Abstract
PURPOSE: The GET FIT Prostate trial (#NCT03741335) is a 3-arm clinical trial determining the efficacy of supervised, in-person fall prevention exercise programs in prostate cancer survivors. The COVID-19 pandemic presented an opportunity to assess feasibility of changing to a remote exercise delivery format delivered by video conference . Exercise adherence is an important metric of trial quality so we compared exercise attendance between facility-based and remotely-delivered settings. METHODS: Men in the GET FIT Prostate trial are randomized into one of 3 study arms: lower-body resistance training, Tai Ji Quan (or tai chi), or flexibility/stretching (control). Men exercise 3 times per week for 6 months. We examine data from 4 “waves” of study participants enrolled over the last 2 years of the trial: 2 in-person waves (n = 68), 1 wave that transitioned to remote classes during week 20 of in-person classes (n = 29), and 1 wave of participants recruited into remote classes (n = 36). Adherence is defined by attendance to exercise sessions over 24 weeks (~72 sessions/wave). Comparisons between study arms and delivery format were assessed using linear regression with a group by training interaction. RESULTS: In-person exercise attendance rates for resistance, Tai Ji Quan, and flexibility arms were 77%, 72%, and 75%, respectively. In that same order, remotely-delivered exercise attendance rates were 91%, 90%, and 91%. Attendance to remotely-delivered classes was significantly higher than in-person classes across all study arms (p-values 0.021-0.004). Within each delivery format, there were no significant differences in attendance between study arms. CONCLUSION: Adherence rates to the exercise interventions were better when delivered remotely than when delivered in-person. Home-based training may be more convenient for older prostate cancer survivors and video-conferencing allowed the supervision and group aspects of the program to be maintained. Remote delivery of study exercise programs could increase program accessibility, but whether or not remotely-delivered programs are as effective as facility-based programs when supervision is maintained remains to be determined.
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