL, Ameli N, Lavaki E, Cedars B, Paciorek AT, et al. Feasibility, acceptability, and behavioral outcomes from a technology-enhanced behavioral change intervention (Prostate 8): a pilot randomized controlled trial in men with prostate cancer. Eur Urol. 2019;75(6):950–8. https://doi.org/10.1016/j.eururo.2018.12.040.

    Article  PubMed  Google Scholar 

  28. Ross KM, Wing RR. Impact of newer self-monitoring technology and brief phone-based intervention on weight loss: a randomized pilot study. Obesity (Silver Spring, Md). 2016;24(8):1653–9. https://doi.org/10.1002/oby.21536.

    Article  Google Scholar 

  29. Lyons EJ, Swartz MC, Lewis ZH, Martinez E, Jennings K. Feasibility and acceptability of a wearable technology physical activity intervention with telephone counseling for mid-aged and older adults: a randomized controlled pilot trial. JMIR mHealth uHealth. 2017;5(3):e28. https://doi.org/10.2196/mhealth.6967.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Valle CG, Deal AM, Tate DF. Preventing weight gain in African American breast cancer survivors using smart scales and activity trackers: a randomized controlled pilot study. J Cancer Surviv Res Pract. 2017;11(1):133–48. https://doi.org/10.1007/s11764-016-0571-2.

    Article  Google Scholar 

  31. McNeil J, Brenner DR, Stone CR, O’Reilly R, Ruan Y, Vallance JK, et al. Activity tracker to prescribe various exercise intensities in breast cancer survivors. Med Sci Sports Exerc. 2019;51(5):930–40. https://doi.org/10.1249/mss.0000000000001890.

    Article  PubMed  Google Scholar 

  32. Yoke M. Physical activity beliefs in sedentary, middle-aged, overweight women. Women Sport Phys Act. 2017;25:65–72.

    Article  Google Scholar 

  33. Norton K, Norton L, Sadgrove D. Position statement on physical activity and exercise intensity terminology. J Sci Med Sport. 2010;13(5):496–502. https://doi.org/10.1016/j.jsams.2009.09.008.

    Article  PubMed  Google Scholar 

  34. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011;43(7):1334–59. https://doi.org/10.1249/MSS.0b013e318213fefb.

    Article  PubMed  Google Scholar 

  35. Thorup C, Hansen J, Gronkjaer M, Andreasen JJ, Nielsen G, Sorensen EE, et al. Cardiac patients’ walking activity determined by a step counter in cardiac telerehabilitation: data from the Intervention Arm of a Randomized Controlled Trial. J Med Internet Res. 2016;18(4):e69. https://doi.org/10.2196/jmir.5191.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Stone CR, Friedenreich CM, O’Reilly R, Farris MS, Vallerand JR, Kang DW, et al. Predictors of adherence to different volumes of exercise in the breast cancer and exercise trial in Alberta. Ann Behav Med. 2019;53(5):453–65. https://doi.org/10.1093/abm/kay057.

    Article  PubMed  Google Scholar 

  37. Courneya KS, Blanchard CM, Laing DM. Exercise adherence in breast cancer survivors training for a dragon boat race competition: a preliminary investigation. Psycho-oncology. 2001;10(5):444–52.

    Article  CAS  PubMed  Google Scholar 

  38. Courneya KS, Segal RJ, Gelmon K, Reid RD, Mackey JR, Friedenreich CM, et al. Predictors of supervised exercise adherence during breast cancer chemotherapy. Med Sci Sports Exerc. 2008;40(6):1180–7. https://doi.org/10.1249/MSS.0b013e318168da45.

    Article  PubMed  Google Scholar 

  39. Courneya KS, Segal RJ, Gelmon K, Mackey JR, Friedenreich CM, Yasui Y, et al. Predictors of adherence to different types and doses of supervised exercise during breast cancer chemotherapy. Int J Behav Nutr Phys Act. 2014;11:85. https://doi.org/10.1186/s12966-014-0085-0.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Huang HP, Wen FH, Tsai JC, Lin YC, Shun SC, Chang HK, et al. Adherence to prescribed exercise time and intensity declines as the exercise program proceeds: findings from women under treatment for breast cancer. Support Care Cancer. 2015;23(7):2061–71. https://doi.org/10.1007/s00520-014-2567-7.

    Article  PubMed  Google Scholar 

  41. Latka RN, Alvarez-Reeves M, Cadmus L, Irwin ML. Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: the Yale exercise and survivorship study. J Cancer Surviv Res Pract. 2009;3(3):148–57. https://doi.org/10.1007/s11764-009-0088-z.

    Article  Google Scholar 

  42. Ormel HL, van der Schoot GGF, Sluiter WJ, Jalving M, Gietema JA, Walenkamp AME. Predictors of adherence to exercise interventions during and after cancer treatment: a systematic review. Psycho-oncology. 2018;27(3):713–24. https://doi.org/10.1002/pon.4612.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Pollock ML, Foster C, Schmidt D, Hellman C, Linnerud AC, Ward A. Comparative analysis of physiologic responses to three different maximal graded exercise test protocols in healthy women. Am Heart J. 1982;103(3):363–73. https://doi.org/10.1016/0002-8703(82)90275-7.

    Article  CAS  PubMed  Google Scholar 

  44. Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc accelerometer. Med Sci Sports Exerc. 1998;30(5):777–81.

    Article  CAS  PubMed  Google Scholar 

  45. Matthew CE. Calibration of accelerometer output for adults. Med Sci Sports Exerc. 2005;37(11 Suppl):S512–22.

    Article  PubMed  Google Scholar 

  46. Matthews CE, Keadle SK, Berrigan D, Staudenmayer J, Saint-Maurice PF, Troiano RP, et al. Influence of accelerometer calibration approach on moderate-vigorous physical activity estimates for adults. Med Sci Sports Exerc. 2018;50(11):2285–91. https://doi.org/10.1249/mss.0000000000001691.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Strath SJ, Rowley TW. Wearables for promoting physical activity. Clin Chem. 2018;64(1):53–63. https://doi.org/10.1373/clinchem.2017.272369.

    Article  CAS  PubMed  Google Scholar 

  48. Ware JE Jr, Kosinski M, Turner-Bowker DM, Gandek B. How to score version 2 of the SF-12® health survey (with a supplement documenting version 1). Lincol, Rhode Island: QualityMetric Incorporated; 2002.

    Google Scholar 

  49. Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33. https://doi.org/10.1097/00005650-199603000-00003.

    Article  PubMed  Google Scholar 

  50. Jakobsson U. Using the 12-item Short Form health survey (SF-12) to measure quality of life among older people. Aging Clin Exp Res. 2007;19(6):457–64. https://doi.org/10.1007/bf03324731.

    Article  PubMed  Google Scholar 

  51. Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211.

    Article  Google Scholar 

  52. An KY, Kang DW, Morielli AR, Friedenreich CM, Reid RD, McKenzie DC, et al. Patterns and predictors of exercise behavior during 24 months of follow-up after a supervised exercise program during breast cancer chemotherapy. Int J Behav Nutr Phys Act. 2020;17(1):23. https://doi.org/10.1186/s12966-020-00924-9.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Courneya KS, Friedenreich CM, Reid RD, Gelmon K, Mackey JR, Ladha AB, et al. Predictors of follow-up exercise behavior 6 months after a randomized trial of exercise training during breast cancer chemotherapy. Breast Cancer Res Treat. 2009;114(1):179–87. https://doi.org/10.1007/s10549-008-9987-3.

    Article  PubMed  Google Scholar 

  54. Keats MR, Culos-Reed SN, Courneya KS, McBride M. Understanding physical activity in adolescent cancer survivors: an application of the theory of planned behavior. Psycho-oncology. 2007;16(5):448–57. https://doi.org/10.1002/pon.1075.

    Article  PubMed  Google Scholar 

  55. Jones LW, Courneya KS, Vallance JK, Ladha AB, Mant MJ, Belch AR, et al. Understanding the determinants of exercise intentions in multiple myeloma cancer survivors: an application of the theory of planned behavior. Cancer Nurs. 2006;29(3):167–75. https://doi.org/10.1097/00002820-200605000-00001.

    Article  PubMed  Google Scholar 

  56. Blanchard CM, Courneya KS, Rodgers WM, Murnaghan DM. Determinants of exercise intention and behavior in survivors of breast and prostate cancer: an application of the theory of planned behavior. Cancer Nurs. 2002;25(2):88–95. https://doi.org/10.1097/00002820-200204000-00002.

    Article  PubMed  Google Scholar 

  57. Karvinen KH, Courneya KS, Plotnikoff RC, Spence JC, Venner PM, North S. A prospective study of the determinants of exercise in bladder cancer survivors using the Theory of Planned Behavior. Support Care Cancer. 2009;17(2):171–9. https://doi.org/10.1007/s00520-008-0471-8.

    Article  PubMed  Google Scholar 

  58. Pope ZC, Zeng N, Zhang R, Lee HY, Gao Z. Effectiveness of combined smartwatch and social media intervention on breast cancer survivor health outcomes: a 10-week pilot randomized trial. J Clin Med. 2018;7(6). https://doi.org/10.3390/jcm7060140.

  59. Wang JB, Cadmus-Bertram LA, Natarajan L, White MM, Madanat H, Nichols JF, et al. Wearable sensor/device (Fitbit One) and SMS text-messaging prompts to increase physical activity in overweight and obese adults: a randomized controlled trial. Telemed J E-health. 2015;21(10):782–92. https://doi.org/10.1089/tmj.2014.0176.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Kirk MA, Amiri M, Pirbaglou M, Ritvo P. Wearable technology and physical activity behavior change in adults with chronic cardiometabolic disease: a systematic review and meta-analysis. Am J Health Promot. 2019;33(5):778–91. https://doi.org/10.1177/0890117118816278.

    Article  PubMed  Google Scholar 

  61. 2018 Physical Activity Guidelines Advisory Committee. Physical Activity Guidelines Advisory Committee Scientifc Report. Washington, DC: Department of Health and Human Services; 2018.

    Google Scholar 

  62. Saint-Maurice PF, Troiano RP, Matthews CE, Kraus WE. Moderate-to-vigorous physical activity and all-cause mortality: do bouts matter? J Am Heart Assoc. 2018;7(6). https://doi.org/10.1161/jaha.117.007678.

  63. Pearce M, Strain T, Kim Y, Sharp SJ, Westgate K, Wijndaele K, et al. Estimating physical activity from self-reported behaviours in large-scale population studies using network harmonisation: findings from UK Biobank and associations with disease outcomes. Int J Behav Nutr Phys Act. 2020;17(1):40. https://doi.org/10.1186/s12966-020-00937-4.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Henriksen A, Haugen Mikalsen M, Woldaregay AZ, Muzny M, Hartvigsen G, Hopstock LA, et al. Using fitness trackers and smartwatches to measure physical activity in research: analysis of consumer wrist-worn wearables. J Med Internet Res. 2018;20(3):e110. https://doi.org/10.2196/jmir.9157.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Aggarwal B, Liao M, Mosca L. Predictors of physical activity at 1 year in a randomized controlled trial of family members of patients with cardiovascular disease. J Cardiovasc Nurs. 2010;25(6):444–9. https://doi.org/10.1097/JCN.0b013e3181defd3e.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Cadmus-Bertram L, Irwin M, Alfano C, Campbell K, Duggan C, Foster-Schubert K, et al. Predicting adherence of adults to a 12-month exercise intervention. J Phys Act Health. 2014;11(7):1304–12. https://doi.org/10.1123/jpah.2012-0258.

    Article  PubMed  Google Scholar 

  67. Joseph RP, Dutton GR, Cherrington A, Fontaine K, Baskin M, Casazza K, et al. Feasibility, acceptability, and characteristics associated with adherence and completion of a culturally relevant internet-enhanced physical activity pilot intervention for overweight and obese young adult African American women enrolled in college. BMC Res Notes. 2015;8:209. https://doi.org/10.1186/s13104-015-1159-z.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Marquez B, Anderson A, Wing RR, West DS, Newton RL, Meacham M, et al. The relationship of social support with treatment adherence and weight loss in Latinos with type 2 diabetes. Obesity (Silver Spring, Md). 2016;24(3):568–75. https://doi.org/10.1002/oby.21382.

    Article  Google Scholar 

  69. Arem H, Sorkin M, Cartmel B, Fiellin M, Capozza S, Harrigan M, et al. Exercise adherence in a randomized trial of exercise on aromatase inhibitor arthralgias in breast cancer survivors: the Hormones and Physical Exercise (HOPE) study. J Cancer Surviv Res Pract. 2016;10(4):654–62. https://doi.org/10.1007/s11764-015-0511-6.

    Article  Google Scholar 

  70. Sadja J, Tomfohr L, Jimenez JA, Edwards KM, Rock CL, Calfas K, et al. Higher physical fatigue predicts adherence to a 12-week exercise intervention in women with elevated blood pressure. Health Psychol. 2012;31(2):156–63. https://doi.org/10.1037/a0025785.

    Article  PubMed  Google Scholar 

  71. Kirkham AA, Campbell KL, McKenzie DC. Comparison of aerobic exercise intensity prescription methods in breast cancer. Med Sci Sports Exerc. 2013;45(8):1443–50. https://doi.org/10.1249/MSS.0b013e3182895195.

    Article  PubMed  Google Scholar 

  72. Gorzelitz J, Costanzo ES, Spencer RJ, Rumble M, Rose SL, Cadmus-Bertram L. Longitudinal assessment of post-surgical physical activity in endometrial and ovarian cancer patients. PLoS One. 2019;14(10):e0223791. https://doi.org/10.1371/journal.pone.0223791.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. McDonald L, Oguz M, Carroll R, Thakkar P, Yang F, Dhalwani N, et al. Comparison of accelerometer-derived physical activity levels between individuals with and without cancer: a UK Biobank study. Future Oncol. 2019;15(33):3763–74. https://doi.org/10.2217/fon-2019-0443.

    Article  CAS  PubMed  Google Scholar 

  74. Sweegers MG, Boyle T, Vallance JK, Chinapaw MJ, Brug J, Aaronson NK, et al. Which cancer survivors are at risk for a physically inactive and sedentary lifestyle? Results from pooled accelerometer data of 1447 cancer survivors. Int J Behav Nutr Phys Act. 2019;16(1):66. https://doi.org/10.1186/s12966-019-0820-7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  75. Peddle-McIntyre CJ, Cavalheri V, Boyle T, McVeigh JA, Jeffery E, Lynch BM, et al. A review of accelerometer-based activity monitoring in cancer survivorship research. Med Sci Sports Exerc. 2018;50(9):1790–801. https://doi.org/10.1249/mss.0000000000001644.

    Article  PubMed  Google Scholar 

  76. Lloyd GR, Oza S, Kozey-Keadle S, Pellegrini CA, Conroy DE, Penedo FJ, et al. Breast cancer survivors’ beliefs and preferences regarding technology-supported sedentary behavior reduction interventions. AIMS Public Health. 2016;3(3):592–614. https://doi.org/10.3934/publichealth.2016.3.592.

    Article  PubMed  PubMed Central  Google Scholar 

  77. Nguyen NH, Hadgraft NT, Moore MM, Rosenberg DE, Lynch C, Reeves MM, et al. A qualitative evaluation of breast cancer survivors’ acceptance of and preferences for consumer wearable technology activity trackers. Support Care Cancer. 2017;25(11):3375–84. https://doi.org/10.1007/s00520-017-3756-y.

    Article  PubMed  Google Scholar 

  78. Hardcastle SJ, Galliott M, Lynch BM, Nguyen NH, Cohen PA, Mohan GR, et al. Acceptability and utility of, and preference for wearable activity trackers amongst non-metropolitan cancer survivors. PLoS One. 2018;13(12):e0210039. https://doi.org/10.1371/journal.pone.0210039.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The BC-PAL pilot trial exercise physiologists were Katy Koots and Rebecca Urbat. Trainees who assisted with data collection and data entry were Maryah Liepert, Renée Kokts-Porietis, Ruwaida Rehman, and Jasleen Nijjar. Data management, including database creation, questionnaire design, data integrity, and quality control, was completed by Dr. Steven Szarka, Farit Vakhetov, and Wendy Walroth.

Funding

Data collection for the BC-PAL Trial was funded by a Catalyst Grant from the O’Brien Institute for Public Health, University of Calgary and the Carole May Yates Memorial Endowment for Cancer Research Fund, administered through the Arnie Charbonneau Cancer Institute, University of Calgary. Dr. McNeil was a recipient of Postdoctoral Fellowship Awards from the Canadian Institutes of Health Research and Alberta Innovates-Health Solutions. Ms. Stone was supported by the Queen Elizabeth II (Province of Alberta) Scholarship. Dr. Courneya holds a Tier I Canada Research Chair. Dr. Friedenreich was supported by a Health Senior Scholar Award from Alberta Innovates-Health Solutions and the Alberta Cancer Foundation Weekend to End Women’s Cancers Breast Cancer Chair.

Author information

Authors and Affiliations

  1. Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada

    Jessica McNeil, Mina Fahim, Chelsea R. Stone, Rachel O’Reilly & Christine M. Friedenreich

  2. Department of Kinesiology, School of Health and Human Sciences, University of North Carolina Greensboro, Room 351D, Coleman Building, 1408 Walker Avenue, Greensboro, NC, 27412-5020, USA

    Jessica McNeil

  3. Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Alberta, Canada

    Kerry S. Courneya

  4. Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada

    Christine M. Friedenreich

Authors
  1. Jessica McNeil
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mina Fahim
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chelsea R. Stone
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rachel O’Reilly
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kerry S. Courneya
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Christine M. Friedenreich
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JM, CRS, KSC, and CMF contributed to the study conception and design. Data collection and analysis were performed by JM and ROR. The first draft of the manuscript was written by JM and MF and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jessica McNeil.

Ethics declarations

Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Health Research Ethics Board of Alberta – Cancer Committee (HREBA.CC-16-0711).

Consent to participate

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

McNeil, J., Fahim, M., Stone, C.R. et al. Adherence to a lower versus higher intensity physical activity intervention in the Breast Cancer & Physical Activity Level (BC-PAL) Trial. J Cancer Surviv 16, 353–365 (2022). https://doi.org/10.1007/s11764-021-01030-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11764-021-01030-w

Keywords

Search

Navigation