title: Recruiting and retaining breast cancer survivors into a randomized controlled exercise trial: the Yale Exercise and Survivorship Study.
abstract: BACKGROUND
  Given observational findings that physical activity reduces breast cancer risk, improves survival, and improves quality of life in breast cancer survivors, a need has been identified for randomized controlled trials that test the efficacy of exercise on biological mechanisms associated with breast cancer survival. The primary aims of the Yale Exercise and Survivorship Study were to 1) determine the feasibility of recruiting breast cancer survivors into a randomized controlled trial of the effects of exercise on biological markers and/or mechanisms associated with survival, 2) compare the effectiveness of various recruitment strategies on accrual rates and baseline characteristics, and 3) report adherence to the exercise trial.
  
  
  METHODS
  Seventy-five postmenopausal breast cancer survivors self-referred into the trial or were recruited through the New Haven Tumor [corrected] Registry and randomly assigned to an exercise (n = 37) or usual-care (n = 38) group. The exercise group participated in 150 min/wk of supervised gym-based and home-based aerobic exercise for 6 months. The usual-care group was instructed to maintain current physical activity level.
  
  
  RESULTS
  A total of 75 women (an accrual rate of 9.5%) were randomized to the trial. Rates of accrual were higher for women who self-referred into the study (19.8%) compared with women recruited via the cancer registry (7.6%); however, demographic, physiologic, and prognostic characteristics did not differ between the 2 recruitment strategies. On average, exercisers increased moderate- intensity to vigorous-intensity aerobic exercise by 129 minutes per week compared with 44 minutes per week among usual-care participants (P < .001). Women in the exercise-intervention group increased their average pedometer steps by 1621 steps per day compared with a decrease of 60 steps per day among women in the usual-care group (P < .01).
  
  
  CONCLUSIONS
  Findings from this study will provide useful information for investigators who are conducting exercise trials in cancer populations, clinicians who are treating women diagnosed with breast cancer, and exercise professionals who are developing community-based exercise programs for cancer survivors.
authors.affiliation: Department of Epidemiology and Public Health, Yale School of Medicine, New Haven, Connecticut, USA. melinda.irwin@yale.edu
authors.forename: Melinda L
authors.initials: ML
authors.lastname: Irwin
authors.forename: Lisa
authors.initials: L
authors.lastname: Cadmus
authors.forename: Marty
authors.initials: M
authors.lastname: Alvarez-Reeves
authors.forename: Mary
authors.initials: M
authors.lastname: O'Neil
authors.forename: Eileen
authors.initials: E
authors.lastname: Mierzejewski
authors.forename: Rebecca
authors.initials: R
authors.lastname: Latka
authors.forename: Herbert
authors.initials: H
authors.lastname: Yu
authors.forename: Loretta
authors.initials: L
authors.lastname: Dipietro
authors.forename: Beth
authors.initials: B
authors.lastname: Jones
authors.forename: M Tish
authors.initials: MT
authors.lastname: Knobf
authors.forename: Gina G
authors.initials: GG
authors.lastname: Chung
authors.forename: Susan T
authors.initials: ST
authors.lastname: Mayne
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000534:rehabilitation*; D003237:Connecticut; D015444:Exercise / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology; D018579:Patient Selection; D011379:Prognosis; D012042:Registries; D017741:Survivors / Q000523:psychology*