Abstract

Abstract Purpose: Rural cancer survivors are less likely to meet physical activity recommendations than urban cancer survivors, contributing to physical inactivity-related cancer health disparities. Evidence-based interventions to reduce psychosocial distress and increase physical activity in cancer survivors were developed in urban or clinical settings and often fail when implemented in rural community settings. The purpose of this study was to use a community-engaged approach to develop and evaluate an intervention to reduce psychosocial stress and increase physical activity in rural breast cancer survivors in Northeast Texas. Method: We conducted interviews with community partners and rural breast cancer survivors to adapt an evidence-based program for rural cancer survivors and for implementation in a rural community setting. The Mind Your BEAT (MYB) intervention combined aerobic exercise, group education, and mind-body strategies to increase physical activity and reduce psychosocial distress in rural breast cancer survivors. Participants were recruited through FitSteps for Life, an existing evidence-based exercise program, and randomized to participate in MYB or FitSteps as usual (control group). Self-reported weekly leisure time physical activity (WLA) was assessed using the Godin Leisure-Time Exercise Questionnaire, and psychosocial distress was assessed using the NCCN distress thermometer. All measures were completed at baseline and following the 3-month intervention. Participants were categorized as meeting physical activity recommendations or not (WLA score ≥24 or <24) and reporting high or low psychosocial distress (NCCN score ≥4 or <4). Results: To date, 29 rural breast cancer survivors (M age=65.8±10.3 years) have enrolled in the study, and 24 (83%) were retained at post-intervention. Most participants completed a bachelor degree or more (62%), reported an annual household income >$40,000 (80%), reported their cancer stage at diagnosis was 0-II (95.9%), and were over 5 years post-treatment (M=5.9±8.4 years). In the MYB intervention, the percent of rural breast cancer survivors who met physical activity recommendations increased from 53.3 to 90.9% compared to the control group, which decreased from 64.3 to 50%. The percent of rural cancer survivors who reported high psychosocial distress decreased from 66.7 to 27.3% in the MYB group and from 57.1 to 41.7% in the control group. Conclusions: MYB integrates physical and psychological health and wellbeing and is feasible among rural breast cancer survivors who are insufficiently active. Furthermore, MYB improved physical activity and reduced psychosocial distress among rural cancer survivors who experience poorer cancer survivorship outcomes and are at greater risk of recurrence, comorbidity and death. Findings from this study fill a critical gap in the literature on the translation of evidence-based interventions into sustained practice in rural community settings. Citation Format: Scherezade K. Mama, Lily Ju, Brandy Friendly, Ian Leavitt, Laura Q. Rogers, Kathryn H. Schmitz, Lorna H. McNeill. Mind Your BEAT: A culturally adapted intervention to increase physical activity and reduce psychosocial distress among rural breast cancer survivors [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A024.

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