Behaviour Change for Cancer Survivors

(BOOST-Up Trial)

Recruiting at 1 trial location

Overseen By Emma V Tung, MSc

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Toronto

Disqualifiers: Advanced cancer, Uncontrolled comorbidities, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 6

Duration: 6 months

236 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial examines how different exercise programs can help cancer survivors increase their physical activity. Participants will join one of two programs: one combines physical activity with motivational counseling, and the other with standard exercise coaching. The goal is to help cancer survivors gradually achieve at least 90 minutes of exercise each week, as recommended for their health. Known as the Behaviour Change for Cancer Survivors Trial, it suits those who have completed cancer treatment in the last five years, are currently not very active, and can join online sessions. As an unphased trial, it offers a unique opportunity for cancer survivors to enhance their well-being through tailored exercise programs.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on physical activity and exercise counseling for cancer survivors.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that participating in structured exercise programs, like those under study, benefits health, particularly for cancer survivors. Reviews of various studies indicate that participants generally tolerate these programs well. Many report improvements in both physical and mental well-being.

In the studies reviewed, no serious side effects or safety issues arose from increased physical activity in these programs. This suggests that the programs are likely safe for most individuals. The goal is to gradually increase activity levels, which helps minimize potential risks.

Overall, evidence suggests these programs provide a safe way for cancer survivors to become more active, enhancing their overall well-being. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative ways to help cancer survivors improve their health through personalized physical activity and counseling. Unlike traditional approaches that might focus solely on general exercise recommendations, this trial offers two unique methods: behavior change counseling and exercise counseling. The behavior change counseling incorporates tailored strategies using the M-PAC framework to motivate lasting lifestyle changes, while the exercise counseling emphasizes proper technique and safe progression of physical activities. This personalized approach aims to empower survivors by providing them with the tools and knowledge to maintain their health long-term.

What evidence suggests that this trial's treatments could be effective for increasing physical activity in cancer survivors?

Research has shown that techniques to change behavior can help cancer survivors become more active. In this trial, participants will join one of two groups: the Physical Activity + Behavioural Counselling (PA + BC) group or the Physical Activity + Exercise Counselling (PA + EC) group. Studies suggest that online exercise programs, when paired with habit-changing support, can boost activity levels in this population. Specifically, a review found that digital programs help breast cancer survivors increase their exercise. However, evidence is limited on whether these activity levels persist over time. Overall, combining counseling with exercise programs appears promising for helping cancer survivors remain active. ^{1 2 6 7 8}

Who Is on the Research Team?

Linda Trinh, PhD

Principal Investigator

University of Toronto

Are You a Good Fit for This Trial?

This trial is for adults over 18 who've had cancer surgery at least 12 weeks ago, are in stages I-III of any cancer type, and finished radiation treatment at least 6 weeks prior. Participants should be physically inactive but able to walk with minimal aid, have internet access, speak English, and own a device capable of videoconferencing.

Inclusion Criteria

I am proficient in English.

My cancer is confirmed and is in stages I to III, not spread widely.

I do less than 90 minutes of moderate to vigorous physical activity per week.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants engage in a 6-month supervised physical activity program with either standard exercise counselling or motivationally-enhanced behavioural counselling

6 months

Bi-weekly virtual sessions

Follow-up

Participants are monitored for maintenance of physical activity levels post-intervention

6 months

Follow-up assessments at 6 months and 1 year post-intervention

Long-term Follow-up

Participants are further monitored for long-term adherence to physical activity guidelines

1 year

What Are the Treatments Tested in This Trial?

Interventions

• Behaviour Change for Cancer Survivors

Trial Overview

The study compares two programs: one combines standard exercise counseling with a virtual physical activity (PA) program; the other adds motivationally-enhanced behavioral counseling to PA. The goal is to increase moderate to vigorous physical activity in cancer survivors following evidence-based guidelines.

How Is the Trial Designed?

Group I: Physical Activity + Behavioural Counselling (PA + BC) Experimental Treatment 1 Intervention

The PA+BC group will be given an individualized, home-based aerobic and resistance prescription based on baseline assessment and previous work. The participants will also receive behavioural counselling support sessions with a QEP every two weeks during the intervention period (12 total). The focus of these sessions will incorporate tailored behaviour change content from the M-PAC framework. At the end of the 6-month program, an individualized PA prescription will be provided based on their fitness level (adjusted throughout) to continue achieving the PA goal for the 6-month post intervention and 1-year post intervention follow-up.

Group II: Physical Activity + Exercise Couselling (PA + EC) Active Control 1 Intervention

The PA+EC group will be given an individualized, home-based aerobic and resistance prescription based on baseline assessment and previous work. The participants will also receive the same frequency of group-based and 1:1 counseling support sessions via Zoom as PA+BC participants. The focus of these sessions will be on exercise training principles for proper PA technique, how to monitor intensity, and progress PA safely to achieve the PA guidelines. The support sessions will be 30-45 minutes and delivered via Zoom each week in either group or 1:1 format depending on the topic.

Who Is Running the Clinical Trial?

University of Toronto

Lead Sponsor

Trials

739

Recruited

1,125,000+

University of British Columbia

Collaborator

Trials

1,506

Recruited

2,528,000+

Toronto Rehabilitation Institute

Collaborator

Trials

55

Recruited

6,000+

Published Research Related to This Trial

Physical activity has been shown to significantly improve both patient-reported outcomes and physiological health in cancer survivors during and after treatment, highlighting its importance in recovery.

The review discusses ongoing phase III trials that are investigating the impact of physical activity on clinical disease endpoints, suggesting a strong focus on integrating exercise into cancer care to enhance patient outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Putting Exercise Into Oncology Practice: State-of-the-Science, Innovation, and Future Directions. Brown, JC., Ligibel, JA.[2023]

The AMPLIFI study is testing web-based diet and exercise interventions for middle-aged and older cancer survivors, focusing on improving health behaviors and reducing obesity-related risks through three randomized controlled trials involving multiple behavior change strategies.

The study will assess the efficacy of sequential versus simultaneous interventions over a 2-year period, measuring various health outcomes such as body mass index, physical activity, and muscle mass, using remote technologies for recruitment and assessment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adapting MultiPLe behavior Interventions that eFfectively Improve (AMPLIFI) cancer survivor health: program project protocols for remote lifestyle intervention and assessment in 3 inter-related randomized controlled trials among survivors of obesity-related cancers. Pekmezi, D., Fontaine, K., Rogers, LQ., et al.[2023]

The MedEx IMPACT intervention was developed to help cancer survivors increase their physical activity levels, using insights from focus groups with 41 survivors and a thorough literature review.

This intervention is unique as it is the first to be designed using established frameworks like the Medical Research Council's guidelines, aiming to ensure its effectiveness and acceptability in promoting regular physical activity among cancer survivors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Development of the MedEx IMPACT Intervention: A Patient-Centered, Evidenced-Based and Theoretically-Informed Physical Activity Behavior Change Intervention for Individuals Living With and Beyond Cancer. Cantwell, M., Walsh, DMJ., Furlong, B., et al.[2021]

Only 24% of the 206 randomized trials reviewed measured both the adoption and maintenance of physical activity in cancer survivors, indicating a significant gap in assessing long-term behavior change.

Interventions that included supervised exercise sessions and focused on improving quality of life were more successful in promoting both the adoption and maintenance of physical activity, suggesting that these strategies should be prioritized in future research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Which Intervention Strategies Promote the Adoption and Maintenance of Physical Activity? Evidence From Behavioral Trials With Cancer Survivors. Sheeran, P., Wright, CE., Listrom, O., et al.[2023]

A 6-month home-based physical activity intervention combined with counselling significantly increased physical activity levels and improved body mass and BMI in 80 breast cancer survivors compared to usual care.

Participants in the intervention group also experienced notable improvements in health-related quality of life and reductions in total cholesterol and LDL cholesterol, indicating both physical and psychological benefits from the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Randomised controlled trial of a home-based physical activity intervention in breast cancer survivors. Lahart, IM., Metsios, GS., Nevill, AM., et al.[2022]

Cancer survivors generally have low levels of physical activity but show a strong interest in increasing their participation in exercise programs, highlighting the potential for tailored interventions.

Adherence to physical activity programs varies based on demographic, medical, and behavioral factors, indicating that exercise programs should be customized to meet the specific needs of cancer survivors for better outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Physical activity among cancer survivors: a literature review. Szymlek-Gay, EA., Richards, R., Egan, R.[2011]

Interventions aimed at maintaining physical activity in cancer survivors were effective, resulting in a moderate increase in moderate to vigorous physical activity (MVPA) of about 65 minutes per week compared to control groups, which saw an increase of 27 minutes per week.

However, many studies included in the review had biases, primarily involving younger, more active, and well-educated participants, suggesting that future interventions should focus on older adults and those with physical limitations to ensure broader applicability.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Systematic review and meta-analysis of maintenance of physical activity behaviour change in cancer survivors. Grimmett, C., Corbett, T., Brunet, J., et al.[2021]

A systematic review of 27 studies found that demonstrating how to perform physical activity was the most commonly used behavior change technique (BCT) among interventions aimed at increasing activity levels in breast cancer survivors.

The use of objects like pedometers or accelerometers was identified as the BCT with the highest potential to boost physical activity, followed by goal setting and self-monitoring, highlighting effective strategies for future interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A systematic review of behaviour change techniques used in interventions to increase physical activity among breast cancer survivors. Hailey, V., Rojas-Garcia, A., Kassianos, AP.[2022]

The internet-delivered physical activity program (UCAN) had significant negative effects on motivation-related factors in cancer survivors, including self-efficacy and attitudes towards physical activity, as shown in a study of 95 participants.

Despite being based on the Theory of Planned Behaviour, the program did not improve motivation and may have methodological issues that affected the measurement of motivation in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A pilot study on the motivational effects of an internet-delivered physical activity behaviour change programme in Nova Scotian cancer survivors. Forbes, CC., Blanchard, CM., Mummery, WK., et al.[2018]

In a pilot study involving 30 cancer patients, the use of a wearable activity tracker combined with personalized text message feedback led to 39% of participants increasing their daily steps by at least 20% over 3 months.

The intervention was well-received, with 72% of participants continuing to use the activity tracker at least 4 days a week after 6 months, suggesting it may effectively promote physical activity among cancer survivors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing physical activity in Cancer Survivors through a Text-messaging Exercise motivation Program (ICanSTEP). Koontz, BF., Levine, E., McSherry, F., et al.[2022]

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC6215922/

Behavior change techniques for increasing physical activity ...

The purpose of this systematic review and meta-analysis is to investigate how physical activity (PA) can be effectively promoted in cancer survivors.

2.

sciencedirect.com

sciencedirect.com/science/article/pii/S2772696724000036

Interim results and program satisfaction of the EXCEL study

EXCEL's group-based exercise program with behaviour change support, delivered in an online supervised setting to individuals living with cancer, may improve ...

3.

ijbnpa.biomedcentral.com

ijbnpa.biomedcentral.com/articles/10.1186/s12966-019-0787-4

Systematic review and meta-analysis of maintenance of ...

This review evaluates the effectiveness of interventions in supporting maintenance of physical activity behaviour change among adults diagnosed with cancer

4.

jmir.org

jmir.org/2025/1/e65278

Digital Behavior Change Interventions to Promote Physical ...

This systematic review and meta-analysis aimed to assess the effectiveness of DBCIs in promoting PA and reducing SB among survivors of breast cancer.

5.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10209249/

Physical activity behaviour change in people living with and ...

Evidence for long-term physical activity maintenance post-exercise intervention for people living with/beyond cancer is limited and inconclusive.

6.

bmccancer.biomedcentral.com

bmccancer.biomedcentral.com/articles/10.1186/s12885-023-11137-1

Promoting physical activity through supervised vs motivational ...

This paper describes the design of the PAC-WOMAN trial, which will test the long-term effectiveness and cost-effectiveness of two state of the art, group-based ...

7.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC10653091/

A Group-Based, Videoconference-Delivered Physical ...

The feasibility and effects of videoconference-delivered interventions to improve PA and other health outcomes among cancer survivors are still emerging (15).

8.

withpower.com

withpower.com/trial/behaviour-change-for-cancer-survivors-1ea78

Behaviour Change for Cancer Survivors (BOOST-Up Trial)

The research articles do not provide specific safety data for the Behaviour Change for Cancer Survivors program, but they focus on increasing physical activity, ...