CBSM increases likelihood of MVPA engagement in breast cancer survivorsCognitive Behavioral Stress Management Helps Breast Cancer Patients Exercise More
Health psychology : official journal of the Division of Health Psychology, American Psychological AssociationPublished August 2, 2026Study authors: St Fleur Ruth G, Ream Molly, Krueger Mason J, Crane Tracy, Blomberg Bonnie B, Antoni Michael HPubMed ↗DOI ↗Editorial oversight: Dr. Sofia Müller, MD · Lifespan & Whole-Person Care
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Key Takeaway
Consider CBSM as an adjunct to promote physical activity engagement in breast cancer patients, but not for increasing frequency.
In a randomized controlled trial, 240 women with Stage 0-III breast cancer, 2-8 weeks postsurgery, were assigned to either a 10-week group cognitive behavioral stress management (CBSM) intervention or a 1-day psychoeducational (PE) control. The primary outcome was changes in engagement versus nonengagement and frequency of engagement in moderate to vigorous physical activity (MVPA) over 12 months. Secondary outcomes included stress awareness, relaxation skills, and coping confidence. The study was published as an RCT, though the phase and setting were not reported.
Results showed that CBSM significantly increased the likelihood of becoming engaged in MVPA over time compared to the PE control in the fully adjusted model (beta = 0.45, p =.02). In the unconditional model, the likelihood of becoming engaged in MVPA also increased significantly (beta = 1.40, p <.001), and the frequency of MVPA engagement increased significantly (beta = 0.11, p <.01). However, in the fully adjusted model, CBSM did not affect MVPA frequency. Additionally, the CBSM group showed greater increases in confidence in relaxation skills (p <.001), but there were no significant differences between groups in stress awareness or coping skills.
Safety and tolerability were not reported. A key limitation is that perceived stress management skills did not mediate the relationship between CBSM and MVPA engagement, suggesting the mechanism remains unclear. The study's findings indicate that CBSM may help breast cancer patients become more physically active during primary treatment, but it does not appear to increase the overall frequency of activity. Clinicians might consider CBSM as a supportive intervention to encourage physical activity engagement, but should not expect it to boost MVPA frequency. Further research is needed to understand how CBSM exerts its effects and to replicate these findings.
How this fits prior evidence
This trial extends prior coverage by showing that a psychological intervention, CBSM, can increase the likelihood of MVPA engagement in early-stage breast cancer patients, complementing earlier findings that activity trackers with walking programs increase activity levels in this population. Unlike the RJBC-APP trial, which showed no significant impact on 12-month compliance, CBSM demonstrated a positive effect on physical activity engagement. However, CBSM did not affect MVPA frequency, and stress management skills did not mediate the effect, contrasting with the assumption that stress reduction would drive behavior change. This addresses a gap by testing a non-technological intervention, but the lack of mediation suggests the mechanism is not yet clear.
Researchers conducted a randomized controlled trial involving 240 women with Stage 0 to III breast cancer. These women were between 2 and 8 weeks after surgery. The study compared a 10-week group cognitive behavioral stress management (CBSM) program against a one-day psychoeducational session.
The results showed that women in the CBSM group were significantly more likely to engage in moderate to vigorous physical activity over time. While the program did not change how often they exercised, it did increase their confidence in relaxation skills. Other factors like stress awareness and coping skills did not show a significant difference between the two groups.
It is important to note that while the program helped women start exercising more, specific stress management skills were not found to be the direct reason for this change. This study suggests that CBSM can be a helpful tool during primary treatment to encourage physical activity. Patients should talk to their doctors about how these programs might fit into their personal recovery plans.
What this means for you:
A 10-week stress management program can help breast cancer patients become more likely to engage in exercise.
Common questions
How does the stress management program help with exercise?
The study found that the 10-week cognitive behavioral stress management (CBSM) program significantly increased the likelihood of women engaging in moderate to vigorous physical activity. While it did not change how often they exercised, it helped them become more likely to start and stick with physical activity during their treatment.
Who was included in this study?
The study included 240 women who were diagnosed with Stage 0 to III breast cancer. These women participated in the study between 2 and 8 weeks after their surgery. The results specifically look at how these patients responded to a 10-week program compared to a one-day session.
Did the program improve stress awareness or coping skills?
The study found no significant difference between the groups regarding stress awareness and coping skills. However, those in the 10-week CBSM group did show greater increases in their confidence in relaxation skills compared to the group that received only a one-day session.
OBJECTIVE: We modeled changes in both engagement versus nonengagement and frequency of engagement in moderate to vigorous physical activity (MVPA) in women with breast cancer (BC) participating in a trial of cognitive behavioral stress management (CBSM) intervention during the first year of treatment.
METHOD: We recruited 240 women with Stage 0-III BC 2-8 weeks postsurgery and randomly assigned them to either a 10-week group CBSM intervention or 1-day psychoeducational (PE) control before they began adjuvant therapy. A brief version of the Seven-Day Physical Activity (PA) Report measured frequency of MVPA, and a measure of perceived stress management skills assessed stress awareness, relaxation skills, and coping confidence in participants at baseline (T1), 6 months (T2), and 12 months (T3) after randomization. We used a two-part latent growth to model change in both engagement versus nonengagement and frequency of engagement in MVPA.
RESULTS: The unconditional model showed significant changes in frequency of engagement in MVPA over time (β = 0.11, < .01) and significant increase in the likelihood of becoming engaged in MVPA over time (β = 1.40, < .001). In a fully adjusted model, assignment to CBSM was associated with a greater likelihood of becoming engaged in MVPA over time (β = 0.45, = .02) compared with PE control, although CBSM did not affect MVPA frequency. Those in CBSM revealed greater increases in confidence in relaxation skills ( < .001) but neither stress awareness nor coping skills versus PE controls. Although greater increases in perceived stress awareness, relaxation skills, and coping confidence over time related to MVPA engagement across the entire sample, they did not mediate the effects of CBSM on changes in MVPA engagement ( > .05).
CONCLUSIONS: CBSM increased the likelihood of MVPA engagement during primary treatment for BC. However, contrary to hypotheses, perceived stress management skills did not mediate this relationship. Further research should explore additional pathways to better understand how CBSM may have supported physical activity engagement during or after cancer treatment. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
