Exercise That Feels as Good as Possible: Acceptability of an Affect-Based Exercise Prescription Among Stage 0-III Breast Cancer Survivors

Abstract

Background: Leaders in the field have called for exercise counseling to become standard of care by 2029. An Affect-based exercise prescription (Affect-Rx) may be a viable strategy for supporting this effort.

Aims: Guided by the ORBIT Model for developing behavioral treatments, this Phase 1b study evaluated breast cancer survivors' perceived acceptability of Affect-Rx. Additionally, the feasibility of trial methods and opportunities for protocol refinements were assessed.

Method: Participants were 36 stage 0-III breast cancer survivors within 5 years of completing primary cancer treatment. Demographics were collected at baseline and via medical record review. Affect-Rx was delivered in conjunction with a low-touch, physical activity promotion intervention over videoconference call. At end-of-study, participants rated Affect-Rx using the Treatment Acceptability and Preferences (TAP) Measure. Participants responded to the Stanford L-Cat at baseline and end-of-study. ActiGraph wGT3X-BT accelerometers measured moderate-vigorous physical activity (MVPA) over 10-day periods at baseline and follow-up.

Results: Affect-Rx was rated acceptable (TAP overall M = 3.30, SD = 0.53). Study retention and accelerometer measurement completion was ≥ 80% across time. L-Cat scores were discordant from accelerometer-measured MVPA at baseline.

Conclusions: Affect-Rx warrants further testing. The trial methods were feasible; however, physical inactivity verification procedures along with targeted recruitment efforts are needed to support future work. The field needs intervention strategies that can be deployed with limited resources and at low cost to offer survivors exercise counseling support in line with the new National Standards for Cancer Survivorship Care, the affect-based exercise prescription is designed to serve this mission.

Trial registration: The study protocol was registered with ClinicalTrials.gov prior to the initiation of participant recruitment NCT04903249.

Keywords: affect‐based exercise prescription; breast neoplasms; cancer; cancer survivors; clinical trials PhaseI; exercise; oncology; standard of care.

Figure 1

CONSORT Flow Diagram

Figure 2

L-CAT Scores Reported at Baseline and End-of-Study Note. Participants were asked, “In the past month, which statement best describes the kinds of physical activity you usually did?” Above, each bar accounts for the number of participants who identified with each category, 1–6, as defined below. 1 = Inactive. “I did not do much physical activity. No more than once or twice a month, did I do anything more active.” 2 = Light activity 1–2X/week. “Once or twice a week, I did light activities.” 3 = Moderate activity 3X/week. “About three times a week, I did moderate activities for about 15–20 minutes each time.” 4 = Moderate activity ≥5X/week. “Almost daily, that is five or more times a week, I did moderate activities for 30 minutes or more each time.” 5 = Vigorous activity 3X/week. “About three times a week, I did vigorous activities for 30 minutes or more each time.” 6 = Vigorous activity ≥5X/week. “Almost daily, that is five or more times a week, I did vigorous activities for 30 minutes or more each time.”