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Exercise adherence in a randomized controlled trial of exercise on quality of life in ovarian cancer survivors

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Abstract

Purpose

Factors associated with improving exercise in ovarian cancer survivors remain unknown. We explored characteristics associated with exercise adherence among women treated for ovarian cancer in the Women’s Activity and Lifestyle Study in Connecticut (WALC) randomized controlled trial.

Methods

We evaluated adherence among women randomized to the WALC exercise intervention (N = 74). Women had to be exercising ≤ 90 min/week and post-treatment. The intervention included 25 telephone-based exercise counseling sessions over 6 months. Adherence was defined as 150 min/week of moderate/vigorous-intensity exercise. We evaluated factors associated with exercise adherence and duration using multivariate logistic and linear regression. The number of sessions sufficient to achieve 150 min/week was modeled with an unadjusted receiver operating characteristic (ROC) curve.

Results

Women were 57.3 ± 8.8 years old and 1.7 ± 1.0 years since diagnosis. The mean exercise time over 6 months was 166.0 ± 66.1 min/week, and 64.9% of women met the 150 min/week goal. Women attended 22.8 ± 3.6 (92%) counseling sessions. No cancer recurrence during the study (OR = 9.15, 95% CI: 1.09–44.02) and greater session attendance (OR = 1.21, 95% CI: 1.02–1.43) were related to meeting the exercise goal. Greater session attendance (P < 0.01) and higher baseline activity level (P = 0.02) were associated with greater average weekly exercise duration. The ROC curve suggested attending 18 counseling sessions was optimal to meet the exercise goal.

Conclusions

Women attending more counseling sessions or with no cancer recurrence during the study were more likely to meet the exercise goal. More research is needed to understand ideal counseling intensity for ovarian cancer survivors.

Implications for Cancer Survivors

Eighteen counseling sessions are sufficient for ovarian cancer survivors to achieve 150 min/week exercise.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

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Acknowledgements

Certain data used in this study were obtained from the Connecticut Tumor Registry located in the Connecticut Department of Public Health. The authors assume full responsibility for analyses and interpretation of the data collected from the Connecticut Tumor Registry. We thank all the study participants and physicians; Rajni Mehta, Director of the Rapid Case Ascertainment Shared Resource of the Yale Cancer Center; and the following Connecticut hospitals: Charlotte Hungerford Hospital, Bridgeport Hospital, Danbury Hospital, Hartford Hospital, Middlesex Hospital, New Britain General Hospital, Bradley Memorial Hospital, Yale/New Haven Hospital, St. Francis Hospital and Medical Center, St. Mary’s Hospital, Hospital of St. Raphael, St. Vincent’s Medical Center, Stamford Hospital, William W. Backus Hospital, Windham Hospital, Eastern Connecticut Health Network, Griffin Hospital, Bristol Hospital, Johnson Memorial Hospital, Day Kimball Hospital, Greenwich Hospital, Lawrence and Memorial Hospital, Milford Hospital, New Milford Hospital, Norwalk Hospital, Sharon Hospital, and Waterbury Hospital.

Funding

This study was supported by the National Cancer Institute at the National Institutes of Health (NCI 5R01CA138556, P30 CA016359), and by the National Center for Advancing Translational Science at the National Institutes of Health (UL1TR000142). The funding agencies had no involvement in study design, collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the paper for publication.

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Authors and Affiliations

  1. Department of Chronic Disease Epidemiology, Yale School of Public Health, 60 College Street, New Haven, CT, 06520-8034, USA

    Anlan Cao, Brenda Cartmel, Fang-Yong Li, Linda T. Gottlieb, Maura Harrigan, Melinda L. Irwin & Leah M. Ferrucci

  2. Yale Cancer Center, New Haven, CT, USA

    Brenda Cartmel, Melinda L. Irwin & Leah M. Ferrucci

  3. Dana-Farber Cancer Institute, Boston, MA, USA

    Jennifer A. Ligibel

  4. Wayne State University, Detroit, MI, USA

    Radhika Gogoi

  5. Yale School of Medicine, New Haven, CT, USA

    Peter E. Schwartz

Authors
  1. Anlan Cao
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  2. Brenda Cartmel
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  4. Linda T. Gottlieb
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Contributions

Anlan Cao: formal analysis, writing—original draft; Brenda Cartmel: supervision, project administration, data curation, writing—review and editing; Fang-yong Li: formal analysis, data curation, writing—review and editing; Linda T. Gottlieb: investigation, writing—review and editing; Maura Harrigan: investigation, writing—review and editing; Jennifer A. Ligibel: supervision, investigation, project administration, writing—review and editing; Radhika Gogoi: supervision, investigation, project administration, writing—review and editing; Peter E. Schwartz: conceptualization, resources, writing—review and editing; Melinda L. Irwin: conceptualization, funding acquisition, supervision, project administration, writing—review and editing; Leah M. Ferrucci: conceptualization, supervision, project administration, writing—review and editing.

Corresponding author

Correspondence to Anlan Cao.

Ethics declarations

Ethics approval

The study was approved by the Connecticut Department of Public Health and the Yale Human Investigation Committees, Dana-Farber/Harvard Cancer Center Institutional Review Board (IRB), Geisinger Health Systems IRB, and all 21 Connecticut hospital IRBs. The trial is registered at ClinicalTrials.gov: NCT02107066 (https://clinicaltrials.gov/ct2/show/NCT02107066).

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All participants gave written informed consent.

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Not applicable.

Conflict of interest

The authors declare no competing interests.

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Cao, A., Cartmel, B., Li, FY. et al. Exercise adherence in a randomized controlled trial of exercise on quality of life in ovarian cancer survivors. J Cancer Surviv 17, 535–543 (2023). https://doi.org/10.1007/s11764-022-01325-6

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