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Predictors of adherence to different volumes of exercise in the breast cancer and exercise trial in Alberta
Stone CR, Friedenreich CM, O'Reilly R, Farris MS, Vallerand JR, Kang DW, Courneya KS
Annals of Behavioral Medicine 2019 Mar;53(5):453-465
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Exercise demonstrates a dose-response effect on many health outcomes; however, adhering to higher doses of exercise can be challenging, and the predictors of adherence may differ based on exercise volume. PURPOSE: To examine the predictors of adherence to two different volumes of aerobic exercise within the Breast Cancer and Exercise Trial in Alberta (BETA). METHODS: In BETA, we randomized 400 inactive but healthy postmenopausal women to either a moderate volume (150 min/week) or a high volume (300 min/week) of aerobic exercise for 1 year. We collected data on several predictors of exercise adherence at baseline and used linear and mixed-effect models to determine predictors of exercise adherence to exercise volume and overall. RESULTS: Adherence was higher in the moderate-volume group (84.5%) compared with the high-volume group (75.2%; p < 0.001). There were no statistically significant interactions between predictors of exercise adherence and exercise volume. Overall, we found that exercise adherence was predicted by randomization group, body mass index (BMI), employment status, and physical health. Adherence was 8.6% lower in the high-volume versus moderate-volume group, 6.7% lower for women working full time versus not, 0.8% lower per BMI increase of 1 kg/m2, and 0.5% higher per unit of physical health. CONCLUSIONS: Adherence to high-volume aerobic exercise was more challenging than for moderate-volume aerobic exercise, but the predictors of adherence were similar. Moreover, few factors were major predictors of exercise adherence in this setting suggesting that well-controlled efficacy trials that produce high adherence rates may reduce the influence of individual characteristics on exercise adherence.

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