Methodological considerations when monitoring and promoting physical activity in cancer populations. Towards translation of evidence into broader application and impact
- Trial lecture starts at 11.15
- Public defence starts at 13.30
Title of trial lecture: Should physical activity be a standard component of cancer care? What are some of the barriers and facilitators to implementation at patient, healthcare professionals and systematic levels?
Read the thesis in AURA
Disputation chair: Professor Stephen Seiler, Department of Sport Science and Physical Education, University of Agder
Assessment committee
- First opponent: Professor Cecilie Thøgersen-Ntoumani, Department of Sport Science and Clinical Biomechanics, University of Southern Denmark, Denmark
- Second opponent: Professor John Saxton, School of Sport Exercise and Rehabilitation, University og Hull, United Kingdom
- Chair of assessment committee: Associate Professor Oddveig Reiersdal Aaberg, Department of Health and Nursing Science, University of Agder
Supervisors in the doctoral work
Main supervisor:
- Professor Sveinung Berntsen Stølevik, Department of Sport Science and Physical Education, University of Agder
Co-supervisors:
- Professor Ingvild Vistad, Sørlandet Hospital Trust and University of Oslo
- Researcher Associate Professor Ingrid Demmelmaier, Department of Public Health and Caring Sciences; Public Health, working life and rehabilitation, Uppsala University
Summary of thesis
The overarching aim of the thesis was to explore unaddressed areas in the literature and close research gaps related to methodological components of studies measuring and promoting physical activity and exercise in cancer populations. As the population of cancer survivors continues to expand, the promotion of long-term health should be a central goal of the cancer survivorship care. The cancer care should provide a follow-up regime that enables and equips cancer survivors to self-manage their health including performance of behaviours such as physical activity, which can positively affect their health and wellbeing long-term. However, this will require translation of current evidence and knowledge into research with broader application and impact.
The first objective of the thesis was to obtain the minimum monitoring period required for reliable estimates of device-based physical activity levels among cancer survivors. Accurate measures of time spent in physical activity intensities is crucial in trials investigating effects of, or changes in, physical activity levels. Wearable devices, often referred to as objective monitoring, is generally considered more accurate compared to self-report methods. However, the applied monitoring protocol can impact the reliability of the physical activity data and may have implications for study participation and dropout. We found reliable physical activity estimates for a shorter, more applicable, less resource demanding, and potentially less burdensome monitoring period.
The second objective of the thesis was to assess participant and intervention characteristics associated with dropout from exercise interventions. Study samples in randomized controlled exercise trials are often prone to selection bias and may not be representative of all cancer survivors. The trials typically experience varying degrees of dropout, which may potentially bias the samples further. Thirty-four randomized controlled exercise trials including 2467 cancer survivors were harmonized. Significantly higher dropout, thus less complete data, was found in some subgroups across different exercise trials, possibly compromising external validity and generalizability of trial results.
The third objective was to assess self-management skills associated with physical activity participation among gynaecological cancer survivors. Little is known about the specific aspects of self-management that may contribute to improved physical activity levels after self-management support interventions. The association between different self-management skills and physical activity participation was assessed among 1433 survivors of endometrial, ovarian, and cervical cancer. The more active participants appeared to be more actively engaged in their life, planned and prioritized activities and hobbies they found enjoyable, and were motivated to improve their life-circumstances. They also possessed self-monitoring skills, an ability to self-manage their condition by taking appropriate actions when symptoms worsened, had reasonable expectations to themselves, and had insight into their health issues and factors affecting these. These skills may constitute relevant targets of physical activity behaviour interventions.
In conclusion, this thesis addressed important methodological considerations for research monitoring and promoting physical activity in cancer populations, related to populations, measurement tools, methods, and outcomes.
What to do as an online audience member
The disputation is open to the public. To follow the trial lecture and the public defence online, register on Zoom.
We ask online audience members to join no earlier than 10 minutes in advance. After these times, you can leave and rejoin the meeting at any time.
Opponent ex auditorio:
Deadline for the public to pose questions is during the break between the two opponents. Questions ex auditorio can be submitted to Professor Stephen Seiler, copy Senior adviser Eli Andås.