Approximately 45% of colon cancer and 38 % of breast cancer in the USA are reported as preventable every year through better diet, physical activity and weight maintenance (AICR, 2009). Survivor rates for many common cancer are on the rise (Jemal, 2006), due to declining rate of mortality (Mettlin, 1999; Greenlee, 2000), early detection and improved therapy.
Today, people living with cancer (like many other chronic illnesses) have many years to benefit from self-management strategies like managing their current health and lifestyle, in order to enhance quality of life and reduce mortality. Progress in reducing the burden of suffering and death from cancer needs to be accelerated through cancer control knowledge across all segments of the population (Jemal, 2006). Physical activity and inactivity are potent strategies for cancer control. ‘Staying active’ is an effective key message for health prevention and cancer control strategy which should be promoted in the model of cancer survivorship care.
B. General and Specific Objectives
This is a mixed method study.
a) The pilot study was to assess what women think of the 4 posters designed specifically to motivate cancer survivors to engage in physical activity. The insights from the participants will be used to inform the development of a 1-minute cancer control video clip.
b) The qualitative study (via focus group interview) was aim at exploring the perception of physical activity engagement during and after cancer treatment. A secondary goal was to examine for myths, barriers and facilitators for physical activity engagement.
c) The quantitative study – pre and post test was aim at evaluating the impact of the 1 minute video clip on getting cancer survivors to engage in more physical activity.
OUTLINE OF RESEARCH PLAN
Design and Setting:
The Phase 1 was conducted in early 2010 and involved poster designs with key messages on physical activity engagement, as well as its benefits on health and lowering risks of cancer recurrence. This was follow up with a pilot study involving a group of women with a cancer diagnosis. The aim was to delineate what key messages they have pick up from the four posters, and which poster was best in delivering clear public health messages on cancer control via active lifestyle.
[The feedback from the cancer survivors provided the insights for designing clear messages for the t-shirt to be used in the video clip. The UICC logo (as the sponsor) and the key message on ‘Stay Active for Life’ was printed on the front of the t-shirt. The word “Move It” was printed at the back of the lower end of the t-shit to covers the gluteal region- was printed to remind people not to sit still]
The Phase 2 study was conducted in mid 2010. The group was stratified into 2 homogenous group – the undergoing treatment (UT) and the completed treatment (CT).
The Phase 3 study involved development of a video clip as the media for promoting cancer control via physical activity. The ideas of staying active and avoiding sedentary activity was used as the story board for the 1-minute video clip. A survey to evaluate the impact of the video was conducted. Baseline data was collected before the viewing of the video clip and upon completion of viewing of the video clip.
The primary outcome measures are IPAQ, barriers and facilitator questionnaire
The secondary outcomes are the exercise self efficacy measures.
Ethical approvals were obtained from the Research Ethics Committee of UMMC
PARTICIPANTS and RECRUITMENT
Participants were recruited from UMMC and breast welfare association. Eligible and interested survivors were followed up with a package, consisting of a cover letter, consent form, and baseline questionnaire. For the focus group, snowballing sampling was used.
Inclusion criteria were:
i) More than 18 years of age, ii) Confirmed by physicians a diagnosis of breast cancer, iii) Can read and understand English, and vi) Give informed-consent.
There were more myths/ misconceptions in survivors in the Undergoing Treatment (UT group) than in the Completed Treatment (CT group).
The key message to avoid sedentary behavior was found to be the most clear, simple yet potent message for motivating people with cancer to be more physically active.
Many women with breast cancer were unaware that physical activity has strong inverse relationship with cancer recurrence and cancer mortality
SY Loh, SL Chew (2011) Physical Activity and women with breast cancer – insights from the expert patients. APJCP Vol 11 2011.
SY Loh SL Chew, SY Lee (2011) Cancer Survivorship – Targeting physical activity and inactivity. JUMMEC
The Union International against cancer control (UICC, Capacity Building Fund 2010), Geneva, Switzerland.
Primary Investigator: Dr Loh Siew Yim
Team : SL Chew, SY Lee,