BRIDGING THE GAP: INCORPORATING EXERCISE EVIDENCE INTO CLINICAL PRACTICE IN BREAST CANCER CARE
Bibliographic record
Abstract
This thesis includes four manuscripts with an overarching objective to develop, implement, and evaluate strategies to close the current knowledge to practice gap in the field of cancer rehabilitation. The overall goal of this objective is to provide a strategy to increase exercise knowledge and behaviour in women with breast cancer. The theory of planned behavior and knowledge-to-action cycle were used across these manuscripts in order to create and implement meaningful, easy-to-access, and effective interventions for women with breast cancer during chemotherapy treatment. The first manuscript presents a qualitative descriptive study outlining the barriers and facilitators to exercise promotion by health care professionals for women with breast cancer. Results found barriers to exercise promotion exist at the institutional, health care professional, and patient level. Patient complexity and availability of services and resources were found to influence exercise promotion in conjunction with the described barriers. The second manuscript presents a qualitative descriptive study using a focus group. The purpose of this study was to bring together a multi-disciplinary group of health care professionals who work with women with breast cancer to determine novel exercise intervention strategies to implement within the cancer care institution in Ontario. Results found that an on-site exercise program, an on-site rehabilitation professional, and more effective self-management educational strategies describing the benefits of exercise during and after breast cancer treatment were needed for women with breast cancer. The third manuscript presents a study protocol for the final thesis chapter. The purpose of this protocol was to describe a pilot study that would assess the feasibility and effectiveness of conducting an innovative knowledge translation intervention for breast cancer survivors using exercise and self-management versus usual care. The intervention was to be considered feasible if the recruitment rate reached >50%, adherence rate >75%, and retention rate >75%. The fourth manuscript presents the preliminary results of the pilot randomized controlled trial. The overall purpose of this study was to determine the feasibility of providing a complex knowledge translation intervention designed specifically for women with breast cancer using technology. This study also set out to explore preliminary estimates of effects of the knowledge translation intervention on physical activity level, exercise knowledge and behaviour, health related quality of life, overall health status, and resource utilization among breast cancer survivors. Results found the intervention to be feasible (recruitment rate of 96%, intervention retention rate of 100%, and intervention adherence rate of 89%). The exploratory findings of secondary outcomes found a significant between group difference in physical activity levels post intervention (mean difference= 25.38, 95%CI= (9.35, 41.42), p=0.003) as measure by the Godin Leisure-Time Exercise Questionnaire. No significant between group differences were found for exercise knowledge scores, health related quality of life, or overall health status.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.267 | 0.499 |
| Meta-epidemiology (narrow) | 0.001 | 0.002 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.008 | 0.008 |
| Science and technology studies | 0.004 | 0.006 |
| Scholarly communication | 0.021 | 0.015 |
| Open science | 0.006 | 0.013 |
| Research integrity | 0.006 | 0.009 |
| Insufficient payload (model declined to judge) | 0.005 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".