Nursing Posters - 2019https://scholarlycommons.libraryinfo.bhs.org/research_education/1007/thumbnail.jp

Gagliarucci, Jeanne

Makari-Judson, Grace, MD

Viskochil, Richard

Walker, Rachel K

English

Scholarly Commons @ Baystate Health

Baystate HealthScholarly Commons @ Baystate HealthResearch and Education Posters Presentations and Posters6-2019Nursing Poster - 2019Rachel K. WalkerRichard ViskochilJeanne GagliarucciGrace Makari-Judson MDFollow this and additional works at: https://scholarlycommons.libraryinfo.bhs.org/research_educationPart of the Medicine and Health Sciences CommonsREDUCED SEDENTARY TIME INTERVENTION FOR BREAST CANCER SURVIVORS: OBJECTIVELY-MEASURED OUTCOMES FOR ACTIVITY AND METABOLISM Rachel K. Walker1, Richard Viskochil2, Ruth Barham3, Jeanne Gagliarucci3, Ann Marie Moraitis1  and Grace Makari-Judson3,4 1Univ. of Massachusetts-Amherst, 2Univ. of Utah, 3Baystate Medical Center, 4Univ. of Massachusetts Medical School R e f e r e n c e s  ( s e l e c t e d )  1.Schmitz KH et al.  American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci. Sports Exerc.  42:1409-28, 2010. 2.Phillips SM et al.  Physical activity and sedentary behavior in breast cancer survivors: new insights into activity patterns and potential intervention targets. Gynecol. Oncol. 2015. 3.Lynch BM et al. Objectively measured physical activity and sedentary time of breast cancer survivors and associations with adiposity: findings from NHANES. Cancer Causes Control 21:2:283-8, 2010. 4.Courneya KS et al. Subgroup effects in a randomized trial of different types and doses of exercise during breast cancer chemotherapy. Br. J. Cancer 111:9: 1718-25, 2014.  UMMS-Baystate Research:  Together we advance the state of caring through discovery & innovation BACKGROUND METHODS INTERVENTION CONCLUSION Results indicate that similar home-based RSTIs are safe, acceptable to survivors, and feasible to implement by cancer center staff. Further research with larger samples and possible monitoring of interruptions in total sedentary time may be needed to establish efficacy and effect sizes for the intervention. A larger dose or addition of behavior-activating components (use of daily activity trackers, text messages, or coaching) may be necessary to realize clinically- meaningful changes in sedentarism, daily activity, metabolism and behavior change. These preliminary results suggest provision of educational material/one-time feedback is likely insufficient to meet PA guidelines & reduce sedentary time.  Acknowledgement of funding support from the Rays of Hope Foundation & the Susan G. Komen Foundation for Breast Cancer Research (CCR16376422)  Acknowledgement of UMASS-Amherst nurses L.Carvalho, E.Lamoureux, and K. Bobianski for their contributions M e t a b o l i c  p a r a m e t e r s  p r e -  a n d  p o s t  i n t e r v e n t i o n Mean ± SD. HDL- High density lipoprotein, LDL- Low density lipoprotein, IGI- Insulinogenic index; DI- Disposition Index. *p<0.05 • Phase 1 proof-of-concept/feasibility trial • One Group Pre/Post-test Design ELIGIBILITY CRITERIA Designed to select a sample of breast cancer survivors most likely to benefit from a home-based intervention designed to reduce sedentary behavior. Inclusion Criteria:  Stage I-III breast cancer survivors age 20-80 who have completed primary treatment greater than 6 months but less than 5 years. Patients may be on adjuvant hormonal therapy.  BMI >25  Less than 150 min/week moderate to vigorous exercise  No gain or loss of >10% body weight over prior 6 months Exclusion Criteria: • Known diabetes • Known coronary artery disease • Pregnancy Table 3. Metabolic Outcomes RESULTS Table 2. Sedentary & Activity Outcomes Table 1. Participant Demographics (Total N=16) Figure 1. Study Flow (PA=Physical Activity, SB=Sedentary Behavior) Figure 2. ActivPAL Accelerometer Figure 3. Personalized Feedback & Suggestions for Environmental Modifications to Reduce Sedentarism (selected pages) TIPS TO   GET UP &  GET M OVIN G   M at erials Developed for “ Act ivit y Study for Breast Cancer Survivors” Sponsored by The Rays of Hope Cent er for Breast Cancer Research & Baystat e M edical Cent er, in partnership wit h t he University of M assachuset t s Am herst A Simple Guid e You Can Use t o: · A ssess How  &  W hen You Ar e M ost  A ct ive · Set  Realist ic Goals · Be W ell &  M ake Posit ive Chang es n=13 Pre-intervention Post-intervention (%) change P-value Hormones and metabolites Fasting glucose (mg/dl) 126.1 ± 44.1 127.4 ± 34.2 +1.0 0.87 1h glucose (mg/dl) 180.2 ± 95.8 188.5 ± 82.4 +4.6 0.51 Fasting insulin (uU/ml) 15.3 ± 6.2 17.5 ± 9.0 +14.4 0.25 1h insulin (uU/ml) 121.6 ± 61.8 123.1 ± 58.3 + 1.2 0.84 Leptin (ng/ml) 55.5 ± 31.6 44.6 ± 26.0 - 19.6         0.01* C-reactive protein (ng/ml) 237.1 ± 257.4 225.3 ± 259.5 - 5.0 0.68 Triglyceride (mg/dl) 107.2 ± 58.8 112.8 ± 52.8 + 5.2 0.49 Total Cholesterol (mg/dl) 189.9 ± 22.2 195.6 ± 18.4 + 3.0 0.32 HDL Cholesterol (mg/dl) 52.9 ± 14.6 58.5 ± 20.6 + 10.6 0.07 LDL Cholesterol (mg/dl) 114.9 ± 26.6 114.6 ± 26.9 - 0.2 0.95 Metrics of glycemic control HOMA-IR 2.2 ± 1.1 2.4 ± 1.3 + 9.0 0.34 HOMA-%B 86.9 ± 22.7 89.1 ± 24.1 + 2.1 0.75 IGI(0-60) 0.40 ± 0.97 0.57 ± 0.73 + 42.5 0.34 DI(HOMA-IR x IGI) 1.26 ± 2.69 1.56 ± 2.19 +23.8 0.51 INTERPRETING YOUR WEEKLY ACTIVITY PATTERNS IF YOU ARE ENROLLED IN THE STUDY, YOU WILL RECEIVE FEEDBACK ABOUT YOUR ACTIVITY PATTERNS. A DEVICE CALLED THE ‘ACTIVPAL’ WILL BE USED TO COLLECT THIS INFO. This is what the activPal wearable monitor looks like: This is how the activPAL presents information about your activity during the day. It detects when you are sitting or lying down (yellow bars), standing (green bars) or walking & running (red bars).  This is recorded for each hour of the day. The feedback from the device looks like the EXAMPLE below: In this examp le , from around 1240pm to 1250pm,  this person got up & walked around . In this examp le , this person spent all of the time between 1pm -2pm sitt ing down at their desk doing work. If this person was you  – you could think about what you m ight have been doing from 1pm -2pm that day. Are there ways you could b reak up that hour of sitt ing? GET UP & GET MOVING AT WORK • Create a Standing W orkstation • Stand to Answer the Phone & Answer Email • Do Walking Meetings • Hand Deliver Messages to Coworkers (Instead of Email) • Use a Restroom on a Different Floor • Take the Stairs! • Eat Your Lunch Outside or Away from your Desk • Use Copier or Printer Down the Hall/Away from your Desk • Stand & Stretch Each Time You Switch Tasks • Set Activity Reminder Alarms on Your Phone or Computer • Form a Walking Group & Walk at Lunch • Schedule Meetings in Rooms Away from Your Workstation • Park Father Away & Walk to W ork Physical activity (PA) promotion and sedentary behavior reduction among cancer survivors is a national priority1   and the number of PA-based behavioral interventions has expanded considerably in recent years.2 There have been relatively few trials focused on reduction of sedentary time among cancer survivors due in part to past limitations related to precise quantitative measurement of sedentary behaviors.3   Many PA interventions rely on clinic-based coaching which is both time- intensive and unrealistic for many clinics.4 The purpose of this study was to investigate the feasibility and effects of a home based 6 week reduced sedentary time intervention (RSTI) in breast cancer survivors who had completed primary treatment. ClinicalTrials.gov NCT02969291 Variable Name Average (SD) T-Test (* = p < .05) Total daily steps Baseline:            6190.40 (2086.25) Post Intervention: 6326.30 (2788.41) 0.76 Total energy expenditure/day (MET/hr.) Baseline:            33.05 (0.92) Post:            33.11 (1.16) 0.74 % of hourly time spent in uninterrupted sedentary behavior (8am-8pm) Baseline:            20% (13%) Post Intervention: 22% (11%) 0.63 Participants No. Completed study 13 Race Black 3                               White 13 Median Age (range) 61.3  (49-73) Median Time since diagnosis 34.4 months (11-55) (range) Prior Therapy Radiation 13                               Chemotherapy 11                               Hormonal 12 

Nursing Poster - 2019

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Nursing Poster - 2019

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