Exercise and behaviour change support for individuals living with and beyond cancer: Interim results and program satisfaction of the EXCEL study
Chad W. Wagoner,
Julianna Dreger,
Melanie R. Keats,
Margaret L. McNeely,
Colleen Cuthbert,
Lauren C. Capozzi,
George J. Francis,
Linda Trinh,
Kristin Campbell,
Daniel Sibley,
Jodi Langley,
S. Nicole Culos-Reed
Affiliations
Chad W. Wagoner
Faculty of Kinesiology, University of Calgary, Canada; Ohlson Research Initiative, Arnie Charbonneau Research Institute, Cumming School of Medicine, University of Calgary, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada; Corresponding author. Faculty of Kinesiology, University of Calgary, 2500 University Dr NW, Calgary, Alberta, T2N IN4, Canada.
Julianna Dreger
Faculty of Kinesiology, University of Calgary, Canada
Melanie R. Keats
Faculty of Health, School of Health and Human Performance, Dalhousie University, Canada; Department of Medicine, Division of Medical Oncology, Nova Scotia Health, Canada
Margaret L. McNeely
University of Alberta, Canada; Supportive Care Services, Cancer Care Alberta, Canada
Colleen Cuthbert
Faculty of Nursing, University of Calgary, Canada
Lauren C. Capozzi
Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Canada
George J. Francis
Physical Medicine & Rehabilitation, Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Canada
Linda Trinh
Faculty of Kinesiology and Physical Education, University of Toronto, Canada
Kristin Campbell
Physical Therapy, Faculty of Medicine, University of British Columbia, Canada
Daniel Sibley
Faculty of Kinesiology and Physical Education, University of Toronto, Canada
Jodi Langley
Faculty of Health, School of Health and Human Performance, Dalhousie University, Canada
S. Nicole Culos-Reed
Faculty of Kinesiology, University of Calgary, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Canada; Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Canada
Purpose: Examine the impact of the EXercise for Cancer to Enhance Living Well's (EXCEL) 10–12-week exercise and behaviour change support intervention on secondary effectiveness outcomes, including patient-reported outcomes, physical function, and program satisfaction. Methods: Individuals with cancer up to 3 years post treatment with any tumour type were eligible. Outcomes were measured at baseline and immediately following the 10–12-week intervention. Patient-reported outcomes included participant characteristics, overall well-being, cognition, fatigue, symptom severity, exercise barrier self-efficacy, and program satisfaction. Physical function included shoulder flexion, 30-s sit to stand, sit and reach, 2-min step test or 6-min walk test (in-person only), and single leg balance. Wilcoxon signed-rank tests were used to assess changes in patient-reported outcomes and physical function assessments from baseline to 12-weeks. Results: A total of 804 participants enrolled in the study in the first 2.5-years, with 699 completing the intervention. Wilcoxon signed rank tests and Rosenthal coefficients (r) showed significant (p < 0.05) small improvements in well-being (r = 0.10), fatigue (r = 0.25), symptom severity (r = 0.17), and self-efficacy (r = 0.11). Significant (p < 0.01) moderate to large improvements were observed for the 30-s sit to stand (r = 0.54), sit and reach (left: r = 0.46; right: r = 0.41), 2-min step test (r = 0.66), 6-min walk test (r = 0.52), and single leg balance (left: r = 0.32; right: r = 0.34) assessments. Participants reported high satisfaction with program staff (average = 4.5/5) and that the program was beneficial and enjoyable (average = 4.6/5). Conclusion: EXCEL's group-based exercise program with behaviour change support, delivered in an online supervised setting to individuals living with cancer, may improve patient-reported outcomes and physical function and is associated with high participant satisfaction.
