title: A Dyadic Exercise Intervention to Reduce Psychological Distress Among Lesbian, Gay, and Heterosexual Cancer Survivors.
abstract: Studies have found disparities in psychological distress between lesbian and gay cancer survivors and their heterosexual counterparts. Exercise and partner support are shown to reduce distress. However, exercise interventions haven't been delivered to lesbian and gay survivors with support by caregivers included.
  
  
  
  In this pilot randomized controlled trial (RCT), ten lesbian and gay and twelve heterosexual survivors and their caregivers were randomized as dyads to: Arm 1, a survivor-only, 6-week, home-based, aerobic and resistance training program (EXCAP©®); or Arm 2, a dyadic version of the same exercise program involving both the survivor and caregiver. Psychological distress, partner support, and exercise adherence, were measured at baseline and post-intervention (6 weeks later). We used t-tests to examine group differences between lesbian/gay and heterosexual survivors and between those randomized to survivor-only or dyadic exercise.
  
  
  
  Twenty of the twenty-two recruited survivors were retained post-intervention. At baseline, lesbian and gay survivors reported significantly higher depressive symptoms (P = .03) and fewer average steps walked (P = .01) than heterosexual survivors. Post-intervention, these disparities were reduced and we detected no significant differences between lesbian/gay and heterosexual survivors. Participation in dyadic exercise resulted in a significantly greater reduction in depressive symptoms than participation in survivor-only exercise for all survivors (P = .03). No statistically significant differences emerged when looking across arm (survivor-only vs. dyadic) by subgroup (lesbian/gay vs. heterosexual).
  
  
  
  Exercise may be efficacious in ameliorating disparities in psychological distress among lesbian and gay cancer survivors, and dyadic exercise may be efficacious for survivors of diverse sexual orientations. Larger trials are needed to replicate these findings.
authors.affiliation: 1 Department of Surgery, University of Rochester Medical Center , Rochester, New York.
authors.forename: Charles
authors.initials: C
authors.lastname: Kamen
authors.affiliation: 1 Department of Surgery, University of Rochester Medical Center , Rochester, New York.
authors.forename: Charles
authors.initials: C
authors.lastname: Heckler
authors.affiliation: 1 Department of Surgery, University of Rochester Medical Center , Rochester, New York.
authors.forename: Michelle C
authors.initials: MC
authors.lastname: Janelsins
authors.affiliation: 1 Department of Surgery, University of Rochester Medical Center , Rochester, New York.
authors.forename: Luke J
authors.initials: LJ
authors.lastname: Peppone
authors.affiliation: 2 School of Nursing, University of Rochester Medical Center , Rochester, New York.
authors.forename: James M
authors.initials: JM
authors.lastname: McMahon
authors.affiliation: 1 Department of Surgery, University of Rochester Medical Center , Rochester, New York.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Morrow
authors.affiliation: 3 School of Public Health, University of Washington , Seattle, Washington.
authors.forename: Deborah
authors.initials: D
authors.lastname: Bowen
authors.affiliation: 1 Department of Surgery, University of Rochester Medical Center , Rochester, New York.
authors.forename: Karen
authors.initials: K
authors.lastname: Mustian
keywords: cancer; caregivers; exercise; health disparities; oncology; sexual orientation