The Long-term Effects Of A Physical Activity Behaviour Change Intervention On Cancer Survivors’ Levels Of Depression, Fatigue And Mental Well-being

Abstract

PURPOSE: Exercise is known to increase cancer survivors' cardiorespiratory fitness and strength, assist in the management of treatment related side effects and reduce the risk of cancer recurrence and mortality. The aim of this study was to determine the long-term effects of the MedEx IMPACT (IMprove Physical Activity after Cancer Treatment) trial, a patient centred, evidenced-based and theoretically informed physical activity behaviour change intervention, on cancer survivors’ long-term levels of depression, fatigue and mental well-being (MWB). METHODS: Adults with an established diagnosis of cancer, who had completed their adjunctive therapy, were referred to a community-based exercise rehabilitation programme (CBERP) for survivors of cancer known as ‘MedEx Move On’. Participants in the control group (CG) and intervention group (IG) attended two 60-min supervised exercise classes each week for 12 weeks. In addition, participants in the IG also received: i) a home-based exercise programme, ii) 4 PA information sessions and iii) a 1:1 exercise consultation. At baseline, programme completion (week 12) and 3-month follow-up, depression, fatigue and MWB were measured using the Patient Health Questionnaire (PHQ-8), Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-Fatigue) and the short Warwick-Edinburgh mental well-being scale (SWEMWBS), respectively. RESULTS: One-hundred and ninety-one survivors of cancer were recruited (CG, n= 87; IG, n=104; mean age 56 ± 10 yrs, 73% female). Cancer diagnoses were breast (60%), colorectal (16%), prostate (13%) and other (11%). On average, participants attended 66% of the supervised exercise classes (CG= 67±22%; IG=65±27%). 97 participants (51%) completed the trial. Depression, fatigue and MWB significantly improved in both groups from baseline to week 12, and 3 month follow-up (p<.001). There were no statistically significant differences between the CG and IG. CONCLUSIONS: Participation in a 12-week CBERP has a positive long-term effect on cancer survivors’ levels of depression, fatigue and MWB. The inclusion of additional behaviour change strategies to the supervised exercise classes did not augment the benefits achieved.