Evaluating recruitment, retention and adherence patterns in the GET FIT fall prevention exercise trial in older, postmenopausal cancer survivors

Evaluating recruitment, retention and adherence patterns in the GET FIT fall prevention exercise trial in older, postmenopausal cancer survivors | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Evaluating recruitment, retention and adherence patterns in the GET FIT fall prevention exercise trial in older, postmenopausal cancer survivors Jessica Sitemba, Mary Crisafio, Fuzhong Li, Elizabeth Eckstrom, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5968659/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose The GET FIT trial tested fall prevention exercise approaches in older (50–75 years) post-chemotherapy, postmenopausal cancer survivors. We describe recruitment, retention, and adherence patterns from GET FIT to inform future trials. Methods Participants were recruited through multiple strategies (e.g., cancer and research registries, clinician referral, outreach, electronic health record (EHR) screening) and were randomized to one of three supervised, facility-based, group exercise programs for six months. We compared effectiveness of accrual across recruitment strategies, examined characteristics of women who completed the interventions to those who withdrew, and women with good ( ≥ 50%) versus poor (< 50%) adherence to training. Results Of 1490 interested women, 442 women were eligible, randomized, and received the assigned intervention (30% accrual rate). Accrual was similar across recruitment strategies, except for EHR screening which yielded no accruals. Retention over 12 months was 87% with most dropouts occurring within the first month. There were no differences in baseline characteristics between women who did or did not drop out. Poor adherers (n = 60) had higher baseline BMI, comorbidities, pain, disability and lower physical functioning (p < 0.05) compared to more adherent women (n = 377). Conclusions A variety of recruitment strategies appear to be effective for enrolling older, postmenopausal cancer survivors into a facility-based exercise trial, except for directly approaching women identified through the EHR. Women with poorer health were at risk for study drop-out and poor adherence to exercise. Implications for Cancer Survivors: Women with poorer initial health may need additional retention strategies to help them stick with supervised, facility-based, group exercise. exercise training feasibility older adult cancer survivorship fall prevention Figures Figure 1 Figure 2 Figure 3 INTRODUCTION Cancer and its treatment can exacerbate age-related declines in physical functioning and increase fall risk [ 1 – 3 ]. The GET FIT trial was a 3-arm randomized controlled trial testing the efficacy of strength training or tai ji quan training compared to a placebo exercise (stretching) condition on fall rates in postmenopausal women who received chemotherapy for cancer [ 4 ]. The exercise interventions in GET FIT were supervised, facility-based, group exercise programs to better ensure fidelity and safety of exercise programs, optimize outcomes with supervised exercise, utilize social support to promote retention and adherence, and economically deliver a training program. Enrolling cancer survivors into supervised, facility-based group exercise programs and achieving high adherence and retention rates is a challenge for clinical exercise research, particularly with a need for adequately powered sample sizes to detect changes in event rates such as falls [ 5 ]. Facility-based group exercise interventions can impose additional constraints over non-interventional or even therapeutic trials, including travel to a facility, substantial time commitment to attend programs, and scheduling constraints with set class days and times that can be barriers to exercise [ 6 ]. While women cancer survivors express interest in engaging in exercise programs [ 7 ], a woman’s readiness to exercise after cancer can be impacted by her starting fitness level, persistent treatment-related symptoms (e.g., pain, fatigue, and neuropathy) and lack of self-efficacy as well as other social and environmental factors (e.g., barriers to facilities and lack of social support), potentially contributing to poor adherence or drop out [ 8 , 9 ]. Older cancer survivors may be less likely to express interest in exercise interventions than their younger counterparts over concerns about their safety, appropriateness of exercise, and study burden [ 10 ]. While randomized controlled trials of post-treatment exercise interventions in postmenopausal women cancer survivors describe recruitment approaches and report study retention and exercise adherence [ 11 – 15 ], there have been no detailed reports comparing success of different recruitment strategies or characterizing study retention and adherence patterns that could inform the design and execution of future trials. Given the need for rigorous controlled trials that test exercise efficacy on outcomes important to older cancer survivors (e.g., falls, fractures, frailty, disability), further detailed reporting on trial accrual, retention, and adherence from completed clinical exercise trials can benefit the research community and help guide implementation into practice. Thus, the aims of this secondary analysis of data from the GET FIT trial [ 4 ] are to: 1) describe and compare accrual rates across a variety of recruitment strategies, 2) describe study retention and adherence and and compare characteristics of study completers versus non-completers and of good versus poor adherers to exercise programs. METHODS Study Design and Procedures Details outlining the study setting, design, participants, procedures, and interventions have been previously published [4]. Briefly, GET FIT was a 3-arm randomized controlled trial of postmenopausal cancer survivors aged 50-75 years who had completed chemotherapy. The sample size powered to test for intervention differences in fall rates was n=456 (accounting for planned attrition of 20%), or 152 per study arm. Enrolled participants were randomized into one of three supervised, facility-based, group exercise interventions (strength training, tai ji quan, or stretching [control]) twice-weekly for 6 months. After supervised training stopped, women were provided an exercise video and written guide to follow at home on their own and were reassessed 6 months later. Participants underwent testing sessions at baseline, 3, 6 and 12 months which included completing questionnaires and physical performance tests previously described [4]. Questionnaire-based measures included in this analysis were baseline demographic and clinical characteristics, comorbidities (Functional Comorbidity Index and Charlson Comorbidity Index) [16], fear of falling (Survey of Activities and Fear of Falling in the Elderly-SAFFE) [17], and lifestyle physical activities outside of the exercise intervention (CHAMPS Physical Activity Questionnaire for Older Adults) [19]. Falls were tracked and collected via monthly surveys. The exercise classes were held at Oregon Health and Science University (OHSU), an academic medical center, plus six community locations in and around the Portland metro area in Oregon. Community settings were strategically selected to reach different geographical sectors of the Portland metro area to reduce barriers to participation related to time and travel. Classes were held on specific days and times, lasted 60 minutes per session, were led by a certified group exercise instructor, in groups of 15-20 participants per class. All study procedures and written informed consent, were reviewed, and approved by the OHSU Institutional Review Board (IRB #8560). The trial is registered with ClinicalTrials.gov (NCT01635413). Study Sample Inclusion criteria were: 1) diagnosed with stage I-III cancer other than cancer of the brain or spinal cord, 2) completed chemotherapy >3 months prior to enrollment, 3) aged 50-75 on date of enrollment, 4) physically underactive (<60 minutes of moderate intensity exercise per week the month prior to enrollment), 5) ability to provide informed consent, and 6) free of contraindications to moderate-intensity exercise. Recruitment Five different strategies were used to recruit women into the trial. These included (a) cancer registries, (b) clinician referral, (c) mailed invitations to past research participants, (d) community outreach (e.g., attending cancer and health related events, posting flyers, email blasts), and (e) screening and outreach through electronic health records (EHR). Accrual rates for each strategy were calculated as the number of women who were randomized and received the intervention (n=442) out of the number of interested and eligible women within each recruitment strategy. We briefly describe each strategy in detail below. Cancer Registries We utilized two cancer registries to recruit participants, the Oregon State Cancer Registry (OSCaR) and the OHSU Hospital Cancer Registry. OSCaR is a population-based tumor registry run by the Oregon Health Authority that collects and analyzes information on cancer cases in Oregon. To partner with the registry, the GET FIT protocol and recruitment approach was approved by the OSCaR advisory board and Oregon Health Authority IRB. The OSCAR registry identified potential participants by age, cancer site, diagnosis date and treatment type. Each woman’s physician of record was sent a letter from OSCaR informing them that their patient would be sent a letter about the trial. In accordance with HIPAA5145 regulations, the OSCaR registry would next mail women a joint OHSU-OSCaR information letter describing the study along with a pre-paid response form to allow the study team permission to contact them about the study (n=5145 letters sent). In addition to OSCaR, the OHSU registry was utilized to identify more potentially eligible women who were treated for cancer at OHSU but had not received a letter through OSCaR (n=824 letters sent). Research Repository The research team has an IRB-approved research repository of persons who provided permission to be contacted for future study opportunities from prior recruitment efforts. Women who met basic eligibility criteria (e.g., time since diagnosis, treatment type) and lived in the Portland metro area were sent an information letter (n=573 letters sent) and were asked to contact study staff by email or phone if they were interested in learning more about the trial. Women in the repository were not directly called by the study team. Community Outreach Recruitment flyers were placed in OHSU clinics and in local hospitals, clinics, and community centers. Direct outreach, via engagement of several community cancer-based organizations (e.g., formal and informal support groups, charities), was used to distribute information about the study through email listservs, newsletters and events. General study advertisements were also posted on social and print media, including small community newspapers. Clinician Referral OHSU oncologists were encouraged to refer potentially eligible patients to the study. If the clinician received permission from the patient for the study team to contact her, s/he then provided study staff with the patient’s medical research number (MRN) that included the patient’s contact information. EHR Screening OHSU clinicians provided study staff permission to review the EHR of their patients to directly identify potentially eligible women. Once a woman was identified, study staff called them on the phone to discuss the study. This strategy was considered unique from the other recruitment strategies since these women were approached about the study before they received information about it from their provider or elsewhere and/or expressed interest in response to a recruitment effort. Retention and Adherence Multiple strategies were used to promote retention of participants during the study period including the following: 1) assignment of every woman to a supervised, group exercise program, including controls, 2) free close-by parking for study visits and exercise classes, 3) a $10 gift card after completion of each testing appointment, 4) small study tokens like a study magnet and t-shirt, and 5) birthday cards mailed to participants. Multiple strategies were used to promote adherence to exercise classes including: 1) professional exercise instruction to provide coaching, individual tailoring, and motivation, 2) one week of exercise class “orientation” to provide education about exercise and establish rapport, trust and support prior to starting exercise classes, 3) regular communication between instructors and participants during and outside of classes about exercise tolerance and missed sessions, 4) fostering group dynamics within exercise classes to engender social support from peers, and 5) in-class celebrations to mark the midpoint and end of the exercise program. Study retention was calculated as number of completers out of the number of women who began the study interventions. Completers were defined as women who finished the 6-month exercise program and the 12-month study follow-up visit. Adherence was calculated as the proportion of attended classes out of those prescribed. Since women were prescribed twice weekly exercise classes, we created a cutoff of 50%, or an average of 1 or more classes per week, where > 50% was deemed good adherence and < 50% deemed poor adherence. Statistical Analysis Descriptive analyses were run to calculate mean, standard deviation and/or proportions as appropriate for each outcome. A chi-square analysis was conducted to compare differences in accrual rates across recruitment strategies. Differences in baseline demographics, clinical characteristics and study outcomes between completers and non-completers and between good and poor adherers were examined by unpaired t tests for continuous variables and chi-square or Fisher’s exact test for categorical variables. All statistical procedures were performed using the SPSS statistical software program, version 24.0 (SPSS, Inc., Chicago, IL, USA); a 2-tailed p-value <0.05 was considered statistically significant. RESULTS Study Sample Participants were enrolled into the GET FIT study between January 2013 and September 2015. A total of 1490 women, identified through our various recruitment strategies, were screened per study eligibility (Fig 1). Of these, 457 were eligible and randomized. Fifteen women either became ineligible (i.e., cancer recurrence) or discontinued study participation prior to the start of the interventions (Fig 1), resulting in an overall accrual rate of 30% over a 33-month recruitment period. The accrual rate of interested persons was similar across all initial strategies, ranging from 29%-37%, except for EHR screening which resulted in zero accruals. The cancer registries were the most fruitful (n=868), and with a similar accrual rate as other approaches, yielded the highest number of enrolled participants (n=279; 32%) (Table 1). Recruitment from the research repository had a smaller yield (n=78), but the highest accrual rate (37%) Retention Of the 442 women who began the study interventions, 385 (87%) completed both the 6-month exercise program and the 12-month follow-up testing visit. Of the 57 (13%) non-completers, 52 did not complete the 6-month exercise program and an additional 5 did not complete the final testing visit, resulting in retention rates of 88% and 87% during the first and second halves of the study, respectively (Figure 2). The majority of non-completers (n=24) withdrew within the first month of the study (Figure 2). Reasons for withdrawal among the non-completers included being too busy (n=18), disliking the class assignment (n=9), no longer interested (n=8), family emergency (n=5), poor health (n=4), schedule conflicts (n=4), transportation issues (n=3), musculoskeletal issues (n=3), and deceased (n=3). There were no significant differences in the number of non-completers across the study arms (p=.471). The only significant difference in baseline characteristics between non-completers and completers was the SAFFE score, where non-completers reported more worry about falling when performing activities of daily living at baseline compared to the completers (p=0.03) (Table 2). Adherence Adherence over the 6-month active exercise intervention averaged 73%, 71%, and 74% for the strength, tai ji quan, and stretching (control) groups, respectively, with no significant difference across study groups. Average adherence rates to supervised classes were highest in the first month of the program (82%), then showed a steady decline (by about 10%) for the next two months of the program and remained steady after that (Figure 3). Women who were considered poor adherers had significantly higher BMI (p<0.01), more comorbidities (p<0.01), higher self-reported pain (p<0.05), lower self-reported physical function (p<0.05), greater disability (p<0.05), and were more likely to be single (p=0.01) compared to good adherers (Table 3). DISCUSSION Overall, we were able to enroll and retain a large number of older, postmenopausal cancer survivors into a large clinical trial of 6-month supervised, facility-based group exercise interventions testing the efficacy of exercise-based fall prevention approaches. We used five different strategies to recruit women, reaching our target enrollment (n = 456) with a 30% accrual rate over a 33-month period. This accrual rate was similar to or higher than that reported in several other randomized controlled trials of cancer survivors that included a supervised, facility-based, group exercise intervention lasting 6 months or more [ 9 , 15 , 20 , 21 ]. Hayes et al reported a 63% accrual rate to an 8-month long facility-based group exercise intervention in post-surgical breast cancer patients by provider referral at the time of surgery [ 12 ]. Similar to other exercise trials, our use of cancer registries was the most effective recruitment tool for enrolling a large sample [ 9 , 15 , 20 , 21 ]. While the relative accrual rate from the registries was comparable to other methods, the number of women who can be reached through the registries is much higher than other approaches, yielding higher absolute numbers of enrolled participants. State and hospital cancer registries may be an effective resource for enrolling large numbers of participants into trials, but research teams should also consider the administrative challenges that this recruitment method may pose including fees, additional IRB approvals, and coordination of large mailings and/or phone calls, all of which can make this high yield approach resource intensive. In comparison, directly calling patients identified through the EHR was both time-intensive and unfruitful. While providers gave the research team permission to contact their patients, they did not discuss the study with their patient beforehand nor did the patient receive information about the study prior to the call from the research team, likely leaving the patient unready to receive a recruitment call. In an improved approach, we now encourage the provider to send an electronic message to their patient introducing and endorsing the study, prior to any contact from the study team. This approach, though being more fruitful, will only work for patients who opt into patient portals, such as MyChart. For patients who do not opt in, sending information by mail or providing it at a clinic visit could also be a “soft introduction” to the study and lead to a more successful recruitment call. Both retention and adherence rates in our trial were similar to or higher than rates reported in other randomized controlled trials of female cancer survivors that included a supervised facility-based group intervention lasting 6 months or more [ 12 , 13 , 15 , 22 ]. Overall, there were no differences in baseline characteristics between completers and non-completers with one exception. Non-completers reported significantly higher worry about falls compared to those who finished the study. Since our trial was focused on fall prevention, this is a curious paradox, but might be explained in part by the known relationship between fear of falling and self-restricted activity levels [ 23 ]. Women in our study who had a greater fear of falling, and who were also underactive per study eligibility criteria, may have felt more worry about falls as they started a new exercise program, though this concern was not specifically cited by any of these women as a reason for withdrawing. Since activity restriction can lead to a greater risk of falls and since exercise offers protection against falls, including specific strategies to reduce concern for falling, such as cognitive behavioral therapy, should be considered. The benefits from exercise are often stronger with greater adherence to exercise [ 24 – 26 ]. In our study a small proportion of participants (14%) attended less than half of the prescribed classes and understanding this subgroup could inform adherence strategies in future studies. Participants with poor attendance had higher BMI, more comorbidities, self-reported pain, and disability, lower self-reported physical function and were more likely to be single. Other studies have also shown high BMI as a predictor for low adherence to exercise [ 27 , 28 ]. One study of breast cancer survivors exercising during treatment reported that less physically fit women were more likely to have poor adherence to exercise prescriptions [ 29 ], while others have reported that low self-efficacy and greater physical limitations are key determinants of poor exercise adherence after cancer treatment [ 31 , 32 ]. Since survivors with poorer health are at greatest risk of further physical decline and therefore could benefit from supervised exercise, incorporating strategies to improve adherence in this subgroup is important. Despite having a second instructor in class to modify programs for participants with low initial functioning (e.g., wall pushups instead of knee pushups), this approach was less successful in retaining these participants. Perhaps the need to have modified exercises within a group setting may have led to feelings of low self-confidence or efficacy which are known to lead to poor adherence. Confidence-enhancing strategies may be needed, especially during the initial acclimation period, for women with low baseline functioning and movement efficacy to slowly ease into structured, prescribed exercise programs. There are limitations to interpreting our findings. Our sample was well educated and mostly identified as non-Hispanic white living in a metropolitan area. Thus, it is possible that our findings may not translate directly to a more racially and ethnically diverse patient population living in different geographic regions. Future studies should increase participant diversity and thus the generalizability of the results by using recruitment methods like community-based participatory research and physician-informed and engaged referrals, since engagement in clinical trials research among underserved groups is notably low. Additionally, participant age was limited to women who were no older than 75 years of age to better test the efficacy of the interventions on falls associated with chemotherapy rather than advanced age and/or age-related comorbidities. Barriers to engagement in clinical research, exercise tolerance and adherence may differ among women over 75 years of age. Importantly, this group is also underrepresented in exercise oncology research and deserves more attention as the proportion of cancer survivors over the age of 75 will double in the coming decades. The GET FIT study demonstrated success in recruiting older postmenopausal cancer survivors into a large exercise clinical trial using strategies primarily involving state and hospital cancer registries. Once enrolled women were highly likely to complete participation in 6 months of supervised, facility-based exercise, and study follow-up visits over a year. However, women’s initial health status and physical function affected our ability to train and retain this small, yet important, subgroup of women who may have benefitted from structured exercise. Future exercise oncology studies need to consider targeted strategies to improve retention and adherence among women with poorer health throughout intervention and follow up periods. Declarations Clinicaltrials.gov NCT01635413 Funding This work was supported by a National Cancer Institute 1R01CA163474-01 to Dr. Winters-Stone. Disclosures: The authors have no relevant financial or non-financial interests to disclose Ethics Approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Oregon Health & Science University Institutional Review Board (IRB##8560). Funding: National Cancer Institute 1R01CA163474-01 to Dr. Winters-Stone Author Contribution Material preparation, data collection and analysis were performed by JS, MC and KWS. The first draft of the manuscript was written by JS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. Acknowledgement The authors thank the GET FIT participants for their time and effort. The authors would also like to thank Carolyn Guidarelli and Lauren Bumgarner for their assistance with project management and data collection and Cassie Boisvert for her assistance with revising the manuscript. The authors recognize the Oregon State Cancer Registry for their collaboration on recruitment for this trial. The Oregon State Cancer Registry is one of the participating registries funded by the National Program of Cancer Registries under the Centers for Disease Control and Prevention. References Chen Z, Maricic M, Aragaki AK, et al. Fracture risk increases after diagnosis of breast or other cancers in postmenopausal women: results from the Women’s Health Initiative. 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Int J Behav Nutr Phys Act . 2014;11(1):1-13. doi:10.1186/1479-5868-11-80 Witlox L, Velthuis MJ, Boer JH, et al. Attendance and compliance with an exercise program during localized breast cancer treatment in a randomized controlled trial: The PACT study. PloS One . 2019;14(5):e0215517. doi:10.1371/journal.pone.0215517 Ormel HL, van der Schoot GGF, Sluiter WJ, Jalving M, Gietema JA, Walenkamp AME. Predictors of adherence to exercise interventions during and after cancer treatment: A systematic review. Psychooncology . 2018;27(3):713-724. doi:10.1002/pon.4612 Theiss JA, Carpenter AM, Leustek J. Partner Facilitation and Partner Interference in Individuals’ Weight Loss Goals. Qual Health Res . 2016;26(10):1318-1330. doi:10.1177/1049732315583980 Tables Table 1. Recruitment strategies and accrual rates in the GET FIT trial Cancer Registry Clinician Referral Community outreach b Research Repository EHR c Screening Not Specified Total Number assessed for eligibility 868 169 282 78 27 66 1490 Received intervention 279 50 80 29 0 4 442 Accrual Rate a 32% 30% 28% 37% 0%* 6% 30% a Accrual rate is number randomized and received the intervention (n=442) divided by number of interested and eligible women within each recruitment strategy b combines Events & Media and Outreach c Electronic Health Record *Significantly lower enrollment rate than other recruitment strategies p<0.01 Table 2: Baseline characteristics of completers and non-completers in the GET FIT trial. Data presented as mean (M), standard deviation (SD), and range for continuous data or % of sample for categorical data. Completers Non-Completers (n = 385) (n = 57) Characteristic M (SD) M (SD) p-value Group Assignment Strength 34% 28% 0.47 Tai Ji Quan 33% 40% Stretching 34% 32% Age (years) 62.0 (6.4) 62.3 (5.8) 0.75 Cancer Type Breast 71% 74% 0.25* Cervical 1% 0% Colon 7% 4% Liver 0% 0% Lung 2% 5% Lymphoma 4% 4% Ovarian 6% 2% Pancreatic 0% 2% Urinary/Bladder 0% 0% Uterine 3% 4% Other 6% 7% Cancer Stage† I 28% 21% 0.72 II 40% 40% III 26% 25% Race White 90% 88% 0.30** African American/Black 2% 5% Native Hawaiian/Pacific Islander 1% 0.0% Native American/Alaskan Native 1% 2% Asian 3% 2% Ethnicity Hispanic 2% 2% 0.62 Non-Hispanic 96% 97% Marital Status Married/Partnered 58% 56% 0.82 Education High School/GED 21% 33% 0.11 > High School 79% 66% Employment Retired 42% 53% 0.14 Full time 29% 14% Part time 17% 21% Homemaker 4% 2% Unemployed 8% 11% Comorbidities Charlson Comorbidity Index 1.9 (1.5) 2.2 (2.0) 0.25 Functional Comorbidity Index 1.9 (1.6) 2.3 (2.1) 0.12 BMI (kg/m 2 ) 29.5 (6.6) 30.4 (7.2) 0.37 Fall History (last 6 months) >=1 Fall 21% 26% 0.20 Injurious Fall (out of fallers) 53% 60% 0.42 Pain Severity 1.3 (1.5) 1.6 (1.6) 0.22 Pain Interference 1.0 (1.6) 1.4 (2.1) 0.17 Neuropathy (yes) 42% 32% 0.50 SAFFE 0.24 (0.35) 0.40 (0.52) 0.03 LLFDI disability limitation 77.3 (14.7) 76.5 (16.8) 0.70 LLFDI overall function 68.2 (11.0) 66.6 (12.1) 0.33 LLFDI function lower extremity 81.1 (14.4) 79.5 (15.6) 0.43 LLFDI function-advanced lower extremity 63.3 (16.3) 61.2 (16.9) 0.36 †Numbers may not add up to 100 due to missing data * Significance test compares breast vs other ** Significance test compares White vs other Table 3: Baseline characteristics of participants who attended > or 50% Adherence < 50% (n = 377) (n = 60) Characteristic M (SD) M (SD) p-value Age (years) 62.1 (6.3) 61.9 (6.5) 0.86 Cancer Type Breast 71% 72% 0.93* Cervical 1% 3% Colon 7% 3% Liver 0% 0% Lung 3% 2% Lymphoma 4% 3% Ovarian 6% 3% Pancreatic 0% 0% Urinary/Bladder 0% 0% Uterine 3% 5% Other 5% 8% Cancer Stage† Don't know stage 5% 8% 0.76 I 28% 22% II 40% 43% III 27% 25% No Stage 1% 2% Race White 91% 83% 0.03** African American/Black 2% 5% Native Hawaiian/Pacific Islander 0% 3% Native American/Alaskan Native 1% 0% Asian 3% 2% Ethnicity Hispanic 1% 2% 0.60 Non-Hispanic 96% 98% Marital Status Married/Partnered 60% 43% 0.01 Education High School/GED 21% 33% 0.29 > High School 79% 66% Employment Retired 43% 43% 0.32 Full time 28% 20% Part time 17% 22% Homemaker 5% 2% Unemployed 8% 13% Group Assignment Strength 33% 32% 0.96 Tai Ji Quan 34% 35% Stretching Control 33% 33% Comorbidities Charlson Comorbidity Index 1.9 (1.5) 2.5 (1.7) 0.002 BMI (kg/m 2 ) 29.2 (6.5) 32.2 (7.2) 0.001 Fall History (last 6 months) > 1 Fall 21% 22% 0.57 Injurious Fall (out of fallers) 51% 77% 0.08 Pain Severity 1.3 (1.5) 1.9 (1.8) 0.03 Pain Interference 1.0 (1.6) 1.5 (2.0) 0.06 Neuropathy (yes) 43% 30% 0.15 SAFFE 0.25 (0.37) 0.34 (0.47) 0.15 LLFDI disability limitation 77.7 (14.8) 0.02 0.02 LLFDI overall function 68.5 (10.9) 0.02 0.02 LLFDI function lower extremity 81.6 (14.4) <0.01 <0.01 LLFDI function-advanced lower extremity 63.7 (16.2) 0.02 0.02 †Numbers may not add up to 100 due to missing data * Significance test compares breast vs other *** Significance test compares Caucasian/white vs other Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5968659","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":412090208,"identity":"08593da9-9fd5-4e18-8db7-3cb7cb11f7a8","order_by":0,"name":"Jessica Sitemba","email":"","orcid":"","institution":"Oregon Health \u0026 Science University","correspondingAuthor":false,"prefix":"","firstName":"Jessica","middleName":"","lastName":"Sitemba","suffix":""},{"id":412090210,"identity":"ae6a0261-9eb0-4be4-8bc0-0dc55826c451","order_by":1,"name":"Mary Crisafio","email":"","orcid":"","institution":"Oregon Health \u0026 Science University","correspondingAuthor":false,"prefix":"","firstName":"Mary","middleName":"","lastName":"Crisafio","suffix":""},{"id":412090212,"identity":"85e5b97e-d966-4cb8-b4d5-9a0cad1460e9","order_by":2,"name":"Fuzhong Li","email":"","orcid":"","institution":"Oregon Research Institute","correspondingAuthor":false,"prefix":"","firstName":"Fuzhong","middleName":"","lastName":"Li","suffix":""},{"id":412090214,"identity":"fbd2a1cc-791b-459a-93a1-fe90a98e8993","order_by":3,"name":"Elizabeth Eckstrom","email":"","orcid":"","institution":"Oregon Health \u0026 Science University","correspondingAuthor":false,"prefix":"","firstName":"Elizabeth","middleName":"","lastName":"Eckstrom","suffix":""},{"id":412090217,"identity":"324cb220-76cb-4f1c-8fec-da2f491cacfb","order_by":4,"name":"Kerri M. Winters-Stone","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwUlEQVRIiWNgGAWjYDACZghlwM/AA2YwNhChBazIQLKBaC1QRQYGB4jVYnCc9/iDj3vqjI2P9x7+zMNgI7vhACEth/kSG2c8O2xmduZcmjQPQ5oxQS1mh3kMm3kOHLAxu5FjxszDcDiROC1/DtTZGM/IMQY67D+RWhgOMJsZSOQYAB12gLAWe6CWmT0HDhtLnDljJjnHINl4JiEtkv1nDD78OFBn2N/eY/zhTYWdbB8hLWjAgDTlo2AUjIJRMApwAABlq0MOHPdZRwAAAABJRU5ErkJggg==","orcid":"","institution":"Oregon Health \u0026 Science University","correspondingAuthor":true,"prefix":"","firstName":"Kerri","middleName":"M.","lastName":"Winters-Stone","suffix":""}],"badges":[],"createdAt":"2025-02-05 21:53:16","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5968659/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5968659/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":75897616,"identity":"8ca1cf5b-c1b0-45df-9103-6a8624e93821","added_by":"auto","created_at":"2025-02-10 10:40:33","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":35214,"visible":true,"origin":"","legend":"\u003cp\u003eRecruitment Flow by Strategy through Randomization\u003c/p\u003e\n\u003cp\u003e*Not specified: women who expressed interest by contacting study staff who were unable to get a successful follow-up contact to find out how they heard about the study\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5968659/v1/1fd2345d413a875bd192e96c.png"},{"id":75896201,"identity":"1b956f6a-a186-4e33-9ece-01b51e325fa4","added_by":"auto","created_at":"2025-02-10 10:32:33","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":50573,"visible":true,"origin":"","legend":"\u003cp\u003eRetention of GET FIT participants by study arm during the supervised exercise intervention and follow-up periods.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5968659/v1/b728495301edb7b140344813.png"},{"id":75896203,"identity":"8602687c-c517-492a-a147-ecc9ec903554","added_by":"auto","created_at":"2025-02-10 10:32:33","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":53333,"visible":true,"origin":"","legend":"\u003cp\u003eAdherence to GET FIT interventions (% of prescribed sessions attended) by study arm over six months.\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5968659/v1/ae965d08517fa49fb56f7d21.png"},{"id":78481281,"identity":"752cb30d-82e9-4179-a814-2762e8c38180","added_by":"auto","created_at":"2025-03-13 19:16:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1041427,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5968659/v1/af3ffa6b-0c74-4edd-b35a-4163dae2023e.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Evaluating recruitment, retention and adherence patterns in the GET FIT fall prevention exercise trial in older, postmenopausal cancer survivors","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eCancer and its treatment can exacerbate age-related declines in physical functioning and increase fall risk [\u003cspan additionalcitationids=\"CR2\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The GET FIT trial was a 3-arm randomized controlled trial testing the efficacy of strength training or tai ji quan training compared to a placebo exercise (stretching) condition on fall rates in postmenopausal women who received chemotherapy for cancer [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The exercise interventions in GET FIT were supervised, facility-based, group exercise programs to better ensure fidelity and safety of exercise programs, optimize outcomes with supervised exercise, utilize social support to promote retention and adherence, and economically deliver a training program. Enrolling cancer survivors into supervised, facility-based group exercise programs and achieving high adherence and retention rates is a challenge for clinical exercise research, particularly with a need for adequately powered sample sizes to detect changes in event rates such as falls [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Facility-based group exercise interventions can impose additional constraints over non-interventional or even therapeutic trials, including travel to a facility, substantial time commitment to attend programs, and scheduling constraints with set class days and times that can be barriers to exercise [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. While women cancer survivors express interest in engaging in exercise programs [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], a woman\u0026rsquo;s readiness to exercise after cancer can be impacted by her starting fitness level, persistent treatment-related symptoms (e.g., pain, fatigue, and neuropathy) and lack of self-efficacy as well as other social and environmental factors (e.g., barriers to facilities and lack of social support), potentially contributing to poor adherence or drop out [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Older cancer survivors may be less likely to express interest in exercise interventions than their younger counterparts over concerns about their safety, appropriateness of exercise, and study burden [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eWhile randomized controlled trials of post-treatment exercise interventions in postmenopausal women cancer survivors describe recruitment approaches and report study retention and exercise adherence [\u003cspan additionalcitationids=\"CR12 CR13 CR14\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e], there have been no detailed reports comparing success of different recruitment strategies or characterizing study retention and adherence patterns that could inform the design and execution of future trials. Given the need for rigorous controlled trials that test exercise efficacy on outcomes important to older cancer survivors (e.g., falls, fractures, frailty, disability), further detailed reporting on trial accrual, retention, and adherence from completed clinical exercise trials can benefit the research community and help guide implementation into practice. Thus, the aims of this secondary analysis of data from the GET FIT trial [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] are to: 1) describe and compare accrual rates across a variety of recruitment strategies, 2) describe study retention and adherence and and compare characteristics of study completers versus non-completers and of good versus poor adherers to exercise programs.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Procedures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDetails outlining the study setting, design, participants, procedures, and interventions have been previously published [4]. Briefly, GET FIT was a 3-arm randomized controlled trial of postmenopausal cancer survivors aged 50-75 years who had completed chemotherapy. The sample size powered to test for intervention differences in fall rates was n=456 (accounting for planned attrition of 20%), or 152 per study arm. Enrolled participants were randomized into one of three supervised, facility-based, group exercise interventions (strength training, tai ji quan, or stretching [control]) twice-weekly for 6 months. After supervised training stopped, women were provided an exercise video and written guide to follow at home on their own and were reassessed 6 months later. Participants underwent testing sessions at baseline, 3, 6 and 12 months which included completing questionnaires and physical performance tests previously described [4]. Questionnaire-based measures included in this analysis were baseline demographic and clinical characteristics, comorbidities (Functional Comorbidity Index and Charlson Comorbidity Index) [16], fear of falling (Survey of Activities and Fear of Falling in the Elderly-SAFFE) [17], and lifestyle physical activities outside of the exercise intervention (CHAMPS Physical Activity Questionnaire for Older Adults) [19]. Falls were tracked and collected via monthly surveys. The exercise classes were held at Oregon Health and Science University (OHSU), an academic medical center, plus six community locations in and around the Portland metro area in Oregon. Community settings were strategically selected to reach different geographical sectors of the Portland metro area to reduce barriers to participation related to time and travel. Classes were held on specific days and times, lasted 60 minutes per session, were led by a certified group exercise instructor, in groups of 15-20 participants per class. \u0026nbsp;All study procedures and written informed consent, were reviewed, and approved by the OHSU Institutional Review Board (IRB #8560). The trial is registered with ClinicalTrials.gov (NCT01635413).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Sample\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInclusion criteria were: 1) diagnosed with stage I-III cancer other than cancer of the brain or spinal cord, 2) completed chemotherapy \u0026gt;3 months prior to enrollment, 3) aged 50-75 on date of enrollment, 4) physically underactive (\u0026lt;60 minutes of moderate intensity exercise per week the month prior to enrollment), 5) ability to provide informed consent, and 6) free of contraindications to moderate-intensity exercise.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecruitment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFive different strategies were used to recruit women into the trial. These included (a) cancer registries, (b) clinician referral, (c) mailed invitations to past research participants, (d) community outreach (e.g., attending cancer and health related events, posting flyers, email blasts), and (e) screening and outreach through electronic health records (EHR). Accrual rates for each strategy were calculated as the number of women who were randomized and received the intervention (n=442) out of the number of interested and eligible women within each recruitment strategy. We briefly describe each strategy in detail below.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCancer Registries\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe utilized two cancer registries to recruit participants, the Oregon State Cancer Registry (OSCaR) and the OHSU Hospital Cancer Registry. OSCaR is a population-based tumor registry run by the Oregon Health Authority that collects and analyzes information on cancer cases in Oregon. To partner with the registry, the GET FIT protocol and recruitment approach was approved by the OSCaR advisory board and Oregon Health Authority IRB. The OSCAR registry identified potential participants by age, cancer site, diagnosis date and treatment type. Each woman\u0026rsquo;s physician of record was sent a letter from OSCaR informing them that their patient would be sent a letter about the trial. In accordance with HIPAA5145 regulations, the OSCaR registry would next mail women a joint OHSU-OSCaR information letter describing the study along with a pre-paid response form to allow the study team permission to contact them about the study (n=5145 letters sent). In addition to OSCaR, \u0026nbsp;the OHSU registry was utilized to identify more potentially eligible women who were treated for cancer at OHSU but had not received a letter through OSCaR (n=824 letters sent).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eResearch Repository\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe research team has an IRB-approved research repository of persons who provided permission to be contacted for future study opportunities from prior recruitment efforts. Women who met basic eligibility criteria (e.g., time since diagnosis, treatment type) and lived in the Portland metro area were sent an information letter (n=573 letters sent) and were asked to contact study staff by email or phone if they were interested in learning more about the trial. Women in the repository were not directly called by the study team.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eCommunity Outreach\u0026nbsp;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eRecruitment flyers were placed in OHSU clinics and in local hospitals, clinics, and community centers. Direct outreach, via engagement of several community cancer-based organizations (e.g., formal and informal support groups, charities), was used to distribute information about the study through email listservs, newsletters and events. General study advertisements were also posted on social and print media, including small community newspapers.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eClinician Referral\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOHSU oncologists were encouraged to refer potentially eligible patients to the study. If the clinician received permission from the patient for the study team to contact her, s/he then provided study staff with the patient\u0026rsquo;s medical research number (MRN) that included the patient\u0026rsquo;s contact information.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eEHR Screening\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eOHSU clinicians provided study staff permission to review the EHR of their patients to directly identify potentially eligible women. Once a woman was identified, study staff called them on the phone to discuss the study. This strategy was considered unique from the other recruitment strategies since these women were approached about the study before they received information about it from their provider or elsewhere and/or expressed interest in response to a recruitment effort.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRetention and Adherence\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMultiple strategies were used to promote retention of participants during the study period including the following: \u0026nbsp;1) assignment of every woman to a supervised, group exercise program, including controls, 2) free close-by parking for study visits and exercise classes, 3) a $10 gift card after completion of each testing appointment, 4) small study tokens like a study magnet and t-shirt, and 5) birthday cards mailed to participants. \u0026nbsp;Multiple strategies were used to promote adherence to exercise classes including: 1) professional exercise instruction to provide coaching, individual tailoring, and motivation, 2) one week of exercise class \u0026ldquo;orientation\u0026rdquo; \u0026nbsp;to provide education about exercise and establish rapport, trust and support prior to starting exercise classes, 3) regular communication between instructors and participants during and outside of classes about exercise tolerance and missed sessions, 4) fostering group dynamics within exercise classes to engender social support from peers, and 5) in-class celebrations to mark the midpoint and end of the exercise program.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStudy retention was calculated as number of completers out of the number of women who began the study interventions. Completers were defined as women who finished the 6-month exercise program and the 12-month study follow-up visit. \u0026nbsp; Adherence was calculated as the proportion of attended classes out of those prescribed. Since women were prescribed twice weekly exercise classes, we created a cutoff of 50%, or an average of 1 or more classes per week, where \u003cu\u003e\u0026gt;\u003c/u\u003e50% was deemed good adherence and \u0026lt; 50% deemed poor adherence.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical Analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDescriptive analyses were run to calculate mean, standard deviation and/or proportions as appropriate for each outcome. A chi-square analysis was conducted to compare differences in accrual rates across recruitment strategies. Differences in baseline demographics, clinical characteristics and study outcomes between completers and non-completers and between good and poor adherers were examined by unpaired \u003cem\u003et\u003c/em\u003e tests for continuous variables and chi-square or Fisher\u0026rsquo;s exact test for categorical variables. All statistical procedures were performed using the SPSS statistical software program, version 24.0 (SPSS, Inc., Chicago, IL, USA); a 2-tailed p-value \u0026lt;0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"RESULTS","content":"\u003cp\u003e\u003cstrong\u003eStudy Sample\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eParticipants were enrolled into the GET FIT study between January 2013 and September 2015. A total of 1490 women, identified through our various recruitment strategies, were screened per study eligibility (Fig 1). Of these, 457 were eligible and randomized. Fifteen women either became ineligible (i.e., cancer recurrence) or discontinued study participation prior to the start of the interventions (Fig 1), resulting in an overall accrual rate of 30% over a 33-month recruitment period. The accrual rate of interested persons was similar across all initial strategies, ranging from 29%-37%, except for EHR screening which resulted in zero accruals. The cancer registries were the most fruitful (n=868), and with a similar accrual rate as other approaches, yielded the highest number of enrolled participants (n=279; 32%) (Table 1). Recruitment from the research repository had a smaller yield (n=78), but the highest accrual rate (37%)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRetention\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOf the 442 women who began the study interventions, 385 (87%) completed both the 6-month exercise program and the 12-month follow-up testing visit. \u0026nbsp;Of the 57 (13%) non-completers, 52 did not complete the 6-month exercise program and an additional 5 did not complete the final testing visit, resulting in retention rates of 88% and 87% during the first and second halves of the study, respectively (Figure 2). The majority of non-completers (n=24) withdrew within the first month of the study (Figure 2). Reasons for withdrawal among the non-completers included being too busy (n=18), disliking the class assignment (n=9), no longer interested (n=8), family emergency (n=5), poor health (n=4), schedule conflicts (n=4), transportation issues (n=3), musculoskeletal issues (n=3), and deceased (n=3). There were no significant differences in the number of non-completers across the study arms (p=.471). \u0026nbsp;The only significant difference in baseline characteristics between non-completers and completers was the SAFFE score, where non-completers reported more worry about falling when performing activities of daily living at baseline compared to the completers (p=0.03) (Table 2).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eAdherence\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAdherence over the 6-month active exercise intervention averaged 73%, 71%, and 74% for the strength, tai ji quan, and stretching (control) groups, respectively, with no significant difference across study groups. Average adherence rates to supervised classes were highest in the first month of the program (82%), then showed a steady decline (by about 10%) for the next two months of the program and remained steady after that (Figure 3). Women who were considered poor adherers had significantly higher BMI (p\u0026lt;0.01), more comorbidities (p\u0026lt;0.01), higher self-reported pain (p\u0026lt;0.05), lower self-reported physical function (p\u0026lt;0.05), greater disability (p\u0026lt;0.05), and were more likely to be single (p=0.01) compared to good adherers (Table 3).\u0026nbsp;\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eOverall, we were able to enroll and retain a large number of older, postmenopausal cancer survivors into a large clinical trial of 6-month supervised, facility-based group exercise interventions testing the efficacy of exercise-based fall prevention approaches. We used five different strategies to recruit women, reaching our target enrollment (n\u0026thinsp;=\u0026thinsp;456) with a 30% accrual rate over a 33-month period. This accrual rate was similar to or higher than that reported in several other randomized controlled trials of cancer survivors that included a supervised, facility-based, group exercise intervention lasting 6 months or more [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Hayes et al reported a 63% accrual rate to an 8-month long facility-based group exercise intervention in post-surgical breast cancer patients by provider referral at the time of surgery [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Similar to other exercise trials, our use of cancer registries was the most effective recruitment tool for enrolling a large sample [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. While the relative accrual rate from the registries was comparable to other methods, the number of women who can be reached through the registries is much higher than other approaches, yielding higher absolute numbers of enrolled participants. State and hospital cancer registries may be an effective resource for enrolling large numbers of participants into trials, but research teams should also consider the administrative challenges that this recruitment method may pose including fees, additional IRB approvals, and coordination of large mailings and/or phone calls, all of which can make this high yield approach resource intensive. In comparison, directly calling patients identified through the EHR was both time-intensive and unfruitful. While providers gave the research team permission to contact their patients, they did not discuss the study with their patient beforehand nor did the patient receive information about the study prior to the call from the research team, likely leaving the patient unready to receive a recruitment call. In an improved approach, we now encourage the provider to send an electronic message to their patient introducing and endorsing the study, prior to any contact from the study team. This approach, though being more fruitful, will only work for patients who opt into patient portals, such as MyChart. For patients who do not opt in, sending information by mail or providing it at a clinic visit could also be a \u0026ldquo;soft introduction\u0026rdquo; to the study and lead to a more successful recruitment call.\u003c/p\u003e \u003cp\u003eBoth retention and adherence rates in our trial were similar to or higher than rates reported in other randomized controlled trials of female cancer survivors that included a supervised facility-based group intervention lasting 6 months or more [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e, \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Overall, there were no differences in baseline characteristics between completers and non-completers with one exception. Non-completers reported significantly higher worry about falls compared to those who finished the study. Since our trial was focused on fall prevention, this is a curious paradox, but might be explained in part by the known relationship between fear of falling and self-restricted activity levels [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Women in our study who had a greater fear of falling, and who were also underactive per study eligibility criteria, may have felt more worry about falls as they started a new exercise program, though this concern was not specifically cited by any of these women as a reason for withdrawing. Since activity restriction can lead to a greater risk of falls and since exercise offers protection against falls, including specific strategies to reduce concern for falling, such as cognitive behavioral therapy, should be considered.\u003c/p\u003e \u003cp\u003eThe benefits from exercise are often stronger with greater adherence to exercise [\u003cspan additionalcitationids=\"CR25\" citationid=\"CR23\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In our study a small proportion of participants (14%) attended less than half of the prescribed classes and understanding this subgroup could inform adherence strategies in future studies. Participants with poor attendance had higher BMI, more comorbidities, self-reported pain, and disability, lower self-reported physical function and were more likely to be single. Other studies have also shown high BMI as a predictor for low adherence to exercise [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. One study of breast cancer survivors exercising during treatment reported that less physically fit women were more likely to have poor adherence to exercise prescriptions [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e29\u003c/span\u003e], while others have reported that low self-efficacy and greater physical limitations are key determinants of poor exercise adherence after cancer treatment [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e]. Since survivors with poorer health are at greatest risk of further physical decline and therefore could benefit from supervised exercise, incorporating strategies to improve adherence in this subgroup is important. Despite having a second instructor in class to modify programs for participants with low initial functioning (e.g., wall pushups instead of knee pushups), this approach was less successful in retaining these participants. Perhaps the need to have modified exercises within a group setting may have led to feelings of low self-confidence or efficacy which are known to lead to poor adherence. Confidence-enhancing strategies may be needed, especially during the initial acclimation period, for women with low baseline functioning and movement efficacy to slowly ease into structured, prescribed exercise programs.\u003c/p\u003e \u003cp\u003eThere are limitations to interpreting our findings. Our sample was well educated and mostly identified as non-Hispanic white living in a metropolitan area. Thus, it is possible that our findings may not translate directly to a more racially and ethnically diverse patient population living in different geographic regions. Future studies should increase participant diversity and thus the generalizability of the results by using recruitment methods like community-based participatory research and physician-informed and engaged referrals, since engagement in clinical trials research among underserved groups is notably low. Additionally, participant age was limited to women who were no older than 75 years of age to better test the efficacy of the interventions on falls associated with chemotherapy rather than advanced age and/or age-related comorbidities. Barriers to engagement in clinical research, exercise tolerance and adherence may differ among women over 75 years of age. Importantly, this group is also underrepresented in exercise oncology research and deserves more attention as the proportion of cancer survivors over the age of 75 will double in the coming decades.\u003c/p\u003e \u003cp\u003eThe GET FIT study demonstrated success in recruiting older postmenopausal cancer survivors into a large exercise clinical trial using strategies primarily involving state and hospital cancer registries. Once enrolled women were highly likely to complete participation in 6 months of supervised, facility-based exercise, and study follow-up visits over a year. However, women\u0026rsquo;s initial health status and physical function affected our ability to train and retain this small, yet important, subgroup of women who may have benefitted from structured exercise. Future exercise oncology studies need to consider targeted strategies to improve retention and adherence among women with poorer health throughout intervention and follow up periods.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003eClinicaltrials.gov\u003c/h2\u003e\n\u003cp\u003eNCT01635413\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis work was supported by a National Cancer Institute 1R01CA163474-01 to Dr. Winters-Stone.\u003c/p\u003e\n\u003ch2\u003eDisclosures:\u003c/h2\u003e\n\u003cp\u003eThe authors have no relevant financial or non-financial interests to disclose\u003c/p\u003e\n\u003ch2\u003eEthics Approval:\u003c/h2\u003e\n\u003cp\u003eThis study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Oregon Health \u0026amp; Science University Institutional Review Board (IRB##8560).\u003c/p\u003e\n\u003ch2\u003eFunding:\u003c/h2\u003e\n\u003cp\u003eNational Cancer Institute 1R01CA163474-01 to Dr. Winters-Stone\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eMaterial preparation, data collection and analysis were performed by JS, MC and KWS. The first draft of the manuscript was written by JS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eThe authors thank the GET FIT participants for their time and effort. The authors would also like to thank Carolyn Guidarelli and Lauren Bumgarner for their assistance with project management and data collection and Cassie Boisvert for her assistance with revising the manuscript. The authors recognize the Oregon State Cancer Registry for their collaboration on recruitment for this trial. The Oregon State Cancer Registry is one of the participating registries funded by the National Program of Cancer Registries under the Centers for Disease Control and Prevention.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eChen Z, Maricic M, Aragaki AK, et al. Fracture risk increases after diagnosis of breast or other cancers in postmenopausal women: results from the Women\u0026rsquo;s Health Initiative. \u003cem\u003eOsteoporos Int\u003c/em\u003e. 2009;20(4):527-536. doi:10.1007/s00198-008-0721-0\u003c/li\u003e\n\u003cli\u003eWinters-Stone KM, Torgrimson B, Horak F, et al. 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Fear of falling and activity restriction: the survey of activities and fear of falling in the elderly (SAFE). \u003cem\u003eJ Gerontol B Psychol Sci Soc Sci\u003c/em\u003e. 1998;53(1):P43-50. doi:10.1093/geronb/53b.1.p43\u003c/li\u003e\n\u003cli\u003eStewart AL, Mills KM, King AC, Haskell WL, Gillis D, Ritter PL. CHAMPS physical activity questionnaire for older adults: outcomes for interventions. \u003cem\u003eMed Sci Sports Exerc\u003c/em\u003e. 2001;33(7):1126-1141. doi:10.1097/00005768-200107000-00010\u003c/li\u003e\n\u003cli\u003eKoutoukidis DA, Beeken RJ, Manchanda R, et al. Diet, physical activity, and health-related outcomes of endometrial cancer survivors in a behavioral lifestyle program: the Diet and Exercise in Uterine Cancer Survivors (DEUS) parallel randomized controlled pilot trial. \u003cem\u003eInt J Gynecol Cancer Off J Int Gynecol Cancer Soc\u003c/em\u003e. 2019;29(3):531-540. doi:10.1136/ijgc-2018-000039\u003c/li\u003e\n\u003cli\u003eRogerino A, Grant LL, Wilcox H, Schmitz KH. Geographic recruitment of breast cancer survivors into community-based exercise interventions. \u003cem\u003eMed Sci Sports Exerc\u003c/em\u003e. 2009;41(7):1413-1420. doi:10.1249/MSS.0b013e31819af871\u003c/li\u003e\n\u003cli\u003eKirkham AA, Van Patten CL, Gelmon KA, et al. Effectiveness of Oncologist-Referred Exercise and Healthy Eating Programming as a Part of Supportive Adjuvant Care for Early Breast Cancer. \u003cem\u003eThe Oncologist\u003c/em\u003e. 2018;23(1):105-115. doi:10.1634/theoncologist.2017-0141\u003c/li\u003e\n\u003cli\u003eYardley L, Smith H. A prospective study of the relationship between feared consequences of falling and avoidance of activity in community-living older people. \u003cem\u003eThe Gerontologist\u003c/em\u003e. 2002;42(1):17-23. doi:10.1093/geront/42.1.17\u003c/li\u003e\n\u003cli\u003evan Gool CH, Penninx BWJH, Kempen GIJM, et al. Effects of exercise adherence on physical function among overweight older adults with knee osteoarthritis. \u003cem\u003eArthritis Rheum\u003c/em\u003e. 2005;53(1):24-32. doi:10.1002/art.20902\u003c/li\u003e\n\u003cli\u003eMartin CK, Church TS, Thompson AM, Earnest CP, Blair SN. Exercise dose and quality of life: a randomized controlled trial. \u003cem\u003eArch Intern Med\u003c/em\u003e. 2009;169(3):269-278. doi:10.1001/archinternmed.2008.545\u003c/li\u003e\n\u003cli\u003eFielding RA, Katula J, Miller ME, et al. Activity adherence and physical function in older adults with functional limitations. \u003cem\u003eMed Sci Sports Exerc\u003c/em\u003e. 2007;39(11):1997-2004. doi:10.1249/mss.0b013e318145348d\u003c/li\u003e\n\u003cli\u003eLatka RN, Alvarez-Reeves M, Cadmus L, Irwin ML. Adherence to a randomized controlled trial of aerobic exercise in breast cancer survivors: the Yale exercise and survivorship study. \u003cem\u003eJ Cancer Surviv Res Pract\u003c/em\u003e. 2009;3(3):148-157. doi:10.1007/s11764-009-0088-z\u003c/li\u003e\n\u003cli\u003eCourneya KS, Segal RJ, Gelmon K, et al. Predictors of adherence to different types and doses of supervised exercise during breast cancer chemotherapy. \u003cem\u003eInt J Behav Nutr Phys Act\u003c/em\u003e. 2014;11:85. doi:10.1186/s12966-014-0085-0\u003c/li\u003e\n\u003cli\u003eKampshoff CS, Jansen F, van Mechelen W, et al. Determinants of exercise adherence and maintenance among cancer survivors: A systematic review. \u003cem\u003eInt J Behav Nutr Phys Act\u003c/em\u003e. 2014;11(1):1-13. doi:10.1186/1479-5868-11-80\u003c/li\u003e\n\u003cli\u003eWitlox L, Velthuis MJ, Boer JH, et al. Attendance and compliance with an exercise program during localized breast cancer treatment in a randomized controlled trial: The PACT study. \u003cem\u003ePloS One\u003c/em\u003e. 2019;14(5):e0215517. doi:10.1371/journal.pone.0215517\u003c/li\u003e\n\u003cli\u003eOrmel HL, van der Schoot GGF, Sluiter WJ, Jalving M, Gietema JA, Walenkamp AME. Predictors of adherence to exercise interventions during and after cancer treatment: A systematic review. \u003cem\u003ePsychooncology\u003c/em\u003e. 2018;27(3):713-724. doi:10.1002/pon.4612\u003c/li\u003e\n\u003cli\u003eTheiss JA, Carpenter AM, Leustek J. Partner Facilitation and Partner Interference in Individuals\u0026rsquo; Weight Loss Goals. \u003cem\u003eQual Health Res\u003c/em\u003e. 2016;26(10):1318-1330. doi:10.1177/1049732315583980\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1. Recruitment strategies and accrual rates in the GET FIT trial\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"714\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCancer Registry\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eClinician Referral\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCommunity outreach\u003csup\u003eb\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eResearch Repository\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEHR\u003csup\u003ec\u003c/sup\u003e Screening\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNot Specified\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003eNumber assessed for eligibility\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e868\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e169\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e282\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e78\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e1490\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003eReceived intervention\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e279\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e80\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e442\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 102px;\"\u003e\n \u003cp\u003eAccrual Rate\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 96px;\"\u003e\n \u003cp\u003e32%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 84px;\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 108px;\"\u003e\n \u003cp\u003e28%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e37%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 90px;\"\u003e\n \u003cp\u003e0%*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 78px;\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 66px;\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003csup\u003e\u0026nbsp;a\u003c/sup\u003eAccrual rate is number randomized and received the intervention (n=442) divided by number of interested and eligible women within each recruitment strategy\u003c/p\u003e\n\u003cp\u003e\u003csup\u003eb\u003c/sup\u003e combines Events \u0026amp; Media and Outreach\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003csup\u003ec\u003c/sup\u003e Electronic Health Record\u003c/p\u003e\n\u003cp\u003e*Significantly lower enrollment rate than other recruitment strategies p\u0026lt;0.01\u003c/p\u003e\n\u003cp\u003eTable 2: Baseline characteristics of completers and non-completers in the GET FIT trial. Data presented as mean (M), standard deviation (SD), and range for continuous data or % of sample for categorical data.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"618\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCompleters\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNon-Completers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(n = 385)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(n = 57)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eM (SD)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eM (SD)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eGroup Assignment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Strength\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e34%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e28%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.47\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Tai Ji Quan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Stretching\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e34%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e32%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e62.0 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e62.3 (5.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.75\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eCancer Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Breast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e71%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e74%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"11\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.25*\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Cervical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Colon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Liver\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Lung\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Lymphoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Ovarian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Pancreatic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Urinary/Bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Uterine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eCancer Stage\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e28%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e21%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.72\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e26%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eRace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;White\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e90%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e88%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"5\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.30**\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;African American/Black\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Native Hawaiian/Pacific Islander\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e0.0%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Native American/Alaskan Native\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Asian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eEthnicity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Hispanic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.62\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Non-Hispanic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e96%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e97%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Married/Partnered\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e58%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e56%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.82\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; High School/GED\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e21%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"2\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.11\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026gt; High School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e79%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e66%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eEmployment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Retired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e42%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e53%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" rowspan=\"5\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Full time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e29%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e14%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Part time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e21%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Homemaker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Unemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e11%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eComorbidities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Charlson Comorbidity Index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1.9 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e2.2 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Functional Comorbidity Index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1.9 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e2.3 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.12\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e29.5 (6.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e30.4 (7.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.37\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eFall History (last 6 months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003e\u0026gt;=1 Fall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e21%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e26%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.20\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eInjurious Fall (out of fallers)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e53%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.42\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003ePain Severity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1.3 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e1.6 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.22\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003ePain Interference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e1.0 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e1.4 (2.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.17\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eNeuropathy (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e42%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e32%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.50\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 230px;\"\u003e\n \u003cp\u003eSAFFE\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.24 (0.35)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 130px;\"\u003e\n \u003cp\u003e0.40 (0.52)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 129px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eLLFDI disability limitation\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e77.3 (14.7)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e76.5 (16.8)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e0.70\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eLLFDI overall function\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e68.2 (11.0)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e66.6 (12.1)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e0.33\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eLLFDI function lower extremity\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e81.1 (14.4)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e79.5 (15.6)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e0.43\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 228px;\"\u003e\n \u003cp\u003eLLFDI function-advanced lower extremity\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e63.3 (16.3)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 132px;\"\u003e\n \u003cp\u003e61.2 (16.9)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 124px;\"\u003e\n \u003cp\u003e0.36\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 2px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026dagger;Numbers may not add up to 100 due to missing data\u003c/p\u003e\n\u003cp\u003e* Significance test compares breast vs other\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e** Significance test compares White vs other\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3: Baseline characteristics of participants who attended \u003cu\u003e\u0026gt;\u003c/u\u003e or \u0026lt; 50% of prescribed exercise classes. Data presented as mean (M), standard deviation (SD) and range for continuous data or % of sample for categorical data.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"606\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" rowspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdherence \u003cu\u003e\u0026gt;\u003c/u\u003e 50%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAdherence \u0026lt; 50%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(n = 377)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e(n = 60)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCharacteristic\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eM (SD)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eM (SD)\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e62.1 (6.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e61.9 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.86\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eCancer Type\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Breast\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e71%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e72%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"11\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.93*\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Cervical\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Colon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e7%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Liver\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Lung\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Lymphoma\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e4%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Ovarian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e6%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Pancreatic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Urinary/Bladder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Uterine\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Other\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eCancer Stage\u0026dagger;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Don\u0026apos;t know stage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.76\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;I\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e28%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e22%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;II\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e43%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;III\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e27%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e25%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;No Stage\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eRace\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;White\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e91%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e83%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.03**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;African American/Black\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Native Hawaiian/Pacific Islander\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Native American/Alaskan Native\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e0%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Asian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e3%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eEthnicity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Hispanic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e1%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.60\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Non-Hispanic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e96%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e98%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eMarital Status\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Married/Partnered\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e60%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e43%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eEducation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;High School/GED\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e21%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026gt; High School\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e79%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e66%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eEmployment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Retired\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e43%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e43%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"5\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Full time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e28%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e20%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Part time\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e17%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e22%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Homemaker\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Unemployed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e13%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eGroup Assignment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Strength\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e32%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width: 83px;\"\u003e\n \u003cp\u003e0.96\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Tai Ji Quan\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e34%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Stretching Control\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e33%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eComorbidities\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;Charlson Comorbidity Index\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e1.9 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e2.5 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.002\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eBMI (kg/m\u003csup\u003e2\u003c/sup\u003e)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e29.2 (6.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e32.2 (7.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.001\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eFall History (last 6 months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003e\u003cu\u003e\u0026gt;\u003c/u\u003e1 Fall\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e21%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e22%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eInjurious Fall (out of fallers)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e51%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e77%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.08\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003ePain Severity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e1.3 (1.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e1.9 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.03\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003ePain Interference\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e1.0 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e1.5 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 247px;\"\u003e\n \u003cp\u003eNeuropathy (yes)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 143px;\"\u003e\n \u003cp\u003e43%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e30%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 83px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 1px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 245px;\"\u003e\n \u003cp\u003eSAFFE\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 144px;\"\u003e\n \u003cp\u003e0.25 (0.37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e0.34 (0.47)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.15\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 245px;\"\u003e\n \u003cp\u003eLLFDI disability limitation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 144px;\"\u003e\n \u003cp\u003e77.7 (14.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 245px;\"\u003e\n \u003cp\u003eLLFDI overall function\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 144px;\"\u003e\n \u003cp\u003e68.5 (10.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 245px;\"\u003e\n \u003cp\u003eLLFDI function lower extremity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 144px;\"\u003e\n \u003cp\u003e81.6 (14.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 84px;\"\u003e\n \u003cp\u003e\u0026lt;0.01\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 245px;\"\u003e\n \u003cp\u003eLLFDI function-advanced lower extremity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 144px;\"\u003e\n \u003cp\u003e63.7 (16.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 132px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 84px;\"\u003e\n \u003cp\u003e0.02\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026dagger;Numbers may not add up to 100 due to missing data\u003c/p\u003e\n\u003cp\u003e* Significance test compares breast vs other\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e*** Significance test compares Caucasian/white vs other\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"exercise training, feasibility, older adult, cancer survivorship, fall prevention","lastPublishedDoi":"10.21203/rs.3.rs-5968659/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5968659/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eThe GET FIT trial tested fall prevention exercise approaches in older (50\u0026ndash;75 years) post-chemotherapy, postmenopausal cancer survivors. We describe recruitment, retention, and adherence patterns from GET FIT to inform future trials.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eParticipants were recruited through multiple strategies (e.g., cancer and research registries, clinician referral, outreach, electronic health record (EHR) screening) and were randomized to one of three supervised, facility-based, group exercise programs for six months. We compared effectiveness of accrual across recruitment strategies, examined characteristics of women who completed the interventions to those who withdrew, and women with good (\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;50%) versus poor (\u0026lt;\u0026thinsp;50%) adherence to training.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eOf 1490 interested women, 442 women were eligible, randomized, and received the assigned intervention (30% accrual rate). Accrual was similar across recruitment strategies, except for EHR screening which yielded no accruals. Retention over 12 months was 87% with most dropouts occurring within the first month. There were no differences in baseline characteristics between women who did or did not drop out. Poor adherers (n\u0026thinsp;=\u0026thinsp;60) had higher baseline BMI, comorbidities, pain, disability and lower physical functioning (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) compared to more adherent women (n\u0026thinsp;=\u0026thinsp;377).\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e \u003cp\u003eA variety of recruitment strategies appear to be effective for enrolling older, postmenopausal cancer survivors into a facility-based exercise trial, except for directly approaching women identified through the EHR. Women with poorer health were at risk for study drop-out and poor adherence to exercise.\u003c/p\u003e\u003ch2\u003eImplications for Cancer Survivors:\u003c/h2\u003e \u003cp\u003eWomen with poorer initial health may need additional retention strategies to help them stick with supervised, facility-based, group exercise.\u003c/p\u003e","manuscriptTitle":"Evaluating recruitment, retention and adherence patterns in the GET FIT fall prevention exercise trial in older, postmenopausal cancer survivors","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-02-10 10:32:28","doi":"10.21203/rs.3.rs-5968659/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7d365bf7-7db4-4aee-a5d9-4888acf659e2","owner":[],"postedDate":"February 10th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-05-05T20:53:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-02-10 10:32:28","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5968659","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5968659","identity":"rs-5968659","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}