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A hybrid effectiveness-implementation trial of an evidence-based exercise intervention for breast cancer survivors.
- Source :
-
Journal of the National Cancer Institute. Monographs [J Natl Cancer Inst Monogr] 2014 Nov; Vol. 2014 (50), pp. 338-45. - Publication Year :
- 2014
-
Abstract
- Background: The primary aims of this hybrid Type 1 effectiveness-implementation trial were to quantitatively assess whether an evidence-based exercise intervention for breast cancer survivors, Strength After Breast Cancer, was safe and effective in a new setting and to qualitatively assess barriers to implementation.<br />Methods: A cohort of 84 survivors completed measurements related to limb volume, muscle strength, and body image at baseline, 67 survivors completed measurements 12 months later. Qualitative methods were used to understand barriers to implementation experienced by referring oncology clinicians and physical therapists who delivered the program.<br />Results: Similar to the efficacy trial, the revised intervention demonstrated safety with regard to lymphedema, and led to improvements in lymphedema symptoms, muscular strength, and body image. Comparison of effects in the effectiveness trial to effects in the efficacy trial revealed larger strength increases in the efficacy trial than in the effectiveness trial (P < .04), but few other differences were found. Qualitative implementation data suggested significant barriers around intervention characteristics, payment, eligibility criteria, the referral process, the need for champions (ie, advocates), and the need to adapt during implementation of the intervention, which should be considered in future dissemination and implementation efforts.<br />Conclusions: This trial successfully demonstrated that a physical therapy led strength training program for breast cancer survivors can be implemented in a community setting while retaining the effectiveness and safety of the clinical trial. However, during the translation process, strategies to reduce barriers to implementation are required. This new program can inform larger scale dissemination and implementation efforts.<br /> (© The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Adult
Aged
Body Image
Breast Neoplasms physiopathology
Breast Neoplasms psychology
Evidence-Based Medicine
Exercise physiology
Exercise psychology
Female
Humans
Integrative Medicine economics
Middle Aged
Muscle Strength
Muscle, Skeletal physiology
Patient Selection
Program Development
Program Evaluation
Referral and Consultation
Attitude of Health Personnel
Breast Neoplasms rehabilitation
Integrative Medicine organization & administration
Lymphedema therapy
Resistance Training adverse effects
Resistance Training economics
Resistance Training organization & administration
Survivors psychology
Subjects
Details
- Language :
- English
- ISSN :
- 1745-6614
- Volume :
- 2014
- Issue :
- 50
- Database :
- MEDLINE
- Journal :
- Journal of the National Cancer Institute. Monographs
- Publication Type :
- Academic Journal
- Accession number :
- 25749601
- Full Text :
- https://doi.org/10.1093/jncimonographs/lgu033