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Tracking exercise benefits for cancer survivors

Abby King, PhD
Abby King, PhD
Steve Fisch Photography

By Ruth Schechter

Since 2002, the Stanford Living Strong Living Well has worked in partnership with community YMCAs to help cancer survivors develop muscle strength, flexibility, and balance, and to integrate exercise into their lives. Studies have shown that regular physical activity helps reduce therapy side effects, improve energy levels, and promote independence. It may also decrease disease recurrence and increase longevity of cancer patients.

But for the program to continue to expand, additional studies are needed to align subjective assessments with objective data. That’s where Abby King, PhD, a professor of health research & policy and of medicine, comes in.

King, a health psychologist in the Stanford Prevention Research Center (SPRC), applies methodologies to measure the success of personal and social interventions in health behaviors and outcomes. She received a Cancer Center seed grant to acquire data that can be used to refine the program and to help it broaden the diversity of its participants. Her findings will provide the groundwork needed for Living Strong Living Well to qualify for future NCI grants.

The study was an opportunity to ‘marry’ science with practice,” says King. We wanted to translate the research coming from SPRC with the pioneering community work of HIP [Health Improvement Program, a component of the Prevention Research Center] and the YMCA in testing the program’s efficacy in a broader way. We wanted to take a closer look at the data being collected, as well as expand the program’s data collection activities, though in a practical, contextually appropriate way.”

To date, close to 1,000 cancer patients have participated in the program. The study followed a baseline group of more than 400 initial participants in eight local YMCAs and incorporated a computerized training tool called FitLinxx that tracks progress on fitness equipment. Exercisers receive instant feedback on everything from number of reps to proper position, and the data can be formatted in graphs and summary sheets.

While these printouts provided an objective measure of strength over the study period, participants also reported back on subjective measures, such as their sense of vitality, mood, stress level, and fatigue.

King and her team analyzed the progress reports and recorded tangible improvements in fitness and well-being. Approximately 80 to 85 percent of the participants have been diagnosed with breast cancer, although people with ovarian, colon, prostate, lymphoma, lung, and other cancers were also represented.

These subjective components are important, especially for people dealing with chronic illness,” says King. How a person feels is a major driver of quality of life as well as visits to the physician’s office.”

The pilot study sets the groundwork for additional investigations that can look more carefully at measureable ways to improve the program and make it more accessible for more diverse populations. Its initial findings have already provided tools for the Living Strong Living Well program to expand into East Palo Alto, and program representatives have traveled to the East Coast to train YMCA staff working with cancer survivors.

A community-based program is different than what takes place in a science lab,” says King. What drives people to make certain choices, and how do we design interventions to help them change in ways that will benefit their health and quality of life? We have to figure out methods to support positive behavior change in ways that make it easy to fit into daily routines. We also want to be able to reach all members of the community to address health disparities for low-income and ethnic minority groups. That’s an important part of this research.”

King hopes the findings from this pilot study will allow Living Strong Living Well to acquire funding for a larger, randomized study to pinpoint exactly what works and to make additional improvements to its community outreach.

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