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Principal Investigator: KERRI M WINTERS-STONE
Organization: OREGON HEALTH & SCIENCE UNIVERSITY
Fiscal Year: 2024
Award: $525,495
Funding agency: National Cancer Institute
Breast and prostate cancer are two of the most common and survivable cancers and most survivors of these
cancers will be married when diagnosed. Compared to couples that aren't facing a chronic illness, both cancer
survivors and their spouses suffer from poorer physical and mental health that leads higher morbidity and
mortality. Since couples experience and navigate an illness together their health becomes intertwined, thus
programs aimed at one member of the dyad ignore the interdependent nature of the couple. Exercise improves
quality of life among cancer survivors; but, we were the first to adapt exercise to be a partnered activity that
amplifies the dose of exercise and builds teamwork to improve dyadic outcomes (i.e., physical and mental health
of patients and partners). We developed and piloted Exercising Together in prostate cancer survivors and their
spouses long after his diagnosis. The pilot showed that six months of partnered exercise could improve physical
and mental health in both partners as well as their intimate relationship. We believe the program would be most
effective at mitigating the impact of newly diagnosed cancer and treatment on the physical and mental health of
each partner if implemented much earlier in the point of care for patients. We have preliminary data on 10 couples
who participated in an adapted version of Exercising Together during his radiation treatment for prostate cancer
(6-8 weeks). The adapted program is much shorter (8 v. 24 wks.) than the original and is more focused on
developing teamwork as a mechanism to amplify the benefits of exercise on dyadic outcomes. All couples
completed the program and improved physical and mental health and their level of communication; however, we
had no control group so we cannot be certain if the program is efficacious or not nor how long lasting the effects
of the program might be. We now propose a Type I hybrid effectiveness-implementation trial of Exercising
Together adapted for the radiation oncology setting. This design allows us to formally test the efficacy of a clinic-
based version of Exercising Together using a randomized controlled design, a larger sample, a broader set of
outcomes, and a follow-up period. We will also examine putative dyadic mechanisms to explain how our
intervention improves dyadic health. At the same time, we will gather critical information from multiple
stakeholders to inform future implementation approaches to integrate Exercising Together into the care plan for
cancer patients. We propose a randomized controlled Phase II trial in 200 couples who will be randomly assigned
to participate in an 8-week program of Exercising Together at the start of his/her radiation therapy or to a usual
care control group that receives standard exercise guidance and receipt of a video of the couples program at the
end of participation. Couples are tested at baseline, post-intervention (2 mos.), and 4- and 6-mos. follow up.
Based on adaptations in other trials developed during COVID19, exercise training and assessments will be
delivered through remote technology, which allows us to better diversity the sample and widen the scalability of
the program.
Terms: <Active Follow-up><Address><Administrator><After Care><After-Treatment><Aftercare><Anxiety><Biometrics><Biometry><Biostatistics><Breast Cancer><Breast Cancer survivor><COVID-19><CV-19><Cancer Patient><Cancer Survivor><Cancer Treatment><Cancers><Cardiac Diseases><Cardiac Disorders><Caring><Categories><Cessation of life><Chronic Disease><Chronic Illness><Clinic><Clinical><Collaborations><Communication><Control Groups><Coronavirus Infectious Disease 2019><Couples><Data><Death><Diagnosis><Dose><Educational process of instructing><Emotional><Exercise><Face><Fatigue><Feasibility Studies><Fortification><General Population><General Public><Health><Health Care Providers><Health Personnel><Healthcare Providers><Healthcare worker><Heart Diseases><Hybrids><Hypertension><Individual><Inflammation><Insulin Resistance><Intervention><Intervention Strategies><Lack of Energy><Malignant Breast Neoplasm><Malignant Neoplasm Therapy><Malignant Neoplasm Treatment><Malignant Neoplasms><Malignant Tumor><Malignant Tumor of the Prostate><Malignant neoplasm of prostate><Malignant prostatic tumor><Marriage><Married Persons><Mental Depression><Mental Health><Mental Hygiene><Metabolic syndrome><Methods><Morbidity><Morbidity - disease rate><Nature><Newly Diagnosed><Obesity><Oncology><Oncology Cancer><Outcome><Pathway interactions><Patient Care><Patient Care Delivery><Patients><Physical Function><Physical Rehabilitation><Play><Process><Process Measure><Prostate CA><Prostate CA therapy><Prostate Cancer><Prostate Cancer therapy><Prostate malignancy><Prostatic Cancer><Psyche structure><Psychological Health><Publications><QOL><Qualitative Methods><Quality of life><Radiation Oncology><Radiation therapy><Radiotherapeutics><Radiotherapy><Randomized><Recommendation><Reporting><Role><Sampling><Science><Scientific Publication><Self Efficacy><Sleep><Social support><Spouses><Supportive Therapy><Supportive care><Survivors><Teaching><Testing><Time><Training><Vascular Hypertensive Disease><Vascular Hypertensive Disorder><Woman><Work><acceptability and feasibility><active followup><adiposity><adverse consequence><adverse outcome><anti-cancer therapy><biopsychosocial><cancer care><cancer diagnosis><cancer therapy><cancer-directed therapy><care as usual><care for patients><care of patients><caring for patients><chronic disorder><clinical care><clinical practice><coronavirus disease 2019><coronavirus disease-19><coronavirus infectious disease-19><corpulence><cost><delivered remotely><depression><design><designing><disability><effectiveness and implementation trial><effectiveness/implementation hybrid study><effectiveness/implementation hybrid trial><effectiveness/implementation study><effectiveness/implementation trial><efficacy testing><efficacy/implementation trial><exercise program><exercise training><experience><faces><facial><falls><fitness><fitness program><follow up><follow-up><followed up><followup><future implementation><health care personnel><health care worker><health provider><health workforce><healthcare personnel><heart disorder><high blood pressure><high risk><hyperpiesia><hyperpiesis><hypertensive disease><hypertensive disorder><implementation science><improved><information gathering><innovate><innovation><innovative><insulin resistant><insulin tolerance><interventional strategy><intimacy><intimate behavior><malignancy><malignant breast tumor><manage symptom><medical personnel><member><men><mental><mortality><multidisciplinary><neoplasm/cancer><pathway><phase 2 trial><phase II trial><physical conditioning><physical health><physical rehab><point of care><post intervention><post treatment><prevent><preventing><programs><prostate cancer survivors><prostate cancer treatment><prostate survivors><psychosocial><qualitative reasoning><radiation treatment><randomisation><randomization><randomized controlled design><randomly assigned><remote delivery><remote technology><satisfaction><sex><social role><social support network><symptom management><theories><treatment as usual><treatment provider><treatment with radiation><usual care><usual care arm><usual care control group>