{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T01:08:20Z","timestamp":1793840900064,"version":"4.6.1"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Canadian Cancer Society Program","award":["015469"],"award-info":[{"award-number":["015469"]}]},{"name":"Canadian Cancer Society Program","award":["021039"],"award-info":[{"award-number":["021039"]}]},{"name":"Canadian Cancer Society Program","award":["704970"],"award-info":[{"award-number":["704970"]}]},{"name":"Canadian Cancer Society Program","award":["707213"],"award-info":[{"award-number":["707213"]}]},{"name":"National Health and Medical Research Council, and in the United Kingdom by Cancer Research UK"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Colon Health and Life-Long Exercise Change (CHALLENGE) was the first phase 3 trial to examine the effects of exercise on cancer-related survival and, therefore, required a substantial and sustained increase in moderate-to-vigorous physical activity (MVPA) that had not been achieved in previous trials. Here, we report the effects of the intervention on the social cognitive beliefs that were targeted to achieve long-term exercise behavior change.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with resected colon cancer who had completed chemotherapy were randomized to health education materials (HEM) or a structured exercise program (SEP) consisting of 48 behavioral support sessions delivered over a 3-year period. Social cognitive constructs from the Theory of Planned Behavior were assessed by single items using 5-point scales at baseline and every 6\u2009months during the 3-year intervention. Regression models for repeated measurements were used to estimate the least square means and robust standard errors (SEs) for each randomized group at each time point.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Between 2009 and 2024, 889 patients were randomized to SEP (n\u2009=\u2009445) or HEM (n\u2009=\u2009444). SEP compared to HEM reported significantly more favorable social cognitive beliefs about exercise at almost all time points. Average intervention effects (AIE) across the 3-year intervention favored SEP for perceived benefit (AIE\u2009=\u20090.29; P\u2009&amp;lt;\u2009.001), enjoyment (AIE\u2009=\u20090.40; P\u2009&amp;lt;\u2009.001), difficulty (AIE = \u22120.18; P\u2009=\u2009.003), confidence (AIE\u2009=\u20090.28; P\u2009&amp;lt;\u2009.001), support (AIE\u2009=\u20090.59; P\u2009&amp;lt;\u2009.001), motivation (AIE\u2009=\u20090.47; P\u2009&amp;lt;\u2009.001), opportunity (AIE\u2009=\u20090.31; P\u2009&amp;lt;\u2009.001), and planning (AIE\u2009=\u20090.82; P\u2009&amp;lt;\u2009.001). All social cognitive variables were significantly associated with self-reported MVPA at all time points.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The SEP intervention in the CHALLENGE trial successfully targeted the social cognitive beliefs that were associated with sustained MVPA. NCT00819208.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag023","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T10:16:23Z","timestamp":1769422583000},"page":"1054-1062","source":"Crossref","is-referenced-by-count":1,"title":["Effects of a structured exercise program on motivational outcomes in patients with colon cancer"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-3918","authenticated-orcid":false,"given":"Kerry S","family":"Courneya","sequence":"first","affiliation":[{"name":"College of Health Sciences, Faculty of Kinesiology, Sport, and Recreation, University of Alberta , Edmonton, Alberta,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1505-0575","authenticated-orcid":false,"given":"Christopher M","family":"Booth","sequence":"additional","affiliation":[{"name":"Department of Oncology, Queen\u2019s University 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Health Services\u2014Cancer Care , Calgary, Alberta,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4039-5169","authenticated-orcid":false,"given":"Haryana M","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Psycho-Oncology Cooperative Research Group, School of Psychology, Faculty of Science, The University of Sydney , Sydney, New South Wales,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9566-4130","authenticated-orcid":false,"given":"Victoria","family":"Coyle","sequence":"additional","affiliation":[{"name":"Queen\u2019s University Belfast , Belfast,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-1382","authenticated-orcid":false,"given":"Kristin L","family":"Campbell","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of 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