A Hybrid Effectiveness-Implementation Trial of an Evidence-Based Exercise Intervention for Breast Cancer Survivors
Identifieur interne : 002E62 ( Main/Exploration ); précédent : 002E61; suivant : 002E63A Hybrid Effectiveness-Implementation Trial of an Evidence-Based Exercise Intervention for Breast Cancer Survivors
Auteurs : Rinad S. Beidas ; Breah Paciotti ; Fran Barg ; Andrea R. Branas ; Justin C. Brown ; Karen Glanz ; Angela Demichele ; Laura Digiovanni ; Domenick Salvatore ; Kathryn H. SchmitzSource :
- Journal of the National Cancer Institute. Monographs [ 1052-6773 ] ; 2014.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Attitude du personnel soignant, Entraînement en résistance (effets indésirables), Entraînement en résistance (organisation et administration), Entraînement en résistance (économie), Exercice physique (physiologie), Exercice physique (psychologie), Femelle, Force musculaire, Humains, Image du corps, Lymphoedème (), Mise au point de programmes, Muscles squelettiques (physiologie), Médecine factuelle, Médecine intégrative (organisation et administration), Médecine intégrative (économie), Orientation vers un spécialiste, Sujet âgé, Survivants (psychologie), Sélection de patients, Tumeurs du sein (physiopathologie), Tumeurs du sein (psychologie), Tumeurs du sein (rééducation et réadaptation), Évaluation de programme.
- MESH :
- effets indésirables : Entraînement en résistance.
- organisation et administration : Entraînement en résistance, Médecine intégrative.
- physiologie : Exercice physique, Muscles squelettiques.
- physiopathologie : Tumeurs du sein.
- psychologie : Exercice physique, Survivants, Tumeurs du sein.
- rééducation et réadaptation : Tumeurs du sein.
- économie : Entraînement en résistance, Médecine intégrative.
- Adulte, Adulte d'âge moyen, Attitude du personnel soignant, Femelle, Force musculaire, Humains, Image du corps, Lymphoedème, Mise au point de programmes, Médecine factuelle, Orientation vers un spécialiste, Sujet âgé, Sélection de patients, Évaluation de programme.
English descriptors
- KwdEn :
- Adult, Aged, Attitude of Health Personnel, Body Image, Breast Neoplasms (physiopathology), Breast Neoplasms (psychology), Breast Neoplasms (rehabilitation), Evidence-Based Medicine, Exercise (physiology), Exercise (psychology), Female, Humans, Integrative Medicine (economics), Integrative Medicine (organization & administration), Lymphedema (therapy), Middle Aged, Muscle Strength, Muscle, Skeletal (physiology), Patient Selection, Program Development, Program Evaluation, Referral and Consultation, Resistance Training (adverse effects), Resistance Training (economics), Resistance Training (organization & administration), Survivors (psychology).
- MESH :
- adverse effects : Resistance Training.
- economics : Integrative Medicine, Resistance Training.
- organization & administration : Integrative Medicine, Resistance Training.
- physiology : Exercise, Muscle, Skeletal.
- physiopathology : Breast Neoplasms.
- psychology : Breast Neoplasms, Exercise, Survivors.
- rehabilitation : Breast Neoplasms.
- therapy : Lymphedema.
- Adult, Aged, Attitude of Health Personnel, Body Image, Evidence-Based Medicine, Female, Humans, Middle Aged, Muscle Strength, Patient Selection, Program Development, Program Evaluation, Referral and Consultation.
Abstract
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.
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.
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 (
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.
Url:
DOI: 10.1093/jncimonographs/lgu033
PubMed: 25749601
PubMed Central: 4411538
Affiliations:
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Le document en format XML
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Beidas</name></author><author><name sortKey="Paciotti, Breah" sort="Paciotti, Breah" uniqKey="Paciotti B" first="Breah" last="Paciotti">Breah Paciotti</name></author><author><name sortKey="Barg, Fran" sort="Barg, Fran" uniqKey="Barg F" first="Fran" last="Barg">Fran Barg</name></author><author><name sortKey="Branas, Andrea R" sort="Branas, Andrea R" uniqKey="Branas A" first="Andrea R." last="Branas">Andrea R. Branas</name></author><author><name sortKey="Brown, Justin C" sort="Brown, Justin C" uniqKey="Brown J" first="Justin C." last="Brown">Justin C. Brown</name></author><author><name sortKey="Glanz, Karen" sort="Glanz, Karen" uniqKey="Glanz K" first="Karen" last="Glanz">Karen Glanz</name></author><author><name sortKey="Demichele, Angela" sort="Demichele, Angela" uniqKey="Demichele A" first="Angela" last="Demichele">Angela Demichele</name></author><author><name sortKey="Digiovanni, Laura" sort="Digiovanni, Laura" uniqKey="Digiovanni L" first="Laura" last="Digiovanni">Laura Digiovanni</name></author><author><name sortKey="Salvatore, Domenick" sort="Salvatore, Domenick" uniqKey="Salvatore D" first="Domenick" last="Salvatore">Domenick Salvatore</name></author><author><name sortKey="Schmitz, Kathryn H" sort="Schmitz, Kathryn H" uniqKey="Schmitz K" first="Kathryn H." last="Schmitz">Kathryn H. Schmitz</name></author></analytic><series><title level="j">Journal of the National Cancer Institute. Monographs</title><idno type="ISSN">1052-6773</idno><idno type="eISSN">1745-6614</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Attitude of Health Personnel</term><term>Body Image</term><term>Breast Neoplasms (physiopathology)</term><term>Breast Neoplasms (psychology)</term><term>Breast Neoplasms (rehabilitation)</term><term>Evidence-Based Medicine</term><term>Exercise (physiology)</term><term>Exercise (psychology)</term><term>Female</term><term>Humans</term><term>Integrative Medicine (economics)</term><term>Integrative Medicine (organization & administration)</term><term>Lymphedema (therapy)</term><term>Middle Aged</term><term>Muscle Strength</term><term>Muscle, Skeletal (physiology)</term><term>Patient Selection</term><term>Program Development</term><term>Program Evaluation</term><term>Referral and Consultation</term><term>Resistance Training (adverse effects)</term><term>Resistance Training (economics)</term><term>Resistance Training (organization & administration)</term><term>Survivors (psychology)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Attitude du personnel soignant</term><term>Entraînement en résistance (effets indésirables)</term><term>Entraînement en résistance (organisation et administration)</term><term>Entraînement en résistance (économie)</term><term>Exercice physique (physiologie)</term><term>Exercice physique (psychologie)</term><term>Femelle</term><term>Force musculaire</term><term>Humains</term><term>Image du corps</term><term>Lymphoedème ()</term><term>Mise au point de programmes</term><term>Muscles squelettiques (physiologie)</term><term>Médecine factuelle</term><term>Médecine intégrative (organisation et administration)</term><term>Médecine intégrative (économie)</term><term>Orientation vers un spécialiste</term><term>Sujet âgé</term><term>Survivants (psychologie)</term><term>Sélection de patients</term><term>Tumeurs du sein (physiopathologie)</term><term>Tumeurs du sein (psychologie)</term><term>Tumeurs du sein (rééducation et réadaptation)</term><term>Évaluation de programme</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Resistance Training</term></keywords><keywords scheme="MESH" qualifier="economics" xml:lang="en"><term>Integrative Medicine</term><term>Resistance Training</term></keywords><keywords scheme="MESH" qualifier="effets indésirables" xml:lang="fr"><term>Entraînement en résistance</term></keywords><keywords scheme="MESH" qualifier="organisation et administration" xml:lang="fr"><term>Entraînement en résistance</term><term>Médecine intégrative</term></keywords><keywords scheme="MESH" qualifier="organization & administration" xml:lang="en"><term>Integrative Medicine</term><term>Resistance Training</term></keywords><keywords scheme="MESH" qualifier="physiologie" xml:lang="fr"><term>Exercice physique</term><term>Muscles squelettiques</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Exercise</term><term>Muscle, Skeletal</term></keywords><keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="psychologie" xml:lang="fr"><term>Exercice physique</term><term>Survivants</term><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Breast Neoplasms</term><term>Exercise</term><term>Survivors</term></keywords><keywords scheme="MESH" qualifier="rehabilitation" xml:lang="en"><term>Breast Neoplasms</term></keywords><keywords scheme="MESH" qualifier="rééducation et réadaptation" xml:lang="fr"><term>Tumeurs du sein</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Lymphedema</term></keywords><keywords scheme="MESH" qualifier="économie" xml:lang="fr"><term>Entraînement en résistance</term><term>Médecine intégrative</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Attitude of Health Personnel</term><term>Body Image</term><term>Evidence-Based Medicine</term><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Muscle Strength</term><term>Patient Selection</term><term>Program Development</term><term>Program Evaluation</term><term>Referral and Consultation</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Attitude du personnel soignant</term><term>Femelle</term><term>Force musculaire</term><term>Humains</term><term>Image du corps</term><term>Lymphoedème</term><term>Mise au point de programmes</term><term>Médecine factuelle</term><term>Orientation vers un spécialiste</term><term>Sujet âgé</term><term>Sélection de patients</term><term>Évaluation de programme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>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.</p></sec><sec sec-type="methods"><title>Methods</title><p>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.</p></sec><sec><title>Results</title><p>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 (<italic>P</italic> < .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.</p></sec><sec><title>Conclusions</title><p>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.</p></sec></div></front></TEI><affiliations><list></list><tree><noCountry><name sortKey="Barg, Fran" sort="Barg, Fran" uniqKey="Barg F" first="Fran" last="Barg">Fran Barg</name><name sortKey="Beidas, Rinad S" sort="Beidas, Rinad S" uniqKey="Beidas R" first="Rinad S." last="Beidas">Rinad S. Beidas</name><name sortKey="Branas, Andrea R" sort="Branas, Andrea R" uniqKey="Branas A" first="Andrea R." last="Branas">Andrea R. Branas</name><name sortKey="Brown, Justin C" sort="Brown, Justin C" uniqKey="Brown J" first="Justin C." last="Brown">Justin C. Brown</name><name sortKey="Demichele, Angela" sort="Demichele, Angela" uniqKey="Demichele A" first="Angela" last="Demichele">Angela Demichele</name><name sortKey="Digiovanni, Laura" sort="Digiovanni, Laura" uniqKey="Digiovanni L" first="Laura" last="Digiovanni">Laura Digiovanni</name><name sortKey="Glanz, Karen" sort="Glanz, Karen" uniqKey="Glanz K" first="Karen" last="Glanz">Karen Glanz</name><name sortKey="Paciotti, Breah" sort="Paciotti, Breah" uniqKey="Paciotti B" first="Breah" last="Paciotti">Breah Paciotti</name><name sortKey="Salvatore, Domenick" sort="Salvatore, Domenick" uniqKey="Salvatore D" first="Domenick" last="Salvatore">Domenick Salvatore</name><name sortKey="Schmitz, Kathryn H" sort="Schmitz, Kathryn H" uniqKey="Schmitz K" first="Kathryn H." last="Schmitz">Kathryn H. Schmitz</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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