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Randomized Controlled Trial of the Effects of Print Materials and Step Pedometers on Physical Activity and Quality of Life in Breast Cancer Survivors

Jeffrey K.H. Vallance, Kerry S. Courneya, Ronald C. Plotnikoff, Yutaka Yasui, John R. Mackey

From the Faculty of Physical Education and Recreation, Centre for Health Promotion Studies, School of Public Health, and Department of Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada

Address reprint requests to Kerry S. Courneya, PhD, Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Centre, Edmonton, Alberta, T6G-2H9, Canada; e-mail: kerry.courneya{at}ualberta.ca

Purpose: To determine the effects of breast cancer–specific print materials and step pedometers on physical activity (PA) and quality of life (QoL) in breast cancer survivors.

Patients and Methods: Breast cancer survivors (N = 377) were randomly assigned to receive one of the following: a standard public health recommendation for PA, previously developed breast cancer–specific PA print materials, a step pedometer, or a combination of breast cancer–specific print materials and step pedometers. The primary outcome was self-reported moderate/vigorous PA minutes per week. Secondary outcomes were QoL (Functional Assessment of Cancer Therapy–Breast), fatigue, self-reported brisk walking, and objective step counts. Assessments were conducted at baseline and postintervention (12 weeks).

Results: Attrition was 10.3% (39 of 377). On the basis of linear mixed-model analyses, PA increased by 30 minutes/week in the standard recommendation group compared with 70 minutes/week in the print material group (mean difference, 39 minutes/week; 95% CI = –10 to 89; d = 0.25; P = .117), 89 minutes/week in the pedometer group (mean difference, 59 minutes/week; 95% CI, 11 to 108; d = 0.38; P = .017), and 87 minutes/week in the combined group (mean difference, 57 minutes/week; 95% CI, 8 to 106; d = 0.37; P = .022). For brisk walking minutes/week, all three intervention groups reported significantly greater increases than the standard recommendation group. The combined group also reported significantly improved QoL (mean difference, 5.8; 95% CI, 2.0 to 9.6; d = 0.33; P = .003) and reduced fatigue (mean difference, 2.3; 95% CI, 0.0 to 4.7; d = 0.25; P = .052) compared with the standard recommendation group.

Conclusion: Breast cancer–specific PA print materials and pedometers may be effective strategies for increasing PA and QoL in breast cancer survivors. A combined approach appears to be optimal.

Clinical Trial Registration: ClinicalTrials.gov Identifier NCT00221221

Supported by a research team grant from the National Cancer Institute of Canada (NCIC) with funds from the Canadian Cancer Society (CCS) and the CCS/NCIC Sociobehavioral Cancer Research Network. At the time of this study, J.K.H.V. was supported by a Canada Graduate Scholarship from the Canadian Institutes of Health Research (CIHR) and a Doctoral Incentive Award from the Alberta Heritage Foundation for Medical Research (AHFMR). K.S.C. is supported by the Canada Research Chairs Program. R.C.P. is supported by Salary Awards from CIHR and AHFMR. Y.Y. is supported by the Canada Research Chairs Program and a Salary Award from AHFMR.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

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