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Searching for maintenance in exercise interventions for cancer survivors

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Abstract

Purpose

Translating evidence-based exercise interventions into practice is important for expanding the capacity to support cancer survivors. Using the reach, efficacy/effectiveness, adoption, implementation, and maintenance (RE-AIM) framework and scoping study methodology, we addressed the research question, “What is known about the maintenance of exercise interventions for cancer survivors that would inform translation from research to practice and community settings?” Maintenance was investigated at the individual and setting level.

Methods

Literature searches were performed in the PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Sport Discus databases for articles published from January 2009 to June 2012. Abstracts were judged using a priori criteria for the survivor population, exercise intervention, and maintenance on the individual or setting level. We included completed and planned randomized controlled trials (RCTs) and other study designs. Publications meeting the criteria were reviewed and coded.

Results

Of the 211 abstracts meeting patient and exercise criteria, 24 (19 RCTs) met the maintenance criteria. Nine of the 12 completed RCTs demonstrated maintenance of intervention outcomes after 3 to 14 months of follow-up. The planned RCTs described interventions lasting 2 to 4.5 months and maintenance intervals lasting 3 to 12 months following the active intervention. Maintenance at the setting level was reported in one publication.

Conclusions

On the individual level, intervention outcomes were maintained in most studies, in a variety of settings and survivor subpopulations. Maintenance on the setting level was scarcely addressed. This scoping study suggests several strategies that could be taken by agencies, clinicians, and researchers to develop more effective and sustainable exercise programs for cancer survivors.

Implications for Cancer Survivors

Many benefits of exercise training are maintained for months after cancer survivors complete controlled research studies but relatively little is known about how to translate research to sustainable community-based exercise programs. A better understanding of how programs can be sustained in practice beyond short-term research or grant funding is needed to support a growing number of survivors.

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Acknowledgments

The authors are grateful to Richard Wood and Alice Franco for organizing the publication searches and to Russell E. Glasgow for his critique of the manuscript. Funding for this research was supported by Cooperative Agreement Number 5U48DP001938(03) and 1U48 DP001924 from the Centers for Disease Control and Prevention. The findings and conclusions in this manuscript are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Conflict of interest

Authors Jankowski, Ory, Freidman, Dwyer, Birken, and Risendal have no conflict of interest.

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Authors and Affiliations

  1. College of Nursing, University of Colorado, Mail Stop C288-19, 13120 E. 19th Avenue, Aurora, CO, 80045, USA

    Catherine M. Jankowski

  2. School of Public Health, University of Colorado, Mail Stop F538, 13001 E. 17th Place, Aurora, CO, 80045, USA

    Andrea Dwyer & Betsy Risendal

  3. Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, 1266 TAMU, College Station, TX, USA

    Marcia G. Ory

  4. Department of Health Promotion, Education, and Behavior & the Statewide Cancer Prevention and Control Program, University of South Carolina, 915 Greene St, Columbia, SC, 29208, USA

    Daniela B. Friedman

  5. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, CB 7411, UNC-CH, Chapel Hill, NC, 27599-7411, USA

    Sarah A. Birken

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  1. Catherine M. Jankowski
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Correspondence to Catherine M. Jankowski.

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Jankowski, C.M., Ory, M.G., Friedman, D.B. et al. Searching for maintenance in exercise interventions for cancer survivors. J Cancer Surviv 8, 697–706 (2014). https://doi.org/10.1007/s11764-014-0386-y

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