Randomized Control Trial of the 3Rs Health Knowledge Training Program for Persons with Intellectual Disabilities.

BACKGROUND: Persons with intellectual disabilities (ID) experience a wide range of health problems. Research is needed on teaching persons with intellectual disabilities about their health to promote self-advocacy. This study used a RCT to evaluate a health knowledge training program for adults with intellectual disabilities and verbal skills. METHODS: Participants were randomly assigned to training (n = 12) or no training control (n = 10) groups. Topics included key body organs, systems, functions, health maintenance and illnesses. Participants played a game answering questions (e.g. 'What does the heart do?'). Instruction involved visuals (e.g., PowerPoint slides), cueing, modelling and feedback. The control group received pre-, post- and follow-up tests as the training group. RESULTS: The training group had significantly higher overall post-test and follow-up health knowledge test scores than the control group. CONCLUSIONS: Health knowledge training is one step in promoting health self-advocacy and better health in persons with intellectual disabilities.

Identification and evaluation of the salient physical activity beliefs of colorectal cancer survivors.

BACKGROUND: Physical activity (PA) has been associated with lower risk of disease recurrence and longer survival in colorectal cancer (CRC) survivors; however, less than one-third of CRC survivors are meeting PA guidelines. Interventions to promote PA in CRC survivors need to understand the most critical beliefs that influence PA behavior. OBJECTIVE: The objective of this study was to examine the strength of associations between the most common PA beliefs of CRC survivors and motivational constructs from the Theory of Planned Behavior (TPB) as well as PA behavior. INTERVENTION/METHODS: Colorectal cancer survivors (n = 600) residing in Alberta, Canada, completed self-report questionnaires assessing medical and demographic variables, PA beliefs, constructs from the TPB, and PA behavior. RESULTS: Colorectal cancer survivors identified improved fitness (69.5%), family members (67.3%), and medical/health problems (8.8%) as the most prevalent behavioral, normative, and control beliefs, respectively. All PA beliefs were significantly correlated with all TPB constructs and PA. CONCLUSIONS: Physical activity interventions for CRC survivors should target many salient beliefs including behavioral, normative, and control beliefs. IMPLICATIONS FOR PRACTICE: Insights into the salient beliefs for PA in CRC survivors can guide nurses in developing successful strategies to promote PA in this population and likely improve quality of life and possibly disease outcomes.

Physical activity preferences among a population-based sample of colorectal cancer survivors.

PURPOSE/OBJECTIVES: To identify the key physical activity (PA) programming and counseling preferences of colorectal cancer (CRC) survivors. DESIGN: Population-based, cross-sectional mailed survey. SETTING: Alberta, Canada. SAMPLE: 600 CRC survivors. METHODS: CRC survivors randomly identified through the Alberta Cancer Registry in Canada completed a mailed survey (34% response rate). MAIN RESEARCH VARIABLES: Self-reported PA, medical and demographic variables, and PA preferences. FINDINGS: Most CRC survivors indicated that they were interested and able to participate in a PA program. The most common PA preferences of CRC survivors were to receive PA counseling from a fitness expert at a cancer center, receive PA information in the form of print materials, start a PA program after cancer treatment, do PA at home, and walk in both the summer and winter. In addition, oncologists and nurses were identified as preferences from whom CRC survivors would like to receive PA information. Chi-square analyses identified that age, education, annual family income, and current PA were the demographic variables most consistently associated with PA preferences. CONCLUSIONS: The majority of CRC survivors expressed an interest in participating in a PA program and key PA preferences were identified. Those preferences may be useful for developing and implementing successful PA interventions for CRC survivors. IMPLICATIONS FOR NURSING: Oncology nurses are in a unique position to promote PA for CRC survivors. Therefore, understanding CRC survivor PA preferences is essential to assist nurses in making appropriate PA recommendations or referrals. KNOWLEDGE TRANSLATION: Although CRC survivors' PA participation rates are low, they may have an interest in receiving PA programming and counseling. CRC survivors have indicated a preference to receive PA information from individuals within their cancer support team (e.g., fitness specialist at a cancer center, oncologist, nurses). The PA preferences identified by CRC survivors are important for the development of successful PA interventions.

Sport participation in colorectal cancer survivors: an unexplored approach to promoting physical activity.

PURPOSE: Physical activity improves health outcomes in colorectal cancer (CRC) survivors, but participation rates are low. One understudied strategy for increasing physical activity in CRC survivors may be sport participation. Here, we report the sport participation rate, sport preferences, and correlates of sport participation among CRC survivors. METHODS: A provincial, population-based mailed survey of CRC survivors in Alberta, Canada was performed and included measures of sport participation, sport preferences, sport benefits and barriers, and medical and demographic variables. RESULTS: A total of 600 CRC survivors completed the survey (34 % response rate). Almost a quarter (23.0 %) of CRC survivors reported participating in a sport in the past month, with the most common sport being golf (58.7 %). In multivariate regression analysis, 33.0 % (p = 0.001) of the variance in sport participation was explained by being male (ß = 0.12; p = 0.006), in better general health (ß = 0.12; p = 0.006), and ≥ 5 years post-diagnosis (ß = 0.09; p = 0.031). The most common barriers to sport participation were time, age/agility, and no interest/dislike of sports. The most common anticipated benefits of sport participation were improved physical fitness, meeting people, and improved health. Over half (57.2 %) of CRC survivors were possibly interested in learning about sport participation opportunities. CONCLUSIONS: Promotion of sport participation may be a potentially fruitful strategy for increasing physical activity in CRC survivors.

Correlates of strength exercise in colorectal cancer survivors.

OBJECTIVE: To estimate the prevalence and correlates of meeting the public health strength exercise guidelines (≥2 days/week) in colorectal cancer (CRC) survivors. METHODS: A random sample of 600 CRC survivors in Alberta, Canada, completed a mailed questionnaire assessing medical, demographic, and behavioral variables and participation in strength exercise. RESULTS: About a quarter (25.5%) of CRC survivors were meeting strength exercise guidelines. In multivariate analysis, meeting guidelines was associated with being male (p = .052), married (p = .079), a drinker (p = .006), in better health (p < .001), nonsmoking (p = .023), and nonobese (p = .010). CONCLUSIONS: Interventions to increase strength exercise participation in CRC survivors are needed.

Predictors of adherence to an Iyengar yoga program in breast cancer survivors.

CONTEXT: Despite the known health benefits of physical activity, participation rates in cancer survivor groups remain low. Researchers have attempted to identify alternative modes of nontraditional physical activities that may increase participation and adherence rates. This study investigated the determinants of yoga in breast cancer survivors. AIM: To examine predictors of Iyengar yoga adherence in breast cancer survivors using the theory of planned behaviour. SETTINGS AND DESIGN: Classes were held either in Campus Recreation facilities or at the Behavioral Medicine Fitness Center at the University of Alberta in Edmonton, Canada. The study was an evaluation of an existing yoga program. MATERIALS AND METHODS: Twenty-three post adjuvant therapy breast cancer survivors participating in a community-based, twice weekly, 12 week Iyengar yoga program were asked to complete baseline measures of the theory of planned behavior, demographic, medical, health/fitness, and psychosocial variables. Adherence was measured by objective attendance to the classes. STATISTICAL ANALYSIS: We analyzed univariate associations between predictors and yoga adherence with independent t-tests. RESULTS: Adherence to the Iyengar yoga program was 63.9% and was predicted by stronger intention (P<0.001), greater self-efficacy (P=0.003), more positive instrumental attitude (Ps=0.025), higher disease stage (P=0.018), yoga experience in the past year, (P=0.044), diagnosis of a second cancer (P=0.008), lower fatigue (P=0.037), and greater happiness (P=0.023). CONCLUSIONS: Adherence to Iyengar yoga in breast cancer survivors was strongly related to motivational variables from the theory of planned behaviour. Researchers attempting to improve yoga adherence in breast cancer survivors may benefit from targeting the key constructs in the theory of planned behaviour.

Pilot evaluation of an Iyengar yoga program for breast cancer survivors.

BACKGROUND: With continual improvements in screening uptake and adjuvant cancer treatments, the number of Canadian women surviving breast cancer continues to grow. Preliminary findings suggest yoga can improve quality of life (QoL) in breast cancer survivors, but few studies have focused on Iyengar yoga (IY). OBJECTIVE: The purpose of this pilot study was to evaluate the impact of IY on QoL and psychosocial functioning in a select sample of breast cancer survivors. METHODS: Breast cancer survivors (N = 24) participating in IY classes completed a questionnaire measuring generic and disease-specific QoL and psychosocial functioning, before and after the 12-week classes. RESULTS: Postprogram questionnaires were completed by 17 participants (71%) who attended an average of 78.9% of the IY sessions. Several indicators of generic QoL improved significantly, including mental health (mean change, +4.2; P = .045), vitality (mean change, +4.9; P = .033), role-emotional (mean change, +6.4; P = .010), and bodily pain (mean change, +4.4; P = .024). Other improvements in QoL and psychosocial functioning were meaningful but were not statistically significant. Findings were further substantiated by participant's evaluation of the program's benefits and motivational value. CONCLUSION: In this pilot study of breast cancer survivors participating in IY, we found improvements in QoL and psychosocial functioning. Moreover, positive program evaluation and motivational profile provide support for the acceptability of IY with breast cancer survivors. Randomized controlled trials comparing IY to usual care and other forms of yoga in breast cancer survivors are warranted. IMPLICATIONS FOR PRACTICE: Nurses may consider IY as a possible intervention strategy to help breast cancer survivors improve their QoL and psychosocial functioning.

Effects of exercise on quality of life and prognosis in cancer survivors.

Cancer is a global health problem with over 10 million cancer survivors in the United States alone. Cancer and its treatments often produce side effects that undermine quality of life. The purpose of this article is to review research examining the effects of physical activity (PA) upon quality of life and disease prognosis in cancer survivors. We divide our review into PA studies focusing upon (a) quality of life during treatments, (b) quality of life during survivorship (after treatments), (c) quality of life during palliative care, and (d) disease prognosis end points. Compelling clinical trial data indicate that PA can improve quality of life end points during treatment and survivorship. Data during palliative care is limited. Observational data suggest that PA may reduce the risk of disease recurrence and extend survival in some cancer survivors. Research findings suggest that PA is an appropriate recommendation for most cancer survivors, although many research questions remain.