Improving the health of communities: Issues relative to physical activity in breast cancer survivors

There are more than 2.4 million breast cancer survivors in the United States accounting for 22% of all cancer survivors. The combined high incidence and prevalence rates have created a relatively large population with distinct public health needs. Physical activity interventions have been shown to be effective for ameliorating many of the negative side effects associated with breast cancer treatment, however, little is known about their potential for translation into practice and the extent to which findings can be generalized. We utilized the RE-AIM (Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance) framework (www.re-aim.org) to provide a quantitative estimate of the extent to which recent studies of physical activity effects on breast cancer survivors have addressed issues related to both internal and external validity. Physical activity trials (N=25) published between 1998 and 2008 were identified and coded relative to the degree to which each study met the criteria for each of the RE-AIM dimensions. The most frequently reported dimensions were reflective of elements of internal validity: Reach (68%) and Efficacy/Effectiveness (75%). Adoption (17.1%), Implementation (54.7%), and Maintenance (5.3%) were reported less frequently in the studies. Thus, the potential of these trials to be translated into effective practice cannot be determined and raises issues relative to improving the health of this rapidly growing community. Such issues include the potential for interventions effects to be consistent and replicable across settings, staff, and conditions and the extent such interventions can contribute to reductions in the healthcare costs associated with other palliative treatments and cancer recurrence.