Steps toward improving diet and exercise for cancer survivors (STRIDE): a quasi-randomised controlled trial protocol

BMC Cancer

Lauren J Frensham¹  Dorota M Zarnowiecki¹  Gaynor Parfitt¹  Rebecca M Stanley¹  James Dollman¹ 

[1] Exercise for Health and Human Performance, School of Health Sciences, University of South Australia, Adelaide, SA 5000, Australia

关键词: Lifestyle intervention;    Online intervention;    Cancer survivorship;    Pedometer;    Walking;    Physical activity;   

Others  :  857286
DOI  :  10.1186/1471-2407-14-428

 received in 2013-11-11, accepted in 2014-06-06,  发布年份 2014

【 摘 要 】

Background

Cancer survivorship rates have increased in developed countries largely due to population ageing and improvements in cancer care. Survivorship is a neglected phase of cancer treatment and is often associated with adverse physical and psychological effects. There is a need for broadly accessible, non-pharmacological measures that may prolong disease-free survival, reduce or alleviate co-morbidities and enhance quality of life. The aim of the Steps TowaRd Improving Diet and Exercise (STRIDE) study is to evaluate the effectiveness of an online-delivered physical activity intervention for increasing walking in cancer survivors living in metropolitan and rural areas of South Australia.

Methods/Design

This is a quasi-randomised controlled trial. The intervention period is 12-weeks with 3-month follow-up. The trial will be conducted at a university setting and community health services in South Australia. Participants will be insufficiently active and aged 18 years or older. Participants will be randomly assigned to either the intervention or control group. All participants will receive a pedometer but only the intervention group will have access to the STRIDE website where they will report steps, affect and ratings of perceived exertion (RPE) during exercise daily. Researchers will use these variables to individualise weekly step goals to increase walking.

The primary outcome measure is steps per day. The secondary outcomes are a) health measures (anthropometric and physiological), b) dietary habits (consumption of core foods and non-core foods) and c) quality of life (QOL) including physical, psychological and social wellbeing. Measures will be collected at baseline, post-intervention and 3-month follow-up.

Discussion

This protocol describes the implementation of a trial using an online resource to assist cancer survivors to become more physically active. It is an innovative tool that uses ratings of perceived exertion and daily affect to create individualised step goals for cancer survivors. The research findings may be of relevance to public health policy makers as an efficacious and inexpensive online-delivered intervention can have widespread application and may improve physical and psychological outcomes among this vulnerable population. Findings may indicate directions for the implementation of future physical activity interventions with this population.

Trial registration

Australian New Zealand Clinical Trials Registry: ACTRN12613000473763.

【 授权许可】

   
2014 Frensham et al.; licensee BioMed Central Ltd.

【 图 表 】

【 参考文献 】

• [1]Australian Institute of Health and Welfare: Australian Institute of Health and Welfare and Australasian Association of Cancer Registries. In Cancer in Australia: An overview. Canberra: AIHW; 2012.
• [2]Pavic M, Sève P, Rousset H, Debourdeau P: Management of cancer related fatigue. Presse Med 2008, 37(6):957-966.
• [3]Stein KD, Syrjala KL, Andrykowski MA: Physical and psychological long-term and late effects of cancer. Cancer 2008, 112(S11):2577-2592.
• [4]Schwartz ALPFNPF: Fatigue in long-term cancer survivors. Oncology 2009, 23(8):27-34.
• [5]Chirikos TN, Russell-Jacobs A, Jacobsen PB: Functional impairment and the economic consequences of female breast cancer. Women Health 2002, 36(1):1-20.
• [6]Makari-Judson G, Judson CH, Mertens WC: Longitudinal patterns of weight gain after breast cancer diagnosis: observations beyond the first year. Breast J 2007, 13(3):258-265.
• [7]Davidson JR, MacLeana AW, Brundage MD, Schulzec K: Sleep disturbance in cancer patients. Soc Sci Med 2002, 54(9):1309-1321.
• [8]Schmitz KH, Holtzman J, Courneya KS, Mâsse LC, Duval S, Kane R: Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2005, 14(7):1588-1595.
• [9]Ferrer R, Huedo-Medina TB, Johnson BT, Ryan S, Pescatello LS: Exercise interventions for cancer survivors: a meta-analysis of quality of life outcomes. Cancer Epidemiol Biomarkers Prev 2011, 41(1):32-47.
• [10]Sabiston CM, Brunet J: Reviewing the benefits of physical activity during cancer survivorship. Am J Lifestyle Med 2012, 6(2):167-177.
• [11]Knobf MT, Musanti R, Dorward J: Exercise and quality of life outcomes in patients with cancer. Semin Oncol Nurs 2007, 23(4):285-296.
• [12]Courneya K, Friedenreich C: Physical exercise and quality of life following cancer diagnosis: a literature review. Ann Behav Med 1999, 21(2):171-179.
• [13]Fong DYT, Ho JWC, Hui BPH, Lee AM, Macfarlane DJ, Leung SSK, Cerin E, Chan WYY, Leung IPF, Lam SHS, Taylor AJ, Cheng K: Physical activity for cancer survivors: meta-analysis of randomised controlled trials. BMJ 2012, 344:1-14.
• [14]Gjerset GM, Fosså SD, Courneya KS, Skovlund E, Thorsen L: Exercise behavior in cancer survivors and associated factors. J Cancer Surviv 2011, 5(1):35-43.
• [15]Jong KE, Smith DP, Yu XQ, O’Connell DL, Goldstein D, Armstrong BK: Remoteness of residence and survival from cancer in New South Wales. Med J Aust 2004, 180(2):618-622.
• [16]Heathcote KE, Armstrong BK: Disparities in cancer outcomes in regional and rural Australia. Cancer Forum 2007, 31(2):70-73.
• [17]Jong KE, Vale PJ, Armstrong BK: Rural inequalities in cancer care and outcome. Med J Aust 2005, 182(1):13-14.
• [18]King A: Interventions to promote physical activity by older adults. J Gerontol 2001, 56(2):36-46.
• [19]Conn V, Minor MA, Burks KJ, Rantz MJ, Pomeroy SH: Integrative review of physical activity intervention research with aging adults. J Am Geriatr Soc 2003, 51(8):1159-1168.
• [20]Conn VS, Valentine JC, Cooper HM: Interventions to increase physical activity among aging adults: a meta-analysis. Ann Behav Med 2002, 24(3):190-200.
• [21]Locke EA, Latham GP: Building a practically useful theory of goal setting and task motivation. Am Psychol 2002, 57(9):705-717.
• [22]Australian Institute of Health and Welfare: The Active Australia Survey: A Guide and Manual for Implementation, Analysis and Reporting. Canberra: AIHW; 2003.
• [23]Sports Medicine Australia: Sports Medicine Australia pre-exercise screening system. Canberra: Australian Government; 2005:1-8. [D.o.H.a. Ageing]
• [24]Bandura A: Health promotion by social cognitive means. Health Educ Behav 2004, 31(2):143-148.
• [25]Hogan BE, Linden W, Najarian B: Social support interventions: do they work? Clin Psychol Rev 2002, 22(3):381-440.
• [26]van Dam HA, van der Horst FG, Knoops L, Ryckman RM, Crebolder HF, van den Borne BH: Social support in diabetes: a systematic review of controlled intervention studies. Patient Educ Couns 2005, 59(1):1-12.
• [27]Dennis C: Peer support within a health care context: a concept analysis. Int J Nurs Stud 2003, 40(3):321-332.
• [28]Levy RL, Finch EA, Crowell MD, Talley NJ, Jeffery RW: Behavioral intervention for the treatment of obesity: strategies and effectiveness data. Am J Gastroenterol 2007, 102(10):2314-2321.
• [29]National health and medical research council: Australian Dietary Guidelines: Providing the Scientific Evidence for Healthier Australian Diets. In The Department of Health and Ageing. Canberra: National health and medical research council; 2013.
• [30]Borg G: Borg’s Perceived Exertion and Pain Scales. Champaign, IL: Human Kinetics; 1998.
• [31]Noble BJ: Clinical applications of perceived exertion. Med Sci Sports Exerc 1982, 14:406-411.
• [32]Scherer S, Cassady SL: Rating of perceived exertion: development and clinical applications for physical therapy exercise testing and prescription. J Cardpulm Phys Ther J 1999, 10:143-147.
• [33]Borg G: Perceived exertion as an indicator of somatic stress. Scand J Rehabil Med 1970, 2(2):92-98.
• [34]Horowitz MB, Littenberg B, Mahler DA: Dyspnea ratings for prescribing exercise intensity in patients with COPD. Chest 1996, 109:1169-1175.
• [35]Horowitz MB, Mahler DA: Dyspnea ratings for prescription of cross-modal exercise in patients with COPD. Chest 1988, 113:60-64.
• [36]Mejia R, Ward J, Lentine T, Mahler DA: Target Dyspnea ratings predict expected oxygen consumption as well as target heart rate values. Am J Respir Crit Care Med 1999, 159:1485-1489.
• [37]Noonan V, Dean E: Submaximal exercise testing: clinical application and interpretation. Phys Ther 2000, 80:782-807.
• [38]Bryan A, Hutchison KE, Seals DR, Allen DL: A transdisciplinary model integrating genetic, physiological, and psychological correlates of voluntary exercise. Health Psychol 2007, 26(1):30-39.
• [39]Hardy CJ, Rejeski JW: Not what, but how one feels: the measurement of affect during exercise. J Sport Exerc Psychol 1989, 11(3):304-317.
• [40]Parfitt G, Evans H, Eston R: Perceptually regulated training at RPE13 is pleasant and improves physical health. Med Sci Sports Exerc 2012, 44(8):1613-1618.
• [41]Ekkekakis P, Parfitt G, Petruzzello SJ: The pleasure and displeasure people feel when they exercise at different intensities: decennial update and progress towards a tripartite rationale for exercise intensity prescription. Sports Med 2011, 41(8):641-671.
• [42]Ekkekakis P: Let them roam free. Sports Med 2009, 39(10):857-888.
• [43]Schneider P, Crouter SE, Lukajic O, Bassett DR Jr: Accuracy and reliability of pedometers for measuring steps over a 400-m walk. Med Sci Sports Exerc 2003, 35(10):1779-1784.
• [44]Stewart A, Marfell-Jones M, International Society for Advancement of Kinanthropometry: International standards for anthropometric assessment. Lower Hutt, New Zealand: ISAK; 2011.
• [45]Hodge A, Patterson AJ, Brown WJ, Ireland P, Giles G: The anti cancer council of Victoria FFQ: relative validity of nutrient intakes compared with weighted food records in young to middle-aged women in a study of iron supplementation. Aust New Zeal J Publ Health 2000, 24(6):576-583.
• [46]Woods RK, Stoney RM, Ireland PD, Bailey MJ, Raven JM, Thien FC, Walters EH, Abramson MJ: A valid food frequency questionnaire for measuring dietary fish intake. Asia Pac J Clin Nutr 2002, 11(1):56-61.
• [47]Hyder ML, Poston CWS, Haddock CKD, AL : Evaluating the Validity of the PAMA, A New Measure of Physical Activity Maintenance. Kansas City, Missouri: University of Kansas; 2012:1-17.
• [48]Sanson-Fisher RW, Perkins J: Adaptation and validation of the SF-36 health survey for use in Australia. J Clin Epidemiol 1998, 51(11):961-967.
• [49]Andersen MR, Bowen DJ, Morea J, Stein KD, Baker F: Involvement in decision-making and breast cancer survivor quality of life. Health Psychol 2009, 28(1):29-37.
• [50]Ware JE, Sherbourne CD, Care M: The MOS short-form health survey (SF-36). Med Care 1992, 30(6):473-483.