Development of an exercise adherence program for breast cancer survivors with cancer-related fatigue—an intervention mapping approach
Cancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors (BCS), with severe impact on quality of life. CRF can be reduced through exercise, but conversely, is also a barrier to exercising. The aim of this article was to apply the intervention mapping protocol (IMP) to develop an exercise adherence intervention for BCS with CRF.
The program was developed using the IMP, which consists of six steps. Based on the data from focus group interviews and literature review, we produced a logic model of change.
Two performance objectives (survivors adopt and maintain exercise and survivors cope with fatigue) and 17 change objectives were generated. Also, we designed theory-based methods of change, and strategies for practical application. A structured program plan that includes intervention content and methods, ranges, and program data was proposed. Finally, an implementation and evaluation plan was developed.
The IMP provided a useful framework to systematically plan an exercise adherence program. This study resulted in a theory and practice-based exercise adherence program, based on behavioral change theories, and practice-based knowledge that fits the needs of BCS with CRF.
KeywordsBreast cancer survivor Cancer-related fatigue Intervention mapping protocol Exercise adherence Social capital
breast cancer survivors
Intervention Mapping Protocol
Theory of Planned Behavior
This research was supported by the Basic Science Research Program through the National Research Foundation for Korea (NRF) funded by the Ministry of Education (grant number 2015R1D1A1A01059846).
Compliance with ethical standards
Ethics approval and consent to participate
An institutional review board exemption was obtained from Severance Hospital, Korea (IRB 4–2017–0164).
The authors declare that they have no competing interests.
- 4.Huang H-P, Wen F-H, Tsai J-C, Lin Y-C, Shun S-C, Chang H-K, Wang JS, Jane SW, Chen MC, Chen ML (2015) Adherence to prescribed exercise time and intensity declines as the exercise program proceeds: findings from women under treatment for breast cancer. Support Care Cancer 23(7):2061–2071CrossRefGoogle Scholar
- 12.Duijts SFA, Faber MM, Oldenburg HSA, van Beurden M, Aaronson NK (2011) Effectiveness of behavioral techniques and physical exercise on psychosocial functioning and health-related quality of life in breast cancer patients and survivors: a meta-analysis. Psycho-Oncology 20(2):115–126CrossRefGoogle Scholar
- 13.Bartholomew Eldredge LK, Markham CM, Ruiter RAC, Fernandez ME, Kok G, Parcel GS (2016) Planning health promotion programs: an intervention mapping approach, 4th edn. Jossey-Bass, San FranciscoGoogle Scholar
- 16.Kim S, Han JH, Lee MY, Jang MK. Breast cancer survivors’ experience of cancer-related fatigue, exercise, and exercise adherence: Insights from focus group interviews. (under review)Google Scholar
- 25.Park M, Kim S, Cho E, Park SM, Kang HC (2013) A study on the development of a self-regulated exercise maintenance program for osteoporotic elderly women: using intervention mapping protocol. J Korean Gerontol Soc 33(2):419–437Google Scholar
- 26.De Craemer M, De Decker E, De Bourdeaudhuij I, Verloigne M, Duvinage K, Koletzko B et al (2014) Applying the I ntervention M apping protocol to develop a kindergarten-based, family-involved intervention to increase E uropean preschool children's physical activity levels: the ToyBox-study. Obes Rev 15:14–26CrossRefGoogle Scholar
- 27.Cherrington A, Martin MY, Hayes M, Halanych JH, Andreae SJ, Safford M et al (2011) Intervention mapping as a guide for the development of a diabetes peer support intervention in rural Alabama. Prev Chronic Dis 9Google Scholar