Physical Activity Program among Cancer Survivors in General Practice: Evaluating Patient Outcomes

Background: Physical activity (PA) benefits cancer survivors' health, yet no PA programs are incorporated in general practice.

Aim: Evaluate cancer survivors' outcomes of a PA program in general practice.

Design and Setting: Single-arm PA intervention implementation study among cancer survivors in 15 Dutch general practices.

Method: Patients aged ≥18 years and ≥6 months post-cancer treatment were eligible. The nine-month intervention comprised counselling sessions with a primary care practitioner (PCP, aimed at increasing daily PA. Reach, Effectiveness, and Implementation of the RE-AIM framework were evaluated among participants. Primary health outcomes included self-reported symptoms of fatigue, depression, and anxiety; secondary outcomes included step count, caloric expenditure, weight, physical function, and self-reported quality of life, and PA. Outcomes were assessed at T0-T3 (0,3,6, and 9 months) or at PCPs' sessions S1-S6 (0,3,6weeks,3,6,9months). Non-participants completed a single baseline questionnaire. We used (non-)parametric independent tests and linear mixed models for analyses.

Results: Of 564 invited patients, 149 (26%) participated. Participants had less formal education, higher unemployment, less PA, and more fatigue and psychological symptoms than non-participants. All primary and most secondary health outcomes improved over time, with clinically relevant changes in step count and physical function. 11% dropped out before, and 26% during the program. Counselling session adherence and PA goal achievement were 98% and 73%, respectively.

Conclusion: The program reached long-term cancer survivors with poorer health status, and showed positive health changes particularly on PA and physical function. Such PA programs may benefit health of a rising number of cancer survivors visiting primary care.