Background Breast cancer survivors' self-perceived physical activity (PA) and sitting time (ST) may differ significantly from the general population and other survivor groups, so it is important that PA and ST measurement tools are compared within the breast cancer survivor population. Objective To compare accelerometer and self-report estimates of PA and ST in breast cancer survivors. Methods 414 breast cancer survivors (age, 56.8 years [SD, 9.2 years]; BMI, 26.2 kg/m(2) [5.4 kg/m2]) wore an accelerometer for 7 consecutive days and completed a modified Godin Leisure-Time Exercise Questionnaire (GLTEQ), the International Physical Activity Questionnaire (IPAQ), and the Sitting Time Questionnaire (STQ) which all measured hours/minutes of activity/sitting per day. Mean differences and correlations of ST, light PA (LPA; <= 1.5 metabolic equivalents [METs]), and moderate and vigorous PA (MVPA; >= 3 METs) were compared using random-intercept mixed-effects regression models and the Spearman rank correlation coefficient (Spearman's rho [r(s)], where r(s) = 1 means a perfect positive correlation, and r(s) = -1 means a perfect negative correlation). Results Mean daily durations of MVPA were: accelerometer, 20.2 minutes; GLTEQ, 23.6 minutes (P-diff = .02); and IPAQ, 87.4 minutes (P-diff < .001). Correlations between accelerometer-estimated MVPA were moderate for the GLTEQ (r(s) = 0.56) and poor for the IPAQ (r(s) = 0.02). Mean daily durations of LPA were 239.5 minutes for the accelerometer and 15.4 minutes for the GLTEQ (P-diff < .001); the measures were not correlated (r(s) = 0.004). Mean daily durations of ST were: accelerometer, 603.9 minutes; STQ, 611.8 minutes (P-diff = 0.9); and IPAQ, 303.8 minutes (P-diff < 0.001). Correlations with the accelerometer were fair (STQ: r(s) = 0.26; IPAQ: r(s) = 0.30). Differences in estimates varied by disease stage, age, presence of chronic conditions, and race. Limitations Participants were predominantly white, highly educated, and high earners, which reduced generalizability. Conclusions Congruency of measurement was dependent on tool, intensity of activity, and participant characteristics. Target outcome, implementation context, and population should be considered when choosing a measurement for physical activity or sitting time in breast cancer survivors.

BackgroundMost adults are insufficiently active. Mindfulness training may increase moderate to vigorous physical activity (MVPA) adoption and adherence. However, physiological and psychological factors underlying these effects are not well understood. This study examined the effects of an acute bout of MVPA, mindfulness training, and combined MVPA and mindfulness training on physiological and psychological outcomes.MethodsHealthy adults (N = 29, Mage = 28.6) completed 20-min counterbalanced conditions: (a) mindfulness training (MIND); (b) moderate intensity walking (PA), and (c) moderate intensity walking while listening to MVPA-specific guided mindfulness training (PAMIND). Heart rate (HR), Rating of Perceived Exertion (RPE), Feeling Scale (FS) and Blood Pressure (BP) were measured at rest, at regular intervals during each condition, and post-condition. Mindfulness, state anxiety, and self-efficacy were assessed pre- and post-condition.ResultsAverage and peak HR, systolic BP (SBP), and RPE were significantly higher, and average and peak FS were significantly lower during the PA and PAMIND conditions compared to MIND (p < 0.001). Average RPE was significantly higher for PA compared to PAMIND (p < 0.001). Heart rate, feeling scale, body and mental events mindfulness, and self-efficacy for walking increased from pre to post (all p’s < 0.001) for all conditions. Time by condition interactions were significant for change in heart rate, mental events mindfulness, and state anxiety from pre- to post-condition.ConclusionThe physiological response to MVPA and PAMIND were similar. However, RPE was rated lower in the PAMIND condition, which could have implications for MVPA adoption and maintenance. Future work should further explore RPE combining MVPA and mindfulness training.

Physical activity (PA) and mindfulness are independently associated with improved cognitive function; however, the effects of their combination on cognitive function are unknown. The purpose of this study was to examine the effects of an acute bout of PA, mindfulness training, and combined PA and mindfulness training on changes in cognitive function and perceived cognitive ability. Using a repeated measures within-subjects design, adults (N = 29, Mage = 28.6) completed three 20-minute counterbalanced conditions: a) mindfulness training (MIND); b) moderate-intensity walking (PA), and c) moderate-intensity walking while listening to PA-specific mindfulness training (PAMIND). Participants completed the NIH Toolbox Cognitive Battery and PROMIS Applied Cognition Short Form before and after each condition. Within-subjects repeated measures ANOVAs revealed inhibitory control, working memory, task shifting, processing speed and the fluid composite score ( P < .01 for all) improved from pre-to post-condition for all conditions. Perceived cognitive ability declined across all conditions pre- to post-condition ( P < .001); decreases were largest in the MIND condition. Cognitive performance improved following acute bouts of general mindfulness, PA, and the combination of the two, but perceived cognitive ability declined. Future work is warranted to examine effects in other populations and as a result of different PA and mindfulness doses and interventions.

BACKGROUND:Moderate to vigorous physical activity (MVPA) interventions improve patient-reported outcomes (PROs) of physical and psychological health among breast cancer survivors (BCS); however, the effects of specific intervention components on PROs are unknown.PURPOSE:To use the Multiphase Optimization Strategy (MOST) to examine overall effects of the Fit2Thrive MVPA promotion intervention on PROs in BCS and explore whether there are intervention component-specific effects on PROs.METHODS:Physically inactive BCS [n = 269; Mage = 52.5 (SD = 9.9)] received a core intervention (Fitbit + Fit2Thrive smartphone app) and were randomly assigned to one of 32 conditions in a full factorial experiment of five components ("on" vs. "off"): (i) support calls, (ii) deluxe app, (iii) text messages, (iv) online gym, and (v) buddy. Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires assessed anxiety, depression, fatigue, physical functioning, sleep disturbance and sleep-related impairment at baseline, post-intervention (12-week), and 24-week follow-up. Main effects for all components at each time point were examined using an intention to treat mixed-effects model.RESULTS:All PROMIS measures except sleep disturbance significantly improved (p's < .008 for all) from baseline to 12-weeks. Effects were maintained at 24-weeks. The "on" level of each component did not result in significantly greater improvements on any PROMIS measure compared to the "off" level.CONCLUSIONS:Participation in Fit2Thrive was associated with improved PROs in BCS, but improvements did not differ for "on" vs. "off" levels for any component tested. The low-resource Fit2Thrive core intervention is a potential strategy to improve PROs among BCS. Future studies should test the core in an RCT and examine various intervention component effects in BCS with clinically elevated PROs.

Purpose Understanding real-time relationships between physical activity (PA) and symptoms during chemotherapy (CT) could have important implications for intervention. This study used ecological momentary assessment to examine the relationship between objective PA and symptoms during CT. Methods Breast cancers patients (n = 67; M-age = 48.6 (SD = 10.3)) participated in data collection at three time points during CT: beginning, middle, and end. At each time point, participants answered four prompts assessing symptoms and wore an accelerometer for 10 days (3 days pre-CT, day of CT, and 6 days post-CT). Multilevel linear regression models examined the between- and within-person associations between moderate to vigorous (MVPA) and light-intensity physical activity (LPA) and same and next-day symptom ratings controlling for covariates. Results On days when individuals engaged in more LPA or MVPA, separately, they reported improved affect, anxiety, fatigue, physical functioning (walking and activities of daily living), pain, and cognition that day (p < 0.001 for all). Findings were consistent for next-day symptom ratings with the exception that only previous day LPA was related to next-day fatigue and neither LPA nor MVPA were related to next-day cognition (p < 0.001 for all). No between-person effects were found. Conclusions Within person higher than usual PA on a given day, regardless of intensity, is associated with improved symptoms ratings on the current and next day. Implications for cancer survivors Encouraging breast cancer patients undergoing CT to engage in daily PA could help manage CT-associated symptoms.

ABSTRACT Purpose To examine the relationship between daily fluctuations in symptoms and sedentary behavior (SB) during chemotherapy (CT) for breast cancer. Methods Breast cancer patients (N = 68, Mage = 48.5 ± 10.4 yr) undergoing CT wore an activity monitor on their hip to assess daily SB and completed prompts assessing symptoms (affect, anxiety, depression, fatigue, pain, and physical and cognitive functioning) for 10 consecutive days (3 d pre-CT, day of, and 6 d post-CT) at the beginning, middle and end cycles of CT. Mixed models assessed the bidirectional between-person (BP) and within-person (WP) associations of current day symptoms with minutes of SB measured on 1) the same day and 2) the next day, controlling for relevant covariates. Results Within person same-day results revealed a significant association between affect, anxiety, fatigue, physical functioning, pain, and cognitive functioning and same-day SB. Worse than average symptom ratings on a given day were associated with more SB that day. There was a significant WP relationship between previous-day anxiety, depression, and physical function and next-day SB (i.e., worse than average symptom ratings the previous day were associated with more SB the next day). Within person same-day results revealed a significant association between same-day SB and affect, anxiety, fatigue, pain, physical functioning, and cognitive functioning. The WP relationships were significant for previous-day SB and next-day affect and pain (i.e., higher than average SB associated with lower ratings). Relationships persisted when controlling for moderate-to-vigorous physical activity. There were no significant BP results. Conclusions Higher symptom ratings were associated with increased SB and higher SB was associated with worse symptoms. Future work should identify SB reduction intervention approaches tailoring to daily symptom burden during CT for breast cancer.

Increased moderate and vigorous physical activity (MVPA) is associated with better health outcomes in breast cancer survivors; yet, most are insufficiently active. Smartphone applications (apps) to promote MVPA have high scalability potential, but few evidence-based apps exist. The purpose is to describe the testing and usability of Fit2Thrive, a MVPA promotion app for breast cancer survivors. A user-centered, iterative design process was utilized on three independent groups of participants. Two groups of breast cancer survivors (group 1 n = 8; group 2: n = 14) performed app usability field testing by interacting with the app for ≥3 days in a free-living environment. App refinements occurred following each field test. The Post-Study System Usability Questionnaire (PSSUQ) and the User Version Mobile Application Rating Scale (uMARS) assessed app usability and quality on a 7- and 5-point scale, respectively, and women provided qualitative written feedback. A third group (n = 15) rated potential app notification content. Quantitative data were analyzed using descriptive statistics. Qualitative data were analyzed using a directed content analysis. The PSSUQ app usability score (M1= 3.8; SD = 1.4 vs. M2= 3.2; SD = 1.1; lower scores are better) and uMARS app quality score (M1 = 3.4; SD = 1.3 vs. M2= 3.4; SD = 0.6; higher scores are better) appeared to improve in Field Test 2. Group 1 participants identified app "clunkiness," whereas group 2 participants identified issues with error messaging/functionality. Group 3 "liked" 53% of the self-monitoring, 71% of the entry reminder, 60% of the motivational, and 70% of the goal accomplishment notifications. Breast cancer survivors indicated that the Fit2Thrive app was acceptable and participants were able to use the app. Future work will test the efficacy of this app to increase MVPA.

PURPOSE: To examine the relationship between daily symptom burden, physical activity, and sedentary behavior among breast and endometrial cancer survivors. METHODS: Survivors (N=74, Mage= 56.3±9.6 years; MBMI= 30.8±7.9 kg/m2) wore an ActiGraph accelerometer to assess daily activity (sedentary behavior (SB), light intensity physical activity (LPA), and moderate-to-vigorous physical activity (MVPA)) and completed ecological momentary assessment prompts 4x/day to assess symptoms (fatigue, pain, mood, anxiety, depression, physical function) for seven consecutive days as part of baseline assessments for a physical activity promotion intervention. Symptom ratings were on a 5-point scale. Separate mixed models assessed the between-person and within-person associations of current daily symptoms with minutes of SB, LPA, and MVPA that same day, controlling for relevant covariates (age, BMI, treatment, wear time). RESULTS: Survivors averaged 516±96 minutes of SB, 271±90 minutes of LPA, and 17±10 minutes of MVPA per day. There were no significant between or within-person associations between daily symptoms and daily LPA or MVPA. There were significant between-person associations for fatigue (β=27.5±8.9 minutes, p=0.002), pain (β=20.6±7.4 minutes, p=0.006), mood (β=28.9±9.5 minutes, p=0.002), and physical function (β=19.9±9.1 minutes, p=0.03) on SB such that those with higher symptom burden spent more time spent sedentary. There were a significant within-person associations for anxiety (β=31.8±14.4 minutes, p=0.028) and depression (β=54.5±21.7 minutes, p=0.013) and SB such that when participants reported higher anxiety or depression than their average on a given day, they spent more time sedentary that day. CONCLUSIONS: Inactive breast and endometrial cancer survivors that reported higher symptom burden spent more time sedentary. Additionally, results indicated a significant temporal, day-level association between anxiety and depression and time spent sedentary but there was no association between any symptoms and time spent in LPA or MVPA. Future interventions targeting changing sedentary time in this population should consider overall fatigue, pain, mood, and physical functioning in their programming, in addition to daily changes in depression and anxiety symptoms.

OBJECTIVE:Although physical activity is associated with better health outcomes in breast cancer survivors (BCS), activity often declines during cancer treatment. Social cognitive theory (SCT) constructs have been associated with physical activity in post-treatment BCS, but little is known about the relation between these constructs and physical activity during chemotherapy. METHODS:BCS (n = 67; Mage  = 48.6 [SD = 10.3]) undergoing chemotherapy wore accelerometers and completed prompts in the morning and at night assessing same-day and next-day exercise self-efficacy, physical and psychological outcome expectations, and goal-setting for 10 consecutive days (3 days pre-, day of, and 6 days post-chemotherapy dose) at three time points (beginning, middle, and end of chemotherapy). Separate mixed models assessed between- and within-person associations of each of the SCT constructs associations with same- and next-day moderate to vigorous physical activity (MVPA) and light physical activity (LPA), independently. RESULTS:Within-person differences in all SCT variables were statistically significantly related to same-day MVPA (p's < 0.001) and LPA (p's < 0.001). Every one-point increase in SCT construct related to an increase in MVPA ranging from (a) 3.70 (self-efficacy) to 8.02 (physical outcome expectations) minute increase in MVPA and (b) 12.72 (self-efficacy) to 20.38 (physical outcome expectations) increase in LPA that day. No same-day between-person effects nor any next-day effects were significant. CONCLUSION:MVPA and LPA were related to same-day within-person differences in SCT variables. Interventions targeted at increasing or mitigating chemotherapy-related declines in daily within-person changes in SCT constructs could help to increase physical activity among BCS during chemotherapy.

HomeJournal of the American Heart AssociationVol. 10, No. 14Relative‐Intensity Physical Activity and Its Association With Cardiometabolic Disease Open AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citations ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toOpen AccessLetterPDF/EPUBRelative‐Intensity Physical Activity and Its Association With Cardiometabolic Disease Juned Siddique, Whitney A. Welch, David Aaby, Barbara Sternfeld, Kelley Pettee Gabriel, Mercedes R. Carnethon, Jamal S. Rana and Stephen Sidney Juned SiddiqueJuned Siddique *Correspondence to: Juned Siddique, DrPH, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr, Suite 1400, Chicago, IL 60611. E‐mail: E-mail Address: [email protected] https://orcid.org/0000-0002-1501-4152 Department of Preventive Medicine, , Northwestern University, , Chicago, , IL , Whitney A. WelchWhitney A. Welch Department of Preventive Medicine, , Northwestern University, , Chicago, , IL , David AabyDavid Aaby https://orcid.org/0000-0002-2395-3563 Department of Preventive Medicine, , Northwestern University, , Chicago, , IL , Barbara SternfeldBarbara Sternfeld Division of Research, , Kaiser Permanente Northern California, , Oakland, , CA , Kelley Pettee GabrielKelley Pettee Gabriel https://orcid.org/0000-0003-4986-7927 Department of Epidemiology, , University of Alabama, , Birmingham, , AL , Mercedes R. CarnethonMercedes R. Carnethon https://orcid.org/0000-0001-7035-0848 Department of Preventive Medicine, , Northwestern University, , Chicago, , IL , Jamal S. RanaJamal S. Rana Division of Research, , Kaiser Permanente Northern California, , Oakland, , CA Department of Cardiology, , Kaiser Permanente Northern California, , Oakland, , CA and Stephen SidneyStephen Sidney Division of Research, , Kaiser Permanente Northern California, , Oakland, , CA Originally published14 Jul 2021https://doi.org/10.1161/JAHA.120.019174Journal of the American Heart Association. 2021;10:e019174Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: July 14, 2021: Ahead of Print Aerobic guidelines from the US Department of Health and Human Services recommend at least 150 min/wk of moderate‐intensity physical activity, 75 min/wk of vigorous‐intensity physical activity, or an equivalent combination of moderate‐to‐vigorous intensity physical activity (MVPA).1 MVPA intensity is defined either in terms of absolute intensity or relative intensity. Absolute intensity refers to the energy required to perform an activity and does not take into account an individual's exercise capacity. Relative intensity is when the level of effort is relative to a person's exercise capacity.2, 3For adults aged 18 to 64 years, US Department of Health and Human Services guidelines are based on an absolute‐intensity scale. There is limited evidence on whether it is better to assess MVPA on a relative scale to promote and maintain health. Addressing this question has important implications about how individuals should monitor their MVPA intensity, how physicians should prescribe MVPA, and whether current MVPA guidelines should be modified.Accelerometer‐derived MVPA intensity is estimated on an absolute scale. Using data from a large observational study, we investigated the prospective association between relative‐intensity MVPA and incident hypertension, incident diabetes mellitus, and waist circumference (WC), and compared our results with those obtained using absolute‐intensity MVPA.Participants were from the CARDIA (Coronary Artery Risk Development in Young Adults) study, an ongoing cohort study of 5115 Black and White men and women aged 18 to 30 years at baseline in 1985 to 1986.4 In 2005 to 2006 (year 20), an ancillary CARDIA Fitness Study was performed on 2760 participants aged 38 to 50 years who wore accelerometers for 1 week. Previously,2 we modeled the relationship between accelerometer counts and rating of perceived exertion3 during the year 20 treadmill test to calculate person‐specific accelerometer cut points corresponding to relative‐intensity MVPA.Participants were reexamined in 2010 to 2011 (year 25) and 2015 to 2016 (year 30). Incident hypertension was defined as systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, or use of hypertension medication, at year 25 or year 30. Incident diabetes mellitus was defined as hemoglobin A1c ≥6.5%, fasting glucose ≥126 mg/dL, 2‐hour glucose ≥200 mg/dL, or use of diabetes mellitus medication, at year 25 or year 30. We excluded those who did not have accelerometer data (n=399) or who wore the accelerometer <4 days (n=241). Those with missing or prevalent year 20 hypertension (n=395) and diabetes mellitus (n=197) were excluded from the hypertension and diabetes mellitus analyses, respectively. Also excluded were participants with missing outcomes: incident hypertension (n=88), incident diabetes mellitus (n=105), year 30 WC (n=262), or missing year 20 covariates (n=23). The study was approved by the Institutional Review Boards at all sites. Participants provided written informed consent. Data and methods used in this analysis are available on request (http://www.cardia.dopm.uab.edu/contact‐cardia).Analyses were performed using R (version 4.0.3). We used generalized additive models5 to examine nonlinear relationships of average daily minutes of MVPA with time to hypertension, time to diabetes mellitus, and year 30 WC, stratified by sex. Separate models were fit using MVPA on relative‐ and absolute‐intensity scales. Models controlled for age, race (Black/White), year 20 education, year 20 smoking status, and accelerometer wear time. Models for hypertension and diabetes mellitus additionally controlled for year 20 body mass index. Models for year 30 WC additionally controlled for year 20 WC and height. Grouped‐time survival models were fit for hypertension and diabetes mellitus using a binomial distribution with a complementary log‐log link. As a sensitivity analysis, we reran all our models after imputing missing data.At year 20, mean age was 45.2 years (SD=3.6 years), mean body mass index was 28.7 kg/m2 (SD=6.3 kg/m2), mean education was 15.2 years (SD=2.5 years), 327 (15.5%) participants were current smokers, 880 (41.5%) were Black race, and 907 (42.8%) were men. Mean relative‐intensity MVPA was 8.8 min/d (SD=12.1 min/d); mean absolute‐intensity MVPA was 33.7 min/d (SD=23.9 min/d).By year 30, 182 incident hypertension and 56 incident diabetes mellitus events occurred in men. Mean change (from year 20) in WC was 4.2 cm (SD=7.0 cm). Among women, 232 incident hypertension and 72 incident diabetes mellitus events occurred, and mean change in WC was 4.1 cm (SD=7.5 cm). Model results are in the Figure. For men, relative‐intensity MVPA was marginally associated with year 30 WC but absolute‐intensity MVPA was not. For women, increasing MVPA on both scales was associated with lower year 30 WC. In both men and women, incident hypertension and diabetes mellitus were not significantly related to either relative‐ or absolute‐intensity MVPA, with the exception of a marginal association between incident diabetes mellitus and absolute MVPA in men.We found no meaningful differences between absolute‐ and relative‐intensity analyses, although there was no formal test to distinguish between these 2 measures. Limitations include a relatively young sample, a single week of measured MVPA, and ≈12% of participants with missing outcomes at year 30 whose absence may result in biased estimates, although analyses after imputing missing data provide similar results to those shown here. The mostly nonsignificant effects of relative‐intensity MVPA support current recommendations focusing on accumulating MVPA on an absolute scale for adults aged 18 to 64 years.Sources of FundingThe CARDIA (Coronary Artery Risk Development in Young Adults) study is supported by contracts HHSN268201800003I, HHSN268201800004I, HHSN268201800005I, HHSN268201800006I, and HHSN268201800007I from the National Heart, Lung, and Blood Institute. Dr Siddique, Dr Welch, D. Aaby, and Dr Sidney were supported by National Institutes of Health (NIH) R01HL131606. The CARDIA Fitness Study was supported by NIH R01HL078972.DisclosuresNone.Download figureDownload PowerPointFigure 1. Incident hypertension, diabetes mellitus, and waist circumference (WC) as a function of moderate‐to‐vigorous intensity physical activity (MVPA) on both relative‐ and absolute‐intensity scales, stratified by sex.Models were fit using generalized additive models that allow for nonlinear relationships between the outcome and continuous covariates using splines. For hypertension and diabetes mellitus, the y axis is the hazard ratio relative to the hazard where MVPA is set to its mean. For WC, the y axis is the change in year 30 WC as MVPA deviates from its mean value. The red dotted lines in the panels are drawn at 1 (hypertension and diabetes mellitus) or 0 (WC) to indicate the effect when MVPA is set to its mean. Shaded areas represent 95% CIs around the smoothed effects. When the 95% CI of the physical activity (PA) effect at a given MVPA value includes the red line, the corresponding inference is that the effect of PA is not significant at the 0.05 level. All models controlled for age, race (Black/White), year 20 smoking status, year 20 education, and accelerometer wear time. Models for hypertension and diabetes mellitus additionally controlled for year 20 body mass index. Models for year 30 WC additionally controlled for year 20 WC and height. The tick marks above the x axis of each plot correspond to observed MVPA values for each participant.Footnotes*Correspondence to: Juned Siddique, DrPH, Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N Lake Shore Dr, Suite 1400, Chicago, IL 60611. E‐mail: [email protected]eduFor Sources of Funding and Disclosures, see page 3.References1 US Department of Health and Human Services . 2018 Physical Activity Guidelines for Americans. 2nd ed. Washington, DC: US Department of Health and Human Services; 2018.Google Scholar2 Siddique J, Aaby D, Montag SE, Sidney S, Sternfeld B, Welch WA, Carnethon MR, Liu K, Craft LL, Gabriel K, et al. Individualized relative‐intensity physical activity accelerometer cut points. Med Sci Sports Exerc. 2020; 52:398–407. DOI: 10.1249/MSS.0000000000002153.CrossrefMedlineGoogle Scholar3 Scherr J, Wolfarth B, Christle JW, Pressler A, Wagenpfeil S, Halle M. Associations between Borg's rating of perceived exertion and physiological measures of exercise intensity. Eur J Appl Physiol. 2013; 113:147–155. DOI: 10.1007/s00421‐012‐2421‐x.CrossrefMedlineGoogle Scholar4 Friedman GD, Cutter GR, Donahue RP, Hughes GH, Hulley SB, Jacobs DR, Liu K, Savage PJ. CARDIA: study design, recruitment, and some characteristics of the examined subjects. J Clin Epidemiol. 1988; 41:1105–1116. DOI: 10.1016/0895‐4356(88)90080‐7.CrossrefMedlineGoogle Scholar5 Wood SN. Generalized Additive Models: An Introduction With R. Boca Raton, FL: CRC Press; 2017.CrossrefGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetails July 20, 2021Vol 10, Issue 14 Article InformationMetrics Copyright © 2021 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley BlackwellThis is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.https://doi.org/10.1161/JAHA.120.019174PMID: 34259009 Manuscript receivedSeptember 1, 2020Manuscript acceptedJune 9, 2021Originally publishedJuly 14, 2021 PDF download SubjectsEpidemiologyExercise

BackgroundIncreased incidence and life expectancy have resulted in a growing population of patients with metastatic breast cancer, and these patients experience high rates of morbidity and premature mortality. Increased physical activity (PA) is consistently associated with improved health and disease outcomes among early-stage survivors. However, there is a paucity of research on PA in patients with metastatic breast cancer, and existing PA interventions have exhibited low feasibility because of their focus on intense PA and/or requirement of on-site visits. Mobile health (mHealth)–based PA interventions may be particularly useful for patients with metastatic breast cancer because they allow for remote monitoring, which facilitates individual tailoring of PA recommendations to patients’ abilities and may minimize participant burden. However, no studies have examined mHealth PA interventions in patients with metastatic breast cancer. ObjectiveWe aim to address these critical research gaps by testing a highly tailored technology-based intervention to promote PA of any intensity (ie, light, moderate, or vigorous) by increasing daily steps in patients with metastatic breast cancer. The primary aim of this study is to test the feasibility and acceptability of the Fit2ThriveMB intervention. We will also examine outcome patterns suggesting the efficacy of Fit2ThriveMB on symptom burden, quality of life, and functional performance. MethodsThe Fit2ThriveMB trial is a two-arm pilot randomized controlled trial that will compare the effects of a smartphone-delivered, home-based PA intervention and an attention-control education condition on PA and quality of life in low-active female patients with metastatic breast cancer. A subsample (n=25) will also complete functional performance measures. This innovative trial will recruit 50 participants who will be randomized into the study’s intervention or control arm. The intervention will last 12 weeks. The Fit2ThriveMB intervention consists of a Fitbit, coaching calls, and the Fit2ThriveMB smartphone app that provides self-monitoring, a tailored goal-setting tool, real-time tailored feedback, app notifications, and a group message board. Assessments will occur at baseline and post intervention. ResultsThe Fit2ThriveMB study is ongoing. Data collection ended in February 2021. ConclusionsData from this study will provide the preliminary effect sizes needed to assemble an intervention that is to be evaluated in a fully powered trial. In addition, these data will provide essential evidence to support the feasibility and acceptability of using a technology-based PA promotion intervention, a scalable strategy that could be easily integrated into care, among patients with metastatic breast cancer. Trial RegistrationClinicalTrials.gov NCT04129346; https://clinicaltrials.gov/ct2/show/NCT04129346 International Registered Report Identifier (IRRID)DERR1-10.2196/24254

PURPOSE: To describe the feasibility, enjoyment, and self-efficacy of older adults completing light intensity physical activities (LPA) and examine whether participant characteristics predict older adults’ beliefs about LPA. METHODS: Older adults (60+ years) completed questionnaires regarding their perception of LPA and self-reported demographics, health history. Usual physical activity was measured with an accelerometer. Descriptive statistics and frequencies were used to describe results of the surveys. Separate linear regression models were used to examine whether the feasibility, enjoyment, and self-efficacy of light intensity physical activity differed by participant demographics. SUMMARY OF RESULTS Participants (N = 45) were 70.9 ± 4.8 years old, overweight (27.1 ± 3.7 kg/m2), 68.9% women, and largely white (97.8%). Results indicate older adults did not participate in LPA to intentionally accumulate physical activity or enhance their health. However, they believed they could easily incorporate LPA into their daily life and over half reported they were ‘maybe’ open to LPA as an acceptable way to increase physical activity. Self-efficacy scores revealed participants were confident they could complete LPA when faced with challenging situations, such as in when it’s raining or snowing or when stressed, with all average ratings above average (>3). Body mass index (B = 0.08, 95% CI: 0.002, 0.15), age (B = 0.05, 95% CI: 0.0004, 0.11), and total time spent in LPA (B = 0.003, 95% CI: 0.0002, 0.005) were significant predictors of participants beliefs towards LPA participation. CONCLUSION: Our results suggest LPA may provide a promising solution to negate many of the often-cited barriers that are associated with physical activity participation. Future research should invest in promoting LPA to older adults as a health-enhancing physical activity.