Courneya 2003a.

Study characteristics
Methods	Study design: cluster RCT, where clusters were psychotherapy classes Number randomized: 108; 60 (in 11 classes) to the exercise group and 48 (in 11 classes) to the control group Study start and stop dates: the group psychotherapy classes were conducted between September 1998 and April 2001 Length of intervention: 10 weeks Length of follow‐up: to end of the intervention
Participants	Type cancer: breast cancer, 40.6%; colon cancer, 9.4%; ovarian cancer, 5.2%; stomach cancer, 4.2%, melanoma, 4.2%; Hodgkin disease, 3.1%; NHL, 3.1%; brain cancer, 3.1%; lung cancer, 3.1%; other, 15.6%; missing, 8.3% Time since cancer diagnosis, mean (SD) months: exercise group: 16.79 (18.45) months control group: 15.71 (16.70) months Time beyond active treatment: not reported, although 43.5% of participants in exercise group and 45.2% of participants in control group were still receiving treatment  Inclusion criteria: diagnosis of cancer voluntary participation in a group psychotherapy class offered at the cancer institute ability to answer questions written in English Eligibility criterion related to interest or ability to exercise, or both: passing the rPAR‐Q, a screening tool to determine the need to consult a physician before increasing exercise levels no contraindications to moderate‐intensity exercise based on a submaximal fitness assessment were inclusionary Exclusion criteria: none Gender, %: exercise group: female, 84.4% control group: female, 86.7% Current age, mean (SD) years: exercise group: 52.51 (10.21) years control group: 50.53 (10.08) years Age at cancer diagnosis: not reported Ethnicity/race: not reported Education level, % completing university: exercise group: 57.1% control group: 60.5% SES, % with family income > USD40,000: exercise group: 63.0% control group: 71.1% Employment status, % currently employed: exercise group: 64.61% control group: 47.7% Comorbidities: not reported Past exercise history, mean (SD) minutes participants engaged in mild, moderate, or strenuous exercise: exercise group: 192.53 (227.43) minutes control group: 137.68 (117.76) minutes On hormone therapy: not reported
Interventions	60 participants assigned to the personalized exercise intervention, including: prescription for walking although participants were allowed to choose alternate mode of exercise (e.g. swimming, cycling) group psychotherapy Type exercise (aerobic/anaerobic): aerobic Intensity of experimental exercise intervention: goal was to achieve 65% to 75% of estimated HR maximum as soon as safely possible Frequency: 3 to 5 times per week Duration of individual sessions: 20 to 30 minutes Duration of exercise program: 10 weeks Total number of exercise sessions: variable, but maximum would be 50 sessions Format: individual Facility: home, with group psychotherapy classes offered in facility (Cross Cancer Institute) Not professionally led 48 participants assigned to the control group, including: group psychotherapy Adherence: 51/60 participants completed the 10‐week intervention; 43/51 (84.3%) achieved the minimum exercise prescription of 60 minutes of moderate to strenuous exercise per week and 16/51 (31.4%) achieved the optimum exercise prescription of 150 minutes of moderate to strenuous exercise per week. Total minutes of exercise, mean (SD) 196.65 (149.56) minutes Contamination of control group: mean (SD) minutes when participants in the control group participated in exercise 100.91 (104.24) minutes
Outcomes	No primary outcome was identified. QoL outcomes included: QoL, assessed using the FACT‐G and subscales for physical, functional, emotional, social/family, and spiritual wellbeing satisfaction with life, measured using the SWLS depression, assessed by the CES‐D scale anxiety, assessed by the STAI fatigue, assessed using the 13‐item FACT‐F Outcomes were measured at baseline and 10 weeks: exercise group: n = 60 at baseline, n = 51 at 10 weeks control group: n = 48 at baseline, n = 45 at 10 weeks Subgroup analysis: several subgroup analyses were prespecified and conducted Adverse events: none reported
Notes	Country: Canada Funding: NIH, Canadian Institutes of Health Research, NCIC, CCS, CCS/NCIC Sociobehavioral Cancer Research Network
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Allocation sequence was generated using a random numbers table
Allocation concealment (selection bias)	High risk	Allocation was not completely concealed. It was concealed from the fitness appraiser but not from other study personnel
Blinding of participants and personnel (performance bias) All outcomes	High risk	Owing to the nature of the intervention, it was not possible to blind the participants; however, it is unclear whether the outcome was influenced by a lack of masking
Blinding of outcome assessment (detection bias) All outcomes	High risk	Study personnel and outcome assessors were not masked or blinded to the study interventions
Incomplete outcome data (attrition bias) All outcomes	High risk	Although stated that analyses were conducted on an ITT basis, the treatment of missing data was not described. There was substantial attrition from the study in both study groups
Selective reporting (reporting bias)	Low risk	There is no evidence of selective reporting of outcomes
Other bias	Low risk	The trial appears to be free of other problems that could put it at a high risk of bias