Evaluating the feasibility and acceptability of a physical activity intervention program guided by the COM-B model for colorectal cancer survivors: A pilot study.

PURPOSE: Physical inactivity is prevalent among colorectal cancer (CRC) survivors and is associated with adverse health and rehabilitation outcomes. However, theory-driven interventions to promote physical activity (PA) in this population remain scarce. This study aimed to evaluate the feasibility and acceptability of a PA intervention program guided by the Capability-Opportunity-Motivation-Behavior (COM-B) model in CRC survivors, and to explore its preliminary effectiveness.

METHODS

A single-arm pre-post pilot study was conducted with 28 CRC survivors at a tertiary hospital in Wuxi, China. A 12-week COM-B model-guided PA intervention was implemented between March and June 2025. Feasibility was assessed via recruitment and retention rates. Acceptability was evaluated using a mixed-methods approach combining self-report questionnaires with semi-structured interviews; qualitative data were analyzed through content analysis. Pre- and post-intervention outcome changes were examined using paired t-test or Wilcoxon signed-rank tests as appropriate, and Cohen's d was calculated to estimate preliminary effectiveness.

RESULTS

Of 36 eligible CRC survivors approached, 28 completed the baseline assessment, and 23 completed the post-intervention assessment. Feasibility was supported by a recruitment rate of 77.8% and a retention rate of 82.1%. Both self-report questionnaires and semi-structured interviews indicated that participants' satisfaction levels exceeded the pre-defined acceptability threshold (scores >21), confirming program acceptability. The intervention demonstrated medium effects on PA levels and health-related outcomes (Cohen's d = 0.28-0.78), supporting its preliminary effectiveness.

CONCLUSIONS

This 12-week COM-B model-guided PA intervention demonstrated feasibility, acceptability, and preliminary effectiveness among CRC survivors. A full-scale randomized controlled trial is warranted to further validate the program's long-term efficacy.