Patient outcomes from a physical activity programme for cancer survivors in general practice: an intervention implementation study

Background Physical activity (PA) benefits cancer survivors' health, yet no PA programmes are incorporated in Dutch general practice. Aim To evaluate cancer survivors' outcomes following a PA programme in general practice. Design and setting A single-arm PA intervention implementation study among cancer survivors in 15 Dutch general practices. Method Patients aged >= 18 years who completed primary cancer treatment >= 6 months prior were eligible. The 9-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, self-reported quality of life, and PA. Outcomes were assessed at time (T)0-T3 (0, 3, 6, and 9 months) or at PCPs' sessions S1-S6 (0, 3, 6 weeks, and 3, 6, 9 months). Non-participants completed a single baseline questionnaire. The study 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. In total, 11% (n = 16/149) dropped out before and 26% (n = 35/133) during the programme. Counselling session adherence and PA goal achievement were 98% (n = 647/661) and 73% (n = 81/111), respectively. Conclusion The programme reached long-term cancer survivors with poorer health status, and showed positive health changes particularly on PA and physical function. Such PA programmes may benefit the health of a rising number of cancer survivors visiting primary care.