Skip to main content
Log in

A Randomized Trial of a Telephone-Delivered Exercise Intervention for Non-urban Dwelling Women Newly Diagnosed with Breast Cancer: Exercise for Health

  • Original Article
  • Published:
Annals of Behavioral Medicine

Abstract

Background

Physical activity is important following breast cancer. Trials of non-face-to-face interventions are needed to assist in reaching women living outside major metropolitan areas.

Purpose

This study seeks to evaluate the feasibility and effectiveness of a telephone-delivered, mixed aerobic and resistance exercise intervention for non-urban Australian women with breast cancer.

Methods

A randomized controlled trial comparing an 8-month intervention delivered by exercise physiologists (n = 73) to usual care (n = 70).

Results

Sixty-one percent recruitment rate and 96% retention at 12 months; 79% of women in the intervention group received at least 75% of calls; odds (OR, 95% CI) of meeting intervention targets favored the intervention group for resistance training (OR 3.2; 1.2, 8.9) and aerobic (OR 2.1; 0.8, 5.5) activity.

Conclusions

Given the limited availability of physical activity programs for non-urban women with breast cancer, results provide strong support for feasibility and modest support for the efficacy of telephone-delivered interventions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Australian Institute of Health and Welfare & Australasian Association of Cancer Registries. Cancer in Australia: An overview. Canberra: AIHW; 2008.

  2. Committee on Cancer Survivorship: Improving Care and Quality of Life, National Cancer Policy Board, Hewitt M, Greenfield S, Stovall E. From cancer patient to cancer survivor: Lost in transition. Washington, DC: National Academy of Sciences; 2006.

  3. Australian Institute of Health and Welfare & National Breast and Ovarian Cancer Centre. Breast cancer in Australia: An overview. Canberra: AIHW; 2009.

  4. Hayes SC, Spence RR, Galvao DA, Newton RU. Australian Association for Exercise and Sport Science position stand: optimising cancer outcomes through exercise. J Sci Med Sport. 2009;12:428–434.

    Article  PubMed  Google Scholar 

  5. Ferrer RA, Huedo-Medina TB, Johnson BT, Ryan S, Pescatello LS. Exercise interventions for cancer survivors: A meta-analysis of quality of life outcomes. Ann Behav Med. 2011;41:32–47.

    Article  PubMed  Google Scholar 

  6. Holick CN, Newcomb PA, Trentham-Dietz A, et al. Physical activity and survival after diagnosis of invasive breast cancer. Cancer Epidemiol Biomarkers Prev. 2008;17:379–386.

    Article  PubMed  Google Scholar 

  7. Holmes MD, Chen WY, Feskanich D, Kroenke CH, Colditz GA. Physical activity and survival after breast cancer diagnosis. JAMA. 2005;293:24792486.

    Article  PubMed  CAS  Google Scholar 

  8. Irwin ML, Smith AW, McTiernan A, et al. Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: The Health, Eating, Activity, and Lifestyle study. J Clin Oncol. 2008;26:3958–3964.

    Article  PubMed  Google Scholar 

  9. Carmichael AR, Daley AJ, Rea DW, Bowden SJ. Physical activity and breast cancer outcome: A brief review of evidence, current practice and future direction. Eur J Surg Oncol. 2010;36:1139–1148.

    Article  PubMed  CAS  Google Scholar 

  10. Eakin EG, Youlden DR, Baade PD, et al. Health behaviors of cancer survivors: Data from an Australian population-based survey. Cancer Causes Control. 2007;18:881–894.

    Article  PubMed  Google Scholar 

  11. Harrison S, Hayes SC, Newman B. Level of physical activity and characteristics associated with change following breast cancer diagnosis and treatment. Psychooncology. 2009;18:387–394.

    Article  PubMed  Google Scholar 

  12. Schmitz KH, Holtzman J, Courneya KS, et al. Controlled physical activity trials in cancer survivors: A systematic review and meta-analysis. Cancer Epidemiol, Biomarkers Prev. 2005;14:1588–1595.

    Article  Google Scholar 

  13. Schwartz AL, Winters-Stone K, Gallucci B. Exercise effects on bone mineral density in women with breast cancer receiving adjuvant chemotherapy. Oncol Nurs Forum. 2007;34:627–633.

    Article  PubMed  Google Scholar 

  14. Cadmus LA, Salovey P, Yu H, et al. Exercise and quality of life during and after treatment for breast cancer: Results of two randomized controlled trials. Psychooncology. 2009;18:343–352.

    Article  PubMed  Google Scholar 

  15. Segal R, Evans W, Johnson D, et al. Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. J Clin Oncol. 2001;19:657–665.

    PubMed  CAS  Google Scholar 

  16. Demark-Wahnefried W, Clipp EC, Lipkus IM, et al. Main outcomes of the FRESH START trial: A sequentially tailored, diet and exercise mailed print intervention among breast and prostate cancer survivors. J Clin Oncol. 2007;25:2709–2718.

    Article  PubMed  Google Scholar 

  17. Morey MC, Snyder DC, Sloane R, et al. Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: A randomized controlled trial. JAMA. 2009;301:1883–1891.

    Article  PubMed  CAS  Google Scholar 

  18. Pinto BM, Frierson GM, Rabin C, Trunzo JJ, Marcus BH. Home-based physical activity intervention for breast cancer patients. J Clin Oncol. 2005;23:35773587.

    Article  PubMed  Google Scholar 

  19. Demark-Wahnefried W, Clipp EC, Morey MC, et al. Lifestyle intervention development study to improve physical function in older adults with cancer: Outcomes from Project LEAD. J Clin Oncol. 2006;24:3465–3473.

    Article  PubMed  Google Scholar 

  20. Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR. Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007;25:2352–2359.

    Article  PubMed  Google Scholar 

  21. Eakin E, Reeves M, Lawler S, et al. Telephone counseling for physical activity and diet in primary care patients. Am J Prev Med. 2009;36:142–149.

    Article  PubMed  Google Scholar 

  22. Eakin EG, Lawler SP, Vandelanotte C, Owen N. Telephone interventions for physical activity and dietary behavior change: A systematic review. Am J Prev Med. 2007;32:419–434.

    Article  PubMed  Google Scholar 

  23. Eakin E, Reeves M, Winkler E, Lawler S, Owen N. Maintenance of physical activity and dietary change following a telephone-delivered intervention. Health Psychol. 2010;29:566–573.

    Article  PubMed  Google Scholar 

  24. Graves N, Barnett AG, Halton KA, et al. Cost-effectiveness of a telephone-delivered intervention for physical activity and diet. PLoS One. 2009;4:e7135.

    Article  PubMed  Google Scholar 

  25. Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31:143–164.

    Article  PubMed  Google Scholar 

  26. Hayes S, Rye S, Battistutta D, et al. Design and implementation of the Exercise for Health trial - A pragmatic exercise intervention for women with breast cancer. Contemp Clin Trials. 2011;32:577–585.

    Article  PubMed  Google Scholar 

  27. Australian Institute of Health and Welfare. Rural, regional and remote health: A guide to remoteness classifications. Canberra: Australian Institute of Health and Welfare AIHW Cat no PHE 53; 2004.

  28. Eakin EG, Reeves MM, Lawler SP, et al. The Logan Healthy Living Program: A cluster randomized trial of a telephone-delivered physical activity and dietary behavior intervention for primary care patients with type 2 diabetes or hypertension from a socially disadvantaged community—rationale, design and recruitment. Contemp Clin Trials. 2008;29:439–454.

    Article  PubMed  Google Scholar 

  29. Eakin EG, Reeves MM, Marshall AL, et al. Living Well with Diabetes: A randomized controlled trial of a telephone-delivered intervention for maintenance of weight loss, physical activity and glycaemic control in adults with type 2 diabetes. BMC Public Health. 2010;10:452.

    Article  PubMed  Google Scholar 

  30. Australian Institute of Health and Welfare. The Active Australia Survey: A guide and manual for implementation, analysis and reporting. Canberra; Australian Institute of Health and Welfare; 2003.

  31. Reeves MM, Marshall AL, Winkler E, Owen N, Eakin EG. Measuring physical activity change in broad-reach intervention trials. J Phys Act Health. 2010;7:194–202.

    PubMed  Google Scholar 

  32. Beesley VL, Eakin EG, Janda M, Battistutta D. Gynecological cancer survivors’ health behaviors and their associations with quality of life. Cancer Causes Control. 2008;19:775–782.

    Article  PubMed  Google Scholar 

  33. Lynch BM, Cerin E, Owen N, Aitken JF. Associations of leisure-time physical activity with quality of life in a large, population-based sample of colorectal cancer survivors. Cancer Causes Control. 2007;18:735–742.

    Article  PubMed  Google Scholar 

  34. Stewart AL, Mills KM, King AC, et al. CHAMPS physical activity questionnaire for older adults: Outcomes for interventions. Med Sci Sports Exerc. 2001;33:1126–1141.

    PubMed  CAS  Google Scholar 

  35. Stewart AL, Mills KM, Sepsis PG, et al. Evaluation of CHAMPS, a physical activity promotion program for older adults. Ann Behav Med. 1997;19:353–361.

    Article  PubMed  CAS  Google Scholar 

  36. Bennett JA, Lyons KS, Winters-Stone K, Nail LM, Scherer J. Motivational interviewing to increase physical activity in long-term cancer survivors: A randomized controlled trial. Nurs Res. 2007;56:18–27.

    Article  PubMed  Google Scholar 

  37. Brady MJ, Cella DF, Mo F, et al. Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. J Clin Oncol. 1997; 15:974–986.

    PubMed  CAS  Google Scholar 

  38. Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E. Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manage. 1997;13:63–74.

    Article  PubMed  CAS  Google Scholar 

  39. Cella D, Yount S, Sorensen M, et al. Validation of the Functional Assessment of Chronic Illness Therapy Fatigue Scale relative to other instrumentation in patients with rheumatoid arthritis. J Rheumatol. 2005;32:811–819.

    PubMed  Google Scholar 

  40. Marteau TM, Bekker H. The development of a six-item short-form of the state scale of the Speilberger State-Trait Anxiety Inventory (STAI). Br J Clin Psychol. 1992;31:301–306.

    Article  PubMed  Google Scholar 

  41. McConnell S, Beaton DE, Bombarider C. The DASH outcome measure user’s manual. Toronto: Institute for Work and Health; 1999

    Google Scholar 

  42. Hayes S, Battitstutta D, Newman B. Objective and subjective upper body function six months following diagnosis of breast cancer. Breast Cancer Res Treat. 2005;94:1–10.

    Article  PubMed  Google Scholar 

  43. Hayes SC, Janda M, Cornish B, Battistutta D, Newman B. Lymphedema after breast cancer: Incidence, risk factors, and effect on upper body function. J Clin Oncol. 2008;26:3536–3542.

    Article  PubMed  Google Scholar 

  44. Coster S, Poole K, Fallowfield LJ. The validation of a quality of life scale to assess the impact of arm morbidity in breast cancer patients post-operatively. Breast Cancer Res Treat. 2001;68:273–282.

    Article  PubMed  CAS  Google Scholar 

  45. Sallis JF, Pinski RB, Grossman RM, Patterson TL, Nader PR. The development of self-efficacy scales for health-related diet and exercise behaviors. Health Educ Res. 1988;3:283–292.

    Article  Google Scholar 

  46. van den Bergh RC, Essink-Bot ML, Roobol MJ, et al. Anxiety and distress during active surveillance for early prostate cancer. Cancer. 2009;115:3868–3878.

    Article  PubMed  Google Scholar 

  47. Krueger C, Tian L. A comparison of the general linear mixed model and repeated measures ANOVA using a dataset with multiple missing data points. Biol Res Nurs. 2004;6:151–157.

    Article  PubMed  Google Scholar 

  48. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40:879–891.

    Article  PubMed  Google Scholar 

  49. Disipio T, Hayes S, Battistutta D, Newman B, Janda M. Patterns, correlates, and prognostic significance of quality of life following breast cancer. Psychooncology. 2011;20:1084–1091

    Article  PubMed  Google Scholar 

  50. DiSipio T, Hayes SC, Newman B, Aitken J, Janda M. Does quality of life among breast cancer survivors one year after diagnosis differ depending on urban and non-urban residence? A comparative study. Health Qual Life Outcomes. 2010;8:3.

    Article  PubMed  Google Scholar 

  51. Ware JE, Snow K, Kosinski M, Gandek MS. SF36 Health Survey—Manual and interpretation guide. Boston: Nimrod Press;1997.

  52. Sallis JF, Saelens BE. Assessment of physical activity by self-report: status, limitations, and future directions. Res Q Exer Sport. 2000; 71:s1–14.

    CAS  Google Scholar 

Download references

Acknowledgements

We warmly thank Kym Spathonis (project manager), the project staff, the breast care nurses who gave generously of their time to assist with recruitment and the patients who took part in the trial.

Disclaimers

The National Breast Cancer Foundation (NBCF, Australia) and a Queensland Health Core Infrastructure grant funded the trial. EGE is supported by a National Health and Medical Research Council Senior Research Fellowship. SCH is supported by an Early Career Research Fellowship from the NBCF.

Conflict of Interest Statement

The authors have no conflict of interest to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Elizabeth G. Eakin Ph.D.

Additional information

Trial registration: ACTRN12609000809235.

Electronic supplementary materials

Below is the link to the electronic supplementary material.

ESM1 (DOCX 15.3 kb)

ESM2 (DOCX 14 kb)

About this article

Cite this article

Eakin, E.G., Lawler, S.P., Winkler, E.A.H. et al. A Randomized Trial of a Telephone-Delivered Exercise Intervention for Non-urban Dwelling Women Newly Diagnosed with Breast Cancer: Exercise for Health. ann. behav. med. 43, 229–238 (2012). https://doi.org/10.1007/s12160-011-9324-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12160-011-9324-7

Keywords

Navigation