INTRODUCTION: Adherence to exercise interventions in patients with cancer is often poorly described. Further, it is unclear if self-regulatory behavior change techniques (BCTs) can improve exercise adherence in cancer populations. We aimed to (1) describe exercise adherence in terms of frequency, intensity, time, type (FITT-principles) and dropouts, and (2) determine the effect of specific self-regulatory BCTs on exercise adherence in patients participating in an exercise intervention during curative cancer treatment. METHODS: This study was a secondary analysis using data from a Swedish multicentre RCT. In a 2x2 factorial design, 577 participants recently diagnosed with curable breast, colorectal or prostate cancer were randomized to 6 months of high (HI) or low-to-moderate intensity (LMI) exercise, with or without self-regulatory BCTs (eg, goal-setting and self-monitoring). The exercise program included supervised group-based resistance training and home-based endurance training. Exercise adherence (performed training/prescribed training) was assessed using attendance records, training logs and heart rate monitors, and is presented descriptively. Linear regression and logistic regression were used to assess the effect of self-regulatory BCTs on each FITT-principle and dropout rates, according to intention-to-treat. RESULTS: For resistance training (groups with versus without self-regulatory BCTs), participants attended on average 52% versus 53% of prescribed sessions, performed 79% versus 76% of prescribed intensity, and 80% versus 77% of prescribed time. They adhered to exercise type in 71% versus 68% of attended sessions. For endurance training (groups with versus without self-regulatory BCTs), participants performed on average 47% versus 51% of prescribed sessions, 57% versus 62% of prescribed intensity, and 71% versus 72% of prescribed time. They adhered to exercise type in 79% versus 78% of performed sessions. Dropout rates (groups with versus without self-regulatory BCTs) were 29% versus 28%. The regression analysis revealed no effect of the self-regulatory BCTs on exercise adherence. CONCLUSION: An exercise adherence rate >= 50% for each FITT-principle and dropout rates at approximately 30% can be expected among patients taking part in long-term exercise interventions, combining resistance and endurance training during curative cancer treatment. Our results indicate that self-regulatory BCTs do not improve exercise adherence in interventions that provide evidence-based support to all participants (eg, supervised group sessions). TRIAL REGISTRATION: NCT02473003.

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