title: A Community-Based Exercise and Support Group Program Improves Quality of Life in African-American Breast Cancer Survivors: A Quantitative and Qualitative Analysis.
abstract: African-American (AA) breast cancer (BCa) survivors have higher mortality rates, more comorbidities and are less likely to meet national physical activity guidelines after diagnosis compared to Caucasian BCa survivors. We previously reported that a 20-week resistance exercise intervention coupled with a support group and home walking program, conducted using facilities and personnel at a community cancer support center, in Stage I-III AA BCa survivors improved strength, fitness and circulating C-peptide levels. Here, we report our findings on changes in quality of life (QoL) and other behavioral measures associated with this 20-week intervention and, discuss findings from a qualitative analysis of semi-structured patient interviews. We found a clinically relevant improvement in QoL using the Functional Assessment of Cancer Therapy for Breast Cancer (FACT-B) (Baseline, B: 101.1 ± 21.5; End-of-Intervention, EOI: 108.5 ± 21.6; p = 0.05) and, a significant decrease in depression using the Beck Depression Inventory-II (B: 11.9 ± 8.1; EOI: 9.0 ± 5.5; p = 0.03). Our analysis of the patient interviews support improvements in these behavioral measures in that participants stated that they "feel better", were "more motivated" and "uplifted" after the program. The patient interviews also provided insights to the primary motivators (e.g., social support, improvements in strength and function, weight loss) and barriers (e.g., family and health issues) in adhering to the program and provided suggestions for improving the program (e.g., incorporating nutritional and treatment related side-effect discussions). Our results suggest that community-based lifestyle interventions may improve QoL and depression in AA BCa survivors and lend insights for improving future programs.
authors.affiliation: Department of Epidemiology and Biostatistics, Case Western Reserve University, USA.
authors.forename: Nora L
authors.initials: NL
authors.lastname: Nock
authors.affiliation: Medicine, Case Western Reserve University, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owusu
authors.affiliation: Family Medicine and Community Health, Case Western Reserve University, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Flocke
authors.affiliation: Case Comprehensive Cancer Center, University Hospitals Case Medical Center, USA.
authors.forename: Susan A
authors.initials: SA
authors.lastname: Krejci
authors.affiliation: Department of Pathobiology, Cleveland Clinic, USA.
authors.forename: Emily L
authors.initials: EL
authors.lastname: Kullman
authors.affiliation: The Gathering Place, Beachwood, OH, USA.
authors.forename: Kris
authors.initials: K
authors.lastname: Austin
authors.affiliation: Solid Tumor Oncology, Cleveland Clinic, USA.
authors.forename: Beth
authors.initials: B
authors.lastname: Bennett
authors.affiliation: Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Cerne
authors.affiliation: Oncology, MetroHealth Medical Center, USA.
authors.forename: Carl
authors.initials: C
authors.lastname: Harmon
authors.affiliation: Cardiovascular Medicine, Cleveland Clinic, USA.
authors.forename: Halle
authors.initials: H
authors.lastname: Moore
authors.affiliation: Department of Pathology and Biochemistry, University of Vermont, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Vargo
authors.forename: Paul
authors.initials: P
authors.lastname: Hergenroeder
authors.forename: Hermione
authors.initials: H
authors.lastname: Malone
authors.forename: Michael
authors.initials: M
authors.lastname: Rocco
authors.forename: Russell
authors.initials: R
authors.lastname: Tracy
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: John P
authors.initials: JP
authors.lastname: Kirwan
authors.forename: Ellen
authors.initials: E
authors.lastname: Heyman
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Berger
keywords: African-American; Breast cancer; Community-based; Lifestyle program