Restoring Balance: A Physical Activity Intervention for Native American Cancer Survivors and Their Familial Support Persons

Abstract

ABSTRACT Introduction/Purpose Exercise interventions among Native American cancer survivors are lacking, despite major cancer health disparities in survivorship. The purpose of this study was to evaluate a 12-wk randomized controlled trial (RCT) of culturally tailored exercise on cancer risk biomarkers and quality of life among Native American cancer survivors and family members. Methods Participants were randomized to immediate start versus 6-wk waitlist control at two rural and two urban sites. Participants enrolled in a small feasibility pilot study (only cancer survivors evaluated, n = 18; cohort 1) or larger efficacy pilot study where cancer survivors (n = 38; cohort 2) and familial supporters (n = 25; cohort 3) were evaluated concurrently. Resistance, aerobic, flexibility, and balance exercises were tailored by cultural experts representing 10 tribes. Exercises were supervised on-site 1 d·wk−1 and continued in home-based settings 2–5 d·wk−1. Fat mass, blood pressure, hemoglobin A1c, 6-min walk, sit-to-stand test, and quality of life (Patient-Reported Outcomes Measurement Information System Global Health short form and isolation subscale) were measured. Mixed-effects models evaluated differences between RCT arms from baseline to 6 wk, and 12-wk intervention effects in combined arms. Results There were no consistent differences at 6 wk between randomized groups. Upon combining RCT arms, 6-min walk and sit-to-stand tests improved in all three cohorts by 12 wk (both survivors and familial support persons, P < 0.001); social isolation was reduced in all three cohorts (P ≤ 0.05). Familial support persons additionally improved blood pressure and hemoglobin A1c (P ≤ 0.05). Conclusions Exercise improved cardiorespiratory fitness and physical function among Native American cancer survivors and familial supporters. A longer intervention may influence other important health outcomes among Native American survivors. Additional improvements demonstrated among Native American family members may have a meaningful impact on cancer prevention in this underserved population with shared heritable and environmental risks.