title: Taking the next step: a systematic review and meta-analysis of physical activity and behavior change interventions in recent post-treatment breast cancer survivors.
abstract: Research has shown that recent post-treatment breast cancer survivors face significant challenges around physical activity as they transition to recovery. This review examined randomized controlled trials targeting physical activity behavior change in breast cancer survivors <5 years post-treatment and described (1) characteristics of interventions for breast cancer survivors as well as (2) effect size estimates for these studies. A systematic search was conducted following PRISMA guidelines with Medline, PubMed, PsycINFO, CINAHL, and Scopus databases. Data were abstracted for primary intervention strategies and other details (e.g., setting, duration, theory use). A subgroup analysis was conducted to assess intensity of exercise supervision/monitoring and intervention effectiveness. The search produced 14 unique behavior intervention trials from the US and abroad published 2005-2013. The mean sample size was 153 participants per study. All interventions included moderate-intensity activities plus various behavioral change strategies. Most interventions were partially or entirely home based. The overall standardized mean difference was 0.47 (0.23, 0.67) with p < 0.001. Most interventions were effective in producing short-term behavior changes in physical activity, but varied greatly relative to intervention strategies and intensity of supervision/monitoring. Highly structured interventions tended to produce larger behavior change effects overall, but many larger effect sizes came from interventions supported by phone counseling or e-mail. We observed that 'more' may not be better in terms of direct supervision/monitoring in physical activity behavior interventions. This may be important in exploring less resource-intensive options for effective behavior change strategies for recent post-treatment survivors.
authors.affiliation: Center for Health Promotion and Prevention Research, University of Texas School of Public Health, 7000 Fannin, Suite 2560, Houston, TX, 77030, USA, shelley.bluethmann@nih.gov.
authors.forename: Shirley M
authors.initials: SM
authors.lastname: Bluethmann
authors.forename: Sally W
authors.initials: SW
authors.lastname: Vernon
authors.forename: Kelley Pettee
authors.initials: KP
authors.lastname: Gabriel
authors.forename: Caitlin C
authors.initials: CC
authors.lastname: Murphy
authors.forename: L Kay
authors.initials: LK
authors.lastname: Bartholomew
mesh_terms: D001521:Behavior Therapy; D001943:Breast Neoplasms / Q000534:rehabilitation* / Q000628:therapy; D005260:Female; D006801:Humans; D009043:Motor Activity; D016032:Randomized Controlled Trials as Topic; D017741:Survivors