JSAMS Plus (Jun 2024)

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

Journal volume & issue
Vol. 3
p. 100055

Abstract

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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.

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