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The purpose of this study is to examine whether nature-based activities provide benefits for breast cancer survivors. The investigators want to know whether a nature-based exercise program is feasible. Women who were diagnosed with breast cancer and have completed cancer treatment will be recruited for the main study. The main study will enroll up to 20 breast cancer subjects in total.
This intervention will also include a sub-study examining the same outcomes among adolescents and young adult (AYA) subjects who were diagnosed with cancer (any type) and have completed cancer treatment. The sub-study will enroll up to 20 AYA (ages 18-39) subjects.
This is a single-arm pilot study
MAIN STUDY Breast cancer survivors (n=20) will engage in three months of moderate intensity walking sessions three times a week in a nature and park conservation area. All walks will be supervised by certified clinical Exercise Physiologists (EP). Participants will be encouraged to keep the same days and walk session times throughout the intervention.
Sessions will be 50-minutes in total (5-minute warm-up, 40 minute walk, 5 minute cool-down and stretch). Session intensity will be tracked with Fitbits. Participants will be asked to reach a moderate intensity heart rate, defined as 40%-59% heart rate reserve.
Participants will complete surveys, physical assessments and collection of biomarkers at baseline and at end of study. Participants also have the option to participate in a 1 hr qualitative exit interview about their participation experiences.
Note. Based on any COVID pandemic restrictions at the time of a walk, sessions will be socially distanced one-on-one with an EP. When no restrictions are in place, they will take place in small groups (3-5 participants).
SUB-STUDY Adolescent and young adult (AYA) (ages 18-39) survivors (n=20) will complete all of the components of the Main-Study described above.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active | Experimental | Participants will be asked to complete a 12 week exercise program |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Nature based exercise | Behavioral | Participants will engage in three months of moderate intensity PA, consisting of three 50-minute walking sessions per week (5-minute warm-up, 40 minute walk, 5 minute cool-down and stretch) with an exercise physiologist for 12 weeks. |
| Measure | Description | Time Frame |
|---|---|---|
| Number of participants that adhere to a 3-month nature-based walking program | Feasibility of Nature Walk Programs | 12 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Short-term effects of green space and nature physical activity environments on well-being | PROMIS-29 | Measured at Baseline and at Week 12 |
| Short-term effects of green space and nature physical activity environments on social well-being |
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Main Breast Cancer Study Inclusion Criteria:
Main Breast Cancer Study Exclusion Criteria:
Sub-study AYA Inclusion Criteria:
Sub-Study AYA Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Celina Shirazipour, PhD | Cedars-Sinai Medical Center | Principal Investigator |
| Arash Asher, M.D. | Cedars-Sinai Medical Center | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cedars-Sinai Medical Center | Los Angeles | California | 90069 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37328178 | Derived | Shirazipour CH, Raines C, Liu E, Ruggieri RM, Capaldi JM, Luna-Lupercio B, Diniz MA, Gresham G, Bhowmick N, Haile RW, Asher A. Benefits of nature-based walking for breast cancer survivors. BMJ Open. 2023 Jun 16;13(6):e071041. doi: 10.1136/bmjopen-2022-071041. |
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| ID | Term |
|---|---|
| D001943 | Breast Neoplasms |
| D009369 | Neoplasms |
| D008223 | Lymphoma |
| D007938 | Leukemia |
| D011471 | Prostatic Neoplasms |
| D013964 | Thyroid Neoplasms |
| D019337 | Hematologic Neoplasms |
| D008228 | Lymphoma, Non-Hodgkin |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D009371 | Neoplasms by Site |
| D001941 | Breast Diseases |
| D012871 | Skin Diseases |
| D017437 | Skin and Connective Tissue Diseases |
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PROMIS Social Support
| Measured at Baseline and at Week 12 |
| Short-term effects of green space and nature physical activity environments on post-trauma growth and self-improvement | PTGI | Measured at Baseline and at Week 12 |
| Short-term effects of green space and nature physical activity environments on physical, social/family, emotional, and functional well-being | FACT-G | Measured at Baseline and at Week 12 |
| Biologic aging markers | DNA methylation, aging genes | Measured at Baseline and at Week 12 |
| TNF-α cytokine | TNF-α | Measured at Baseline and at Week 12 |
| Inflammatory cytokines | IL-1ß | Measured at Baseline and at Week 12 |
| Inflammatory cytokines, anti-inflammatory myokines | IL-6 | Measured at Baseline and at Week 12 |
| Inflammatory marker | CRP | Measured at Baseline and at Week 12 |
| TGF-ß cytokine | TGF-ß | Measured at Baseline and at Week 12 |
| Anti-inflammatory cytokine | IL-10 | Measured at Baseline and at Week 12 |
| IL-13 cytokine | IL-13 | Measured at Baseline and at Week 12 |
| D009370 |
| Neoplasms by Histologic Type |
| D008232 | Lymphoproliferative Disorders |
| D008206 | Lymphatic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D007160 | Immunoproliferative Disorders |
| D007154 | Immune System Diseases |
| D006402 | Hematologic Diseases |
| D005834 | Genital Neoplasms, Male |
| D014565 | Urogenital Neoplasms |
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D011469 | Prostatic Diseases |
| D052801 | Male Urogenital Diseases |
| D004701 | Endocrine Gland Neoplasms |
| D006258 | Head and Neck Neoplasms |
| D004700 | Endocrine System Diseases |
| D013959 | Thyroid Diseases |
| D001519 | Behavior |