title: Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors.
abstract: OBJECTIVE
  To determine the effects of breast cancer-specific print materials and step pedometers on physical activity (PA) and quality of life (QoL) in breast cancer survivors.
  
  
  METHODS
  Breast cancer survivors (N = 377) were randomly assigned to receive one of the following: a standard public health recommendation for PA, previously developed breast cancer-specific PA print materials, a step pedometer, or a combination of breast cancer-specific print materials and step pedometers. The primary outcome was self-reported moderate/vigorous PA minutes per week. Secondary outcomes were QoL (Functional Assessment of Cancer Therapy-Breast), fatigue, self-reported brisk walking, and objective step counts. Assessments were conducted at baseline and postintervention (12 weeks).
  
  
  RESULTS
  Attrition was 10.3% (39 of 377). On the basis of linear mixed-model analyses, PA increased by 30 minutes/week in the standard recommendation group compared with 70 minutes/week in the print material group (mean difference, 39 minutes/week; 95% CI = -10 to 89; d = 0.25; P = .117), 89 minutes/week in the pedometer group (mean difference, 59 minutes/week; 95% CI, 11 to 108; d = 0.38; P = .017), and 87 minutes/week in the combined group (mean difference, 57 minutes/week; 95% CI, 8 to 106; d = 0.37; P = .022). For brisk walking minutes/week, all three intervention groups reported significantly greater increases than the standard recommendation group. The combined group also reported significantly improved QoL (mean difference, 5.8; 95% CI, 2.0 to 9.6; d = 0.33; P = .003) and reduced fatigue (mean difference, 2.3; 95% CI, 0.0 to 4.7; d = 0.25; P = .052) compared with the standard recommendation group.
  
  
  CONCLUSIONS
  Breast cancer-specific PA print materials and pedometers may be effective strategies for increasing PA and QoL in breast cancer survivors. A combined approach appears to be optimal.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier NCT00221221
authors.affiliation: Faculty of Physical Education and Recreation, Centre for Health Promotion Studies, School of Public Health, and Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Jeffrey K H
authors.initials: JK
authors.lastname: Vallance
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Plotnikoff
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: John R
authors.initials: JR
authors.lastname: Mackey
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology / Q000523:psychology; D005221:Fatigue / Q000517:prevention & control; D005260:Female; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods; D011788:Quality of Life / Q000523:psychology; D017741:Survivors; D016138:Walking / Q000502:physiology / Q000523:psychology