By Michele Sequeira

Making Every Step Count

Researcher uses $750,000 grant and novel "Whole-of-Day" approach to help cancer survivors become more active

Exercise helps people at any age become healthier. But people who have just completed cancer treatment may not always feel well enough to exercise regularly. So Cindy Blair, PhD, wondered if increasing their physical activity throughout the day might improve their health.

Blair's recently awarded five-year $750,000 grant will allow her to explore ways to help older cancer survivors in New Mexico become more active and study how being more active affects their health. She hopes that helping people make small changes to increase their physical activity throughout the day will lead to lasting lifestyle changes and that these changes will lead to bigger changes and more health benefits.

Blair, an assistant professor and cancer epidemiologist at The University of New Mexico Comprehensive Cancer Center, explains that exercise differs from physical activity.

"Exercise is structured and it's done for the purpose of improving fitness," Blair says. "You're breathing faster, you're sweating. It is associated with numerous health benefits." Conversely, any movement at any intensity is considered physical activity. So walking the dog, walking to the mailbox, light gardening or doing the laundry count as physical activity, but not as exercise.

Blair saw that people who have completed cancer treatment may be unable to start or maintain a structured exercise program. Additionally, older people may have other health conditions that keep them from exercising. But, most people can move around.

"So, my idea was to start slow and break up sedentary time with light physical activity throughout the day," Blair says. "That's the 'whole-of-day' approach to physical activity."

She chose this approach based on research showing that people who sit for long periods without getting up and moving are at greater risk for health issues. Blair's clinical trial will study whether physical activity throughout the day, every day, improves cancer survivors' physical functioning - their ability to perform daily living tasks - and their quality of life. In her study, she says, "Every step counts."

Blair wants to open her clinical trial widely. She wants to include older people throughout New Mexico, and, unlike many clinical trials, people who have survived any type of cancer. But many exercise clinical trials require people to travel to the research team to participate in the program.

Blair didn't want her clinical trial to force people to travel, but she needed ways to measure physical activity and physical functioning objectively and remotely. So she turned to technology.

People in the study will wear an activity monitor on their wrist so that they can track their daily sedentary time and physical activity. They can upload their data to a website through a mobile device or computer. The activity monitors can alert them when they haven't recorded physical activity in the previous hour and can motivate them with electronic messages to get more steps.

Blair will also test whether she can use videoconferencing to remotely conduct standard physical performance tests of lower-limb strength. Lower-limb strength is often used as measure of how well someone is able to perform everyday activities.

"My research program is about going to where the cancer survivors are, with minimal disruption to their lives, with minimal requirements on them," Blair says. "They can do [their physical activity] when it's right for them, on their schedule." And, she hopes that any positive lifestyle changes that result from taking part in her clinical trial will stay with them a long time.

Cindy Blair, PhD, is an assistant professor in the Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, at The University of New Mexico School of Medicine. She is a full member of the Cancer Control Research Group at the UNM Comprehensive Cancer Center. Blair holds a master in public health and a doctorate in epidemiology from the University of Minnesota and completed a postdoctoral fellowship on the National Cancer Institute R25 Cancer Prevention and Control Training Program at the University of Alabama at Birmingham. She joined UNM in 2015 and is a recipient of the Cancer Prevention, Control, Behavioral Sciences, and Population Sciences Career Development Award (K07) from the National Cancer Institute.

The National Cancer Institute of the National Institutes of Health supported the research reported in this publication under Award Number 1K07CA215937-01A1, Principal Investigator: Cindy Kay Blair, PhD. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Categories: Comprehensive Cancer Center