{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:31:55Z","timestamp":1786422715945,"version":"build-2736575974"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T00:00:00Z","timestamp":1786406400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"\n Background<\/jats:title>\n Prostate cancer (PCa) survivors undergoing androgen deprivation therapy (ADT) experience significant physical and psychosocial side effects that negatively impact quality of life. Although exercise is effective in mitigating these effects, adherence to traditional programs remains low. The Golf Recreational Exercise for Enhanced Survivorship (GREENS) program was developed as a novel multimodal recreational activity (MRA) integrating structured exercise with golf to enhance engagement and sustainability.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the feasibility of the GREENS program in PCa survivors on hormone therapy, focusing on safety, adherence, enjoyment, and satisfaction, while exploring participant experiences through mixed methods.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n This single-arm, within-subjects feasibility study included a 5-week delayed-entry control period followed by a 10-week intervention. Fifteen participants were enrolled, with 11 initiating and 10 completing the intervention. Participants attended twice-weekly 90-minute group sessions combining exercise and golf activities. Feasibility outcomes included attendance, within-session adherence, adverse events (CTCAE), Physical Activity Enjoyment Scale (PACES-8), and a 4-item satisfaction scale. Post-intervention exit interviews were analyzed using thematic analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Among completers, attendance was 90% and within-session adherence was 98.9%. No adverse events \u2265 Grade 2 were reported, indicating high safety. Mean PACES-8 scores ranged from 52.9 to 54.8, and satisfaction scores ranged from 26.2 to 27.1 across program phases, demonstrating high enjoyment and satisfaction. All participants reported a strong willingness to recommend the program (mean = 7\/7), and high likelihood of continued participation (mean = 6.4\/7). Qualitative analysis identified four key themes: perceived value and satisfaction, program design and delivery, challenges and barriers, and expectations and reflections. Participants highlighted holistic health benefits, social support, skill development, and program structure as major facilitators of engagement; while scheduling and health-related factors were the primary barriers.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n The GREENS program is a safe, highly adherent, and well-accepted MRA for PCa survivors on hormone therapy. The integration of exercise with a socially engaging and skill-based activity such as golf may enhance motivation and long-term participation. These findings support further investigation of golf-based and other recreational interventions in exercise oncology.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fonc.2026.1844481","type":"journal-article","created":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:21:45Z","timestamp":1786422105000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility of the Golf Recreational Exercise for Enhanced Survivorship in prostate cancer survivors undergoing hormone therapy"],"prefix":"10.3389","volume":"16","author":[{"given":"Guanrong","family":"Cai","sequence":"first","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacek","family":"Pinski","sequence":"additional","affiliation":[{"name":"Keck School of Medicine, University of Southern California","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lori A.","family":"Michener","sequence":"additional","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Todd","family":"Schroeder","sequence":"additional","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Kirages","sequence":"additional","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joy","family":"Tu","sequence":"additional","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimiko","family":"Yamada","sequence":"additional","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Salem","sequence":"additional","affiliation":[{"name":"Division of Biokinesiology and Physical Therapy, University of Southern California","place":["Los Angeles, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,11]]},"reference":[{"key":"B1","unstructured":"Cancer Stat Facts: Prostate Cancer\n \n 2025"},{"key":"B2","unstructured":"Cancer Stat Facts: Common Cancer Sites\n \n 2025"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djab131","article-title":"Annual report to the nation on the status of cancer, part 1: national cancer statistics","volume":"113","author":"Islami","year":"2021","journal-title":"J Natl Cancer Inst"},{"key":"B4","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1038\/ncpuro1296","article-title":"Androgen deprivation therapy: progress in understanding mechanisms of resistance and optimizing androgen depletion","volume":"6","author":"Harris","year":"2009","journal-title":"Nat Clin Pract Urol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6601235","article-title":"Androgen deprivation and cognition in prostate cancer","volume":"89","author":"Salminen","year":"2003","journal-title":"Br J Cancer"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.07.010","article-title":"Adverse effects of androgen deprivation therapy and strategies to mitigate them","volume":"67","author":"Nguyen","year":"2015","journal-title":"Eur Urol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-021-00399-0","article-title":"Barriers and facilitators related to undertaking physical activities among men with prostate cancer: a scoping review","volume":"24","author":"Sattar","year":"2021","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2019.06.003","article-title":"Barriers and facilitators of adherence to a perioperative physical activity intervention for older adults with cancer and their family caregivers","volume":"11","author":"Sun","year":"2020","journal-title":"J Geriatr Oncol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14102452","article-title":"Exercise adherence in men with prostate cancer undergoing androgen deprivation therapy: a systematic review and meta-analysis","volume":"14","author":"Toohey","year":"2022","journal-title":"Cancers (Basel)"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0000000000002116","article-title":"Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable","volume":"51","author":"Campbell","year":"2019","journal-title":"Med Sci Sports Exerc"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1177\/1534735419894063","article-title":"Sport medicine in the prevention and management of cancer","volume":"18","author":"Luo","year":"2019","journal-title":"Integr Cancer Ther"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.5055\/ajrt.2022.0265","article-title":"The fitness effects of a 10-week golf training program for older adults: a non-randomized, pre-post, pilot study","volume":"21","author":"Moore","year":"2022","journal-title":"Am J Recreat Ther"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1249\/01.mss.0000517432.56468.0c","article-title":"The Golf Intervention for Veterans Exercise (GIVE) study: golf training program and study design\u2014a methodological protocol","volume":"7","author":"Du Bois","year":"2019","journal-title":"Int J Golf Sci"},{"key":"B14","first-page":"1","article-title":"The effects of a comprehensive golf training program on measures of physical performance and dynamic balance in older military veterans","volume":"9","author":"Du Bois","year":"2021","journal-title":"Int J Golf Sci"},{"key":"B15","article-title":"The lower-extremity biomechanical demands of golf play in older adult novices","volume":"12","author":"Moore","year":"2024","journal-title":"Int J Golf Sci"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.mhpa.2021.100410","article-title":"Golf as a physical activity to improve walking speed and cognition in older adults: a non-randomized, pre-post, pilot study","volume":"21","author":"Kanwar","year":"2021","journal-title":"Ment Health Phys Act"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1129028","article-title":"Effects of walking football on adherence, safety, quality of life and physical fitness in patients with prostate cancer: findings from the PROSTATA_MOVE randomized controlled trial","volume":"13","author":"Capela","year":"2023","journal-title":"Front Oncol"},{"key":"B18","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s40814-019-0499-1","article-title":"Guidelines for reporting non-randomised pilot and feasibility studies","volume":"5","author":"Lancaster","year":"2019","journal-title":"Pilot Feasibility Stud"},{"key":"B19","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1186\/s40814-018-0326-0","article-title":"Pilot and feasibility studies in exercise, physical activity, or rehabilitation research","volume":"4","author":"El-Kotob","year":"2018","journal-title":"Pilot Feasibility Stud"},{"key":"B20","first-page":"89","article-title":"Golf Recreational Exercise for Enhanced Survivorship (GREENS) in prostate cancer survivors: protocol for a feasibility and efficacy pilot study","volume":"29","author":"Cai","year":"2026","journal-title":"J Exerc Physiol"},{"key":"B21","unstructured":"Common Terminology Criteria for Adverse Events (CTCAE) V5.0\n \n 2017"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5868-8-103","article-title":"Measuring enjoyment of physical activity in older adults: invariance of the physical activity enjoyment scale (PACES) across groups and time","volume":"8","author":"Mullen","year":"2011","journal-title":"Int J Behav Nutr Phys Act"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1093\/geroni\/igab041","article-title":"Questions to measure enjoyment of and satisfaction with physical activity: are they appropriate for use in an older population","volume":"5","author":"Huffman","year":"2021","journal-title":"Innov Aging"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.2196\/games.4275","article-title":"Exposure to \u201cexergames\u201d increases older adults\u2019 perception of the usefulness of technology for improving health and physical activity: a pilot study","volume":"3","author":"Bird","year":"2015","journal-title":"JMIR Serious Games"},{"key":"B25","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"Braun","year":"2006","journal-title":"Qual Res Psychol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1123\/tsp.2022-0113","article-title":"It\u2019s absolutely essential\u201d: sport and performance psychology practitioners\u2019 perspectives on training, use, and importance of debriefing in applied work","volume":"37","author":"Maurice","year":"2023","journal-title":"Sport Psychol"},{"key":"B27","doi-asserted-by":"publisher","first-page":"347","DOI":"10.1007\/s00520-025-09410-z","article-title":"I\u2019ve got plenty of energy when I\u2019m doing something I want to do\u201d: applying self-determination theory to exercise motivation in people with prostate cancer","volume":"33","author":"Naismith","year":"2025","journal-title":"Support Care Cancer"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/4653635","article-title":"Efficacy of Wii-Fit on static and dynamic balance in community-dwelling older veterans: a randomized controlled pilot trial","volume":"2017","author":"Padala","year":"2017","journal-title":"J Aging Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1089\/g4h.2021.0104","article-title":"Physical activity and exergames among older adults: a scoping review","volume":"11","author":"Ismail","year":"2022","journal-title":"Games Health J"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/167651","article-title":"We\u2019re all in the same boat\u201d: a review of the benefits of dragon boat racing for women living with breast cancer","volume":"2012","author":"Harris","year":"2012","journal-title":"Evid Based Complement Alternat Med"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1111\/sms.12193","article-title":"All boys and men can play football\u201d: a qualitative investigation of recreational football in prostate cancer patients","volume":"24","author":"Bruun","year":"2014","journal-title":"Scand J Med Sci Sports"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-021-00406-4","article-title":"Exercise medicine in men with prostate cancer: breaking barriers to increase participation","volume":"24","author":"Galv\u00e3o","year":"2021","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(97)90058-7","article-title":"Neuromuscular fatigue in prostate cancer patients undergoing radiation therapy","volume":"78","author":"Monga","year":"1997","journal-title":"Arch Phys Med Rehabil"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3389\/fspor.2021.687365","article-title":"Relationship between cancer-related fatigue, physical activity related health competence, and leisure time physical activity in cancer patients and survivors","volume":"3","author":"Koeppel","year":"2021","journal-title":"Front Sports Act Living"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1037\/hea0000161","article-title":"From ideas to efficacy: the ORBIT model for developing behavioral treatments for chronic diseases","volume":"34","author":"Czajkowski","year":"2015","journal-title":"Health Psychol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1844481\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,11]],"date-time":"2026-08-11T04:21:47Z","timestamp":1786422107000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1844481\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,11]]},"references-count":35,"alternative-id":["10.3389\/fonc.2026.1844481"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1844481","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,11]]},"article-number":"1844481"}}