Breast Carcinoma
Conditions
Brief summary
This clinical trial evaluates a digital health intervention for improving symptoms and physical activity among patients with breast cancer undergoing radiation. Cancer-related fatigue is common and strongly associated with quality of life during and after treatment. Increasing emphasis on early symptom detection and management has prompted initiatives to collect patient-reported fatigue from all patients during treatment. Mind-body interventions including physical activity and yoga are recommendations to treat fatigue and comorbid (coexisting) symptoms. Lower socioeconomic status has not only been associated with higher rates of physical inactivity but also with perceptions that it could negatively impact fatigue and quality of life during treatment. A virtual mind-body program called Integrative Medicine at Home (IM@Home) includes cardio fitness and yoga classes in a bundled intervention that has demonstrated decreased fatigue, depression, insomnia, and symptom distress among patients undergoing breast radiation. The IM@Home program may also increase physical activity among patients with breast cancer undergoing radiation.
Detailed description
OUTLINE: REGISTRY: Patients receive a FitBit activity tracker and complete patient-reported outcomes (PRO) surveys every 2 weeks (Q2W) to monitor fatigue, comorbid symptoms, and physical activity during and immediately after radiation therapy. Patients with presence of self-reported symptoms or physical inactivity at baseline and/or from any Q2W PRO surveys are then invited to participate and register for IM@Home. INTERVENTION: Patients participate in the IM@Home program consisting of 20+ live, virtual mind-body and fitness classes ranging from yoga and tai chi to dance cardio, guided meditation, and music therapy delivered via Zoom over 30-60 minutes. Patients are instructed to complete at least 3 classes per week for 12 weeks.
Interventions
BEHAVIORALIM@Home Program
Participate in the IM@Home program delivered via Zoom
OTHERMedical Device Usage and Evaluation
Wear a FitBit activity tracker
OTHERQuestionnaire Administration
Ancillary studies
OTHERInterview
Ancillary studies
Sponsors
University of Washington
Study design
Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
SUPPORTIVE_CARE
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age ≥ 18 years old. * Ability to understand English, or has a caregiver who understands English. * Ability to understand and willingness to sign a written informed consent document, virtually or in-person. * Current breast cancer diagnosis. * Currently receiving radiation with curative intent (including partial breast, whole breast, or regional nodal radiation).
Exclusion criteria
* Patients who are non-English speaking that would prevent their participation in IM@Home.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of eligible patients that consent to the screening registry (Feasibility) | Up to 6 months | Will be considered feasible, as designed, if over 50% of eligible patients consent to the screening registry. Will be determined using descriptive statistics. |
| Proportion of patients with fatigue or other comorbid symptoms enrolling to the Integrative Medicine at Home (IM@Home) virtual intervention (Acceptability) | Up to 6 months | Will be considered acceptable if 50% of patients reporting fatigue or other comorbid symptoms agree to enroll to the IM@Home intervention. Will be determined using descriptive statistics. |
| Proportion of patients enrolling in IM@Home virtual intervention that report favorable implementation outcomes (Appropriateness) | At 12 weeks | Will be assessed using a validated patient-reported outcomes (PRO) scale with responses as agree or completely agree. Will be determined using descriptive statistics. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Proportion of participants meeting guideline recommendations for physical activity | At baseline, 2, 4, 6, 8, 10, and 12 weeks | Will be assessed using the Godin Leisure Time Exercise Questionnaire. Will be estimated, along with an exact binomial 95% confidence interval, though no formal statistical testing will be performed. |
| Relationship between self-reported and monitor-based physical activity | At baseline, 2, 4, 6, 8, 10, and 12 weeks | Will be evaluated graphically via a scatterplot and Bland-Altman plot. Pearson's correlation coefficient will be estimated for descriptive purposes. |
| Patient-reported fatigue | At baseline, 2, 4, 6, 8, 10, and 12 weeks | Will be assessed using the Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events. Will be plotted graphically for all patients, showing those participating in IM@Home compared to those not assigned to IM@Home. |
| Sleep quality | At baseline, 4, 8, and 12 weeks | Will be assessed using the Insomnia Severity Index. Paired T-tests will be assessed for significant within-patient differences in insomnia. |
| Social isolation | At baseline, 6, and 12 weeks | Will be assessed using the Cancer Loneliness Scale. Paired T-tests will be assessed for significant within-patient differences in social isolation. |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORErin Gillespie, MD, MPH
Fred Hutch/University of Washington Cancer Consortium
Outcome results
None listed