For the over 3 million breast cancer survivors in the United States (including at least 135,000 Texans), physical activity is a crucial component of survivorship. Physical activity is an effective, safe, and evidence-based behavior that improves physical and psychosocial functioning, and potentially improves recurrence and survival among breast cancer survivors.

Multiple organizations, including the American Cancer Society, the National Comprehensive Cancer Network, and the American College of Sports Medicine, recommend cancer survivors engage in at least 75 minutes intense or 150 minutes moderate activity per week. Despite the significant benefits of physical activity, at least two-t...

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For the over 3 million breast cancer survivors in the United States (including at least 135,000 Texans), physical activity is a crucial component of survivorship. Physical activity is an effective, safe, and evidence-based behavior that improves physical and psychosocial functioning, and potentially improves recurrence and survival among breast cancer survivors.

Multiple organizations, including the American Cancer Society, the National Comprehensive Cancer Network, and the American College of Sports Medicine, recommend cancer survivors engage in at least 75 minutes intense or 150 minutes moderate activity per week. Despite the significant benefits of physical activity, at least two-thirds of breast cancer survivors do not meet these recommendations.

Evidence-based strategies for increasing physical activity range from brief physical activity education and self-monitoring, to more intensive lifestyle counseling and on-site supervised activity. However, such interventions are rarely covered by insurance or offered within standard oncologic care, making them out of reach for cancer survivors. In addition, although multiple strategies have proven efficacious, little is known about the optimal intervention strategies for breast cancer survivors.

We have mobilized Texas-based experts in physical activity and cancer survivorship to serve breast cancer survivors treated within the last 5 years at the safety net (Parkland) and academic (UT Southwestern) settings associated with the Simmons Cancer Center. Our comprehensive program will: a) provide evidence-based education on physical activity to breast cancer survivors, and b) deliver more intensive evidence-based interventions to survivors with the greatest need (those not meeting physical activity recommendations). The primary goal of the program is to increase physical activity among breast cancer survivors.

Through rigorous evaluation, we will also identify the optimal combination of intervention components to increase physical activity among breast cancer survivors. Finally, evaluation of factors related to dissemination and implementation of the program will ensure it can be successfully sustained at the Simmons Cancer Center and disseminated across the state of Texas. We seek CPRIT funding to accomplish three goals:

• Goal 1. Provide education and evidence-based interventions to Increase physical activity among breast cancer survivors treated at the Simmons Cancer Center. Objective 1. Provide targeted, evidence-based education about physical activity during survivorship to 4500 breast cancer survivors. Objective 2. Deliver more intensive evidence-based physical activity interventions to 500 survivors who are not meeting physical activity recommendations.
• Goal 2. Rigorously evaluate changes in physical activity and identify the optimal intervention or combination of interventions for increasing physical activity in breast cancer survivors who are not meeting physical activity guideline recommendations at baseline. Objective 1. Measure physical activity at baseline and follow-up periods (3- and 6-months post-baseline) and assess percentage of survivors meeting physical activity guideline recommendations. Objective 2. Utilizing the Multiphase Optimization Strategy framework, compare improvements in physical activity across intervention components utilized for breast cancer survivors. Objective 3. Evaluate secondary outcomes. Objective 4. Evaluate psychosocial factors as predictors of physical activity behavior change.
• Goal 3. Assess factors related to dissemination and implementation of the PACES program, including psychosocial predictors of behavior change and satisfaction with the program. Objective 1: Evaluate program acceptability. Objective 2: Evaluate program satisfaction outcomes.

This program is innovative in its reach and its focus on identifying the most effective components of a physical activity intervention for breast cancer survivors. With a catchment area of 12 counties and a focus on underserved patients, the Simmons Cancer Center provides the optimal setting to serve a large and diverse population. Our program’s creative integration of multiple evidence-based intervention components allows an opportunity to understand which of intervention components result in the best outcomes.

CPRIT investment will result not only in delivery of physical activity services with immediate impact for in our project setting and population, but also an understanding of optimal and feasible service delivery that can be disseminated for cancer survivors throughout Texas. Physical activity is an essential component of survivorship care with significant need for intervention among cancer survivors. This program can serve as a catalyst to ensure that Texas leads the nation in active lifestyles during survivorship.

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