# Behaviour Change for Physical Activity Is Feasible and Effective in Women Living with Metastatic Breast Cancer: A Pilot Two-Arm Randomised Trial

## TL;DR

A home-based, remotely delivered physical activity program is feasible and beneficial for women with metastatic breast cancer.

## Contribution

This study demonstrates the feasibility and potential efficacy of a remotely delivered behavior change program for physical activity in metastatic breast cancer patients.

## Key findings

- Most participants completed the 12-week program and found it helpful and manageable.
- The behavior change group showed greater improvements in physical activity compared to the generic advice group.
- High retention and adherence rates suggest the program is practical for home-based delivery.

## Abstract

Physical activity can improve health and wellbeing for women living with metastatic breast cancer. Previous research has mostly been performed in supervised and well-resourced contexts. This study explored whether a home-based, remotely delivered program could support women with metastatic breast cancer to be more active. Twenty women took part in a 12-week programme and received an activity tracker, written educational materials, and regular phone/video calls from an exercise physiologist. One half received personalised support on motivation, barriers, and social support, while the other half received general advice only. We examined whether the programme was practical, acceptable, and showed signs of benefits. Most women completed the programme and reported that it was helpful and manageable in daily life, and women receiving personalised support tended to show greater improvements. These findings suggest that remotely delivered behaviour change programmes are a practical and beneficial way to support physical activity in this population.

Background/Objectives: Physical activity benefits women with metastatic breast cancer. Past trials are typically well-resourced and supervised, but home-based interventions may be preferable and more accessible. This pilot trial evaluated the feasibility and preliminary efficacy of a remotely delivered behaviour change intervention aiming to increase physical activity for women with metastatic breast cancer. Methods: A 12-week, two-arm trial involved 20 women with metastatic breast cancer randomised 1:1 to a generic recommendation group or behaviour change group. Both groups received a physical activity recommendation, Fitbit® watch, diary, and nine phone/video call sessions. The behaviour change group received individualised advice around physical activity benefits, motivation, barriers, and social support; the generic recommendation group completed a recurring symptom questionnaire. Feasibility outcomes were recruitment, retention and adherence rates. Acceptability was evaluated with a structured interview at trial completion. Preliminary efficacy outcomes included 5-day Actigraph wear, 6 min walk distance, 30 s sit-to-stands, and questionnaires for self-reported physical activity, quality-of-life, fatigue, behavioural factors, and patient-specific function. Results: Recruitment, retention, and adherence rates were 63% (n = 20/32), 80% (n = 16/20), and 76% (137/180 sessions), respectively. Participants across both groups reported that participation was acceptable, and their behaviour change was perceived as sustainable. Preliminary change scores for efficacy measures favoured the behaviour change group, except some quality-of-life and behavioural factor subscales. Conclusions: Participants were receptive to the trial, and feasibility and efficacy measures were positive. This indicates that a behaviour change intervention for unsupervised physical activity is acceptable and can be beneficial to women with metastatic breast cancer, warranting further exploration.