Smith Whitney J, Martin Michelle Y, Pisu Maria, Oster Robert A, Qu Haiyan, Shewchuk Richard M, Sheffield Mary E, Minter Alex, Baumann Ana A, Rogers Laura Q
College of Medicine, University of South Alabama, Mobile, AL.
Department of Preventive Medicine and Center for Innovation in Health Equity Research, University of Tennessee Health Science Center, Memphis, TN.
Transl J Am Coll Sports Med. 2021 Fall;6(4). doi: 10.1249/tjx.0000000000000180.
Implementing efficacious physical activity interventions in real-world rural settings is needed because rural cancer survivors are more physically inactive and experience poorer health. To address this gap, this study evaluated effectiveness of an evidenced-based physical activity program (Better Exercise Adherence after Treatment for Cancer [BEAT Cancer]) for rural women cancer survivors when implemented by community-based, non-research staff.
16 rural women cancer survivors received BEAT Cancer implemented by a rural, community organization and non-research staff; physical activity, patient-reported outcomes, and social cognitive constructs were measured at baseline and post-program. Cancer survivors and interventionists completed program evaluations post-program.
Cancer survivor mean age was 58±12 years; 62% were White. Mean months since diagnosis was 54±72; 69% had breast cancer. Significant improvements from pre- to post-program occurred for self-report weekly minutes of moderate-to-vigorous physical activity (mean change [] = 146±186, = 0.009), anxiety ( = -1.3±1.8, = 0.016), depression ( = -2.1±2.0, = 0.001), self-efficacy ( = 20.9±30.5, = 0.019), barriers interference ( = -15.0±14.1, = 0.001), and social support ( = 5.0±7.4, = 0.02). Cancer survivors ranked the program highly, identified strategies that were helpful (e.g., group activities, personalized exercise plan, etc.), and suggested additional implementation strategies (e.g., guide for home-based phase, etc.). Interventionists identified strategies (e.g., logistics, staff training and certification, cost, etc.) for enhancing organizational readiness for program delivery.
Evidence-based physical activity programs can be effective when implemented by non-research staff in rural settings. Further research testing strategies that improve implementation is needed.
Effectiveness and identified strategies supporting delivery when implemented by a rural organization can improve physical activity promotion for rural, at-risk populations.
由于农村癌症幸存者身体活动较少且健康状况较差，因此需要在现实世界的农村环境中实施有效的身体活动干预措施。为了填补这一空白，本研究评估了一项基于证据的身体活动计划（癌症治疗后更好地坚持锻炼[战胜癌症]）在由社区非研究人员实施时，对农村女性癌症幸存者的有效性。
16名农村女性癌症幸存者接受了由农村社区组织和非研究人员实施的“战胜癌症”计划；在基线和计划结束后测量身体活动、患者报告的结果以及社会认知结构。癌症幸存者和干预人员在计划结束后完成了计划评估。
癌症幸存者的平均年龄为58±12岁；62%为白人。自诊断以来的平均月数为54±72个月；69%患有乳腺癌。从计划前到计划后，自我报告的每周中等至剧烈身体活动分钟数（平均变化[ ] = 146±186， = 0.009）、焦虑（ = -1.3±1.8， = 0.016）、抑郁（ = -2.1±2.0， = 0.001）、自我效能感（ = 20.9±30.5， = 0.019）、障碍干扰（ = -15.0±14.1， = 0.001）和社会支持（ = 5.0±7.4， = 0.02）均有显著改善。癌症幸存者对该计划评价很高，确定了有帮助的策略（如团体活动、个性化锻炼计划等），并提出了额外的实施策略（如居家阶段指南等）。干预人员确定了提高组织实施计划准备程度的策略（如后勤、工作人员培训和认证、成本等）。
基于证据的身体活动计划由农村地区的非研究人员实施时可能有效。需要进一步研究测试改善实施的策略。
农村组织实施时的有效性以及确定的支持实施的策略可以改善对农村高危人群的身体活动促进。
