Group trajectory analysis helps to identify older cancer survivors who benefit from distance-based lifestyle interventions

Cancer. 2015 Dec 15;121(24):4433-40. doi: 10.1002/cncr.29684. Epub 2015 Oct 29.

Abstract

Background: The number of older cancer survivors is increasing as more adults survive to older ages. The objectives of this study were to examine trajectories of physical activity (PA) and physical function (PF) over a 2-year lifestyle counseling study and to identify characteristics of the trajectory groups.

Methods: This was a secondary analysis of Reach Out to Enhance Wellness, a randomized controlled trial of home-based lifestyle counseling. The 641 participants were older (≥65 years), overweight (body mass index [BMI], 25 to <40 kg/m(2)), long-term community-dwelling survivors (>5 years) of breast, prostate, and colorectal cancer from Canada, the United Kingdom, and the United States (21 states) who had been randomly assigned to an immediate intervention or a 12-month-wait-listed control arm. The main outcome measures were PA and PF trajectory group membership.

Results: Three PA groups and 5 PF trajectory groups were observed. The baseline BMI (P < .001) and self-efficacy for performing strength (P < .0001) and endurance exercises (P < .0002) were the strongest predictors of achieving the highest amount of PA and the most favorable functional trajectory over 2 years. Individuals with low baseline self-efficacy, no PA, and a Short Form 36 PF subscale score < 65 did not benefit from the intervention.

Conclusions: This study identified characteristics of survivors who benefited from home-based interventions and suggested alternative approaches for survivors requiring more structured and intensive interventions to promote behavioral changes.

Keywords: aged; breast neoplasms; colorectal neoplasms; counseling; exercise; health behavior; lifestyle; prevention and control; prostatic neoplasms; survivors.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Body Mass Index
  • Breast Neoplasms
  • Canada
  • Colorectal Neoplasms
  • Counseling / methods*
  • Female
  • Humans
  • Male
  • Motor Activity*
  • Neoplasms*
  • Overweight / therapy*
  • Prostatic Neoplasms
  • Risk Reduction Behavior*
  • Self Efficacy
  • Survivors*
  • Telephone*
  • United Kingdom
  • United States
  • Waiting Lists