Prostate Cancer Survivors and Exercise and Behavioral Counseling


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Primary Outcome Measures:

  • Objectively assessed physical activity [ Time Frame: Change in from baseline at 12 weeks ]

    Objective Physical activity will be measured using an activity device, accelerometry (i.e., Actigraph GTX3+)

Secondary Outcome Measures:

  • Self-reported physical activity [ Time Frame: Change in from baseline at 12 weeks ]

    Self-reported physical activity will be assessed using the Godin Leisure-Time Exercise Questionnaire

  • Physical Function [ Time Frame: Change in from baseline at 12 weeks ]

    Mobility-related fitness parameters will be measured through the six-items of the Seniors’ Fitness Test.

  • General quality of life [ Time Frame: Change in from baseline at 12 weeks ]

    Self-reported quality of life measured via the Functional Assessment of Cancer Therapy (FACT-G) for general quality of life.

  • Prostate-specific quality of life [ Time Frame: Change in from baseline at 12 weeks ]

    Self-reported quality of life measured via the FACT-Prostate for prostate-specific quality of life.

  • Cancer-related fatigue [ Time Frame: Change in from baseline at 12 weeks ]

    Self-reported fatigue will be assessed using the FACT-Fatigue

  • General well-being [ Time Frame: Change in from baseline at 12 weeks ]

    Self-reported Short-Form 36 will be used for assessing general well-being.

  • Body composition [ Time Frame: Change in from baseline at 12 weeks ]

    Body composition will be estimated using anthropometric measurements will be taken – height, weight and waist circumference.

  • Cardiorespiratory fitness [ Time Frame: Change in from baseline at 12 weeks ]

    Aerobic endurance capacity will be assessed by using the modified Balke sub-maximual exercise test.

  • Cognitive function [ Time Frame: Change in from baseline at 12 weeks ]

    The primary set of neuropsychological assessments will be assessed using the validated NIH Toolbox Cognition Battery. This battery consists of tests to assess Executive Function, Attention, Episodic Memory, Language, Processing Speed and Working Memory.

  • Sexual Health [ Time Frame: Change in from baseline at 12 weeks ]

    The International Index of Erectile Function (IIEF) will be used to assess sexual health including erectile function, orgasmic function, sexual desire, intercourse satisfaction and overall satisfaction.

  • Relationship quality [ Time Frame: Change in from baseline at 12 weeks ]

    The Perceived Relationship Quality Components (PRQC) Inventory will be used to assess relationship quality.

  • Masculine self-esteem [ Time Frame: Change in from baseline at 12 weeks ]

    Masculine self-esteem will be assessed using the Masculinity in Chronic Disease Inventory (MCD-I).

  • Motivational outcomes [ Time Frame: Change in from baseline at 12 weeks ]

    multi-process action control (M-PAC) framework assessing attitudes, subjective norms, perceived behavioral control, planning, habit, and identity

  • Self-reported sedentary behavior [ Time Frame: Change in from baseline at 12 weeks ]

    sitting time as measured by via self-report using the Measuring Older Adults’ Sedentary Time (MOST) questionnaire which assesses sitting while watching TV, using the computer, hobbies, socializing, transportation, doing hobbies, and other activities.

  • Objectively assessed sedentary behavior [ Time Frame: Change in from baseline at 12 weeks ]

    Objective measures of sitting time will be assessed using an activity device, inclinometers (i.e., ActivPALs)

Physical activity (PA) has a positive impact on clinical outcomes such as improvement in overall QoL, cancer-specific mortality, reducing treatment-related toxicities, and reducing fatigue across many cancer survivor groups including PCS. Despite these benefits of regular PA, the majority of PCS are still not meeting public health PA guidelines.

Short-term supervised PA programs have been shown to improve health-related fitness and patient-reported outcomes in PCS, but PA declines significantly after the supervised intervention has been completed. Research examining the effect of short- term supervised exercise programs on motivational outcomes and longer term PA among cancer survivors is limited, especially theoretical approaches to identify key motivational outcomes for behavior change.

This study will pilot a two-armed, single blind, RCT comparing SPA+EC to SPA+BC. The proposed RCT in PCS is noteworthy given that it differs from standard approaches to supervised PA with the addition of a behavioral counseling component. This rigorous comparison condition will provide further evidence that theoretically-informed interventions are needed to adopt long-term PA maintenance.

The program’s supervised exercise length will be 6 weeks, followed by a tapered contact throughout the a 6-week home-based component through ‘booster’ behavioral counseling delivered via telephone. In terms of study measures, objective measures of PA will be used (i.e.,accelerometry, inclinometers), and cardiorespiratory fitness will be evaluated using maximal graded exercise testing via treadmill. Additional secondary outcomes include cognitive function, quality of life, physical function, body composition, motivational outcomes, sexual functioning, masculinity, sedentary behavior, and cardiorespiratory fitness.