Exploring Associations of Sedentary Behavior and Physical Activity with Quality of Life in Young Adult Cancer Survivors.

PURPOSE: To explore sedentary behavior, physical activity (PA), and quality of life (QoL) in young adult cancer survivors (YACS), a population that is underrepresented in the literature. METHODS: YACS 18-44 years of age, recruited through social media and cancer support group websites (e.g., Young Adult Cancer Canada), completed an online survey, which assessed sedentary behavior, PA, and QoL using validated measures (i.e., The SIT-Q, Leisure Score Index [LSI], Short Form-36 Health Survey [SF-36], and Functional Assessment of Cancer Therapy: General [FACT-G]). RESULTS: Results indicated that YACS accumulated an average of 13.0 (SD = 4.6) hours/day of total sedentary time and reported watching TV for an average of 2.3 (SD = 1.9) hours/day. For PA, participants reported a mean of 113 minutes/week of moderate-to-vigorous PA (SD = 132) and low levels of resistance exercise (M = 26 minutes/week, SD = 58). Almost a third of the participants met the public health-recommended PA guidelines, and moderate-to-vigorous PA was positively correlated with the physical component score (PCS) (r = 0.3, p < 0.01) of the SF-36. Regression analyses showed that moderate-to-vigorous PA significantly predicted the PCS [F(1, 93) = 10.6, p < 0.01, R2 = 0.1], whereas napping and TV viewing time were inversely associated with the PCS [F(2, 93) = 6.9, p < 0.01, R2 = 0.1]. CONCLUSION: Total sedentary behavior, while considerable, was not related to QoL in YACS. However, TV watching was negatively associated with QoL, suggesting the importance of measuring TV watching and other domain-specific behaviors in studies on sedentary behavior. PA levels were also associated with QoL levels in YACS.

Evaluation of the accuracy and availability of cancer-related physical activity and sedentary behaviour information on English-language websites.

PURPOSE: To assess the quality and accuracy of cancer-related physical activity (PA) and sedentary behaviour (SB) information provided on major cancer websites from English-speaking countries. DESIGN: The study used a cross-sectional design. SAMPLE: A list of major cancer websites (N = 11) was generated from countries that speak English primarily (e.g., Canada, Australia). METHODS: These websites were assessed for quality and accuracy based on a detailed coding framework (e.g., PA guidelines, PA and cancer prevention). Frequencies and descriptive statistics were derived for website characteristics of interest. FINDINGS: All sites reviewed within this study offered PA information for cancer prevention and cancer survivorship. However, while 81% of the sites presented information for SB and cancer prevention, very little information was presented for SB and cancer survivorship, with only 18.2% of the information being offered. CONCLUSIONS: The quality and accuracy of cancer-related PA and SB information presented on leading cancer websites is variable. Further information is warranted in the areas of SB, resistance training, and behaviour change strategies. IMPLICATIONS: Websites have considerable value as knowledge translation tools and, therefore, presenting evidence-based information that is easy to understand may positively impact the health and behaviours of cancer populations, as well as the general population.

The role of the built environment in a randomized controlled trial to increase physical activity among men with prostate cancer: the PROMOTE trial.

PURPOSE: The purpose of the study was to examine the association between the built environment and physical activity (PA) in prostate cancer survivors (PCS), as well as whether built environment factors (walkability, count of sports complexes) were effect modifiers of a PA intervention. METHODS: Our study included 165 PCS residing in Edmonton, Alberta, from the PROMOTE trial. The PROMOTE trial was a randomized controlled trial of a behaviour change intervention to increase PA and quality of life in PCS. In the PROMOTE trial, 423 PCS were randomly assigned to a standard physical activity recommendation, self-administered implementation intention, or telephone-assisted implementation intention group. PA and quality of life outcomes were assessed at baseline, 1, and 3 months. To explore the role of the built environment, this study examined walkability and count of sport complexes. RESULTS: Linear regression analyses revealed that the self-administered intervention group had an increase in self-reported PA minutes/week (ß = 133.4, 95% CI = -18.9 to 285.6); however, none of the built environment variables were found to be significantly associated with PA. The logistic regression showed that the self-administered intervention group had a significantly greater likelihood of meeting the PA guidelines (OR = 2.1, 95% CI = 0.9 to 4.9), though no built environment variables were associated with PA levels. CONCLUSIONS: Our findings suggest that the built environment was not associated with PA and was not an effect modifier in a PA behaviour change intervention for PCS. Further research is needed before clear conclusions can be generated ( ClinicalTrials.gov number NCT01410656).

Identification and evaluation of the salient physical activity beliefs of colorectal cancer survivors.

BACKGROUND: Physical activity (PA) has been associated with lower risk of disease recurrence and longer survival in colorectal cancer (CRC) survivors; however, less than one-third of CRC survivors are meeting PA guidelines. Interventions to promote PA in CRC survivors need to understand the most critical beliefs that influence PA behavior. OBJECTIVE: The objective of this study was to examine the strength of associations between the most common PA beliefs of CRC survivors and motivational constructs from the Theory of Planned Behavior (TPB) as well as PA behavior. INTERVENTION/METHODS: Colorectal cancer survivors (n = 600) residing in Alberta, Canada, completed self-report questionnaires assessing medical and demographic variables, PA beliefs, constructs from the TPB, and PA behavior. RESULTS: Colorectal cancer survivors identified improved fitness (69.5%), family members (67.3%), and medical/health problems (8.8%) as the most prevalent behavioral, normative, and control beliefs, respectively. All PA beliefs were significantly correlated with all TPB constructs and PA. CONCLUSIONS: Physical activity interventions for CRC survivors should target many salient beliefs including behavioral, normative, and control beliefs. IMPLICATIONS FOR PRACTICE: Insights into the salient beliefs for PA in CRC survivors can guide nurses in developing successful strategies to promote PA in this population and likely improve quality of life and possibly disease outcomes.

Randomized controlled trial of a behavior change intervention to increase physical activity and quality of life in prostate cancer survivors.

BACKGROUND: Physical activity improves health in prostate cancer survivors; however, participation rates are low. PURPOSE: This study aims to determine the effects of an implementation intention intervention on physical activity and quality of life in prostate cancer survivors. METHODS: Prostate cancer survivors (N = 423) were randomly assigned to a standard physical activity recommendation, a self-administered implementation intention, or a telephone-assisted implementation intention. Physical activity and quality of life were assessed at baseline, 1, and 3 months. RESULTS: Analyses of covariance using multiple imputation showed that physical activity at 1 month increased by 86 min/week in the standard physical activity recommendation group compared with 168 min/week in the self-administered implementation intention group (P = 0.023) and 105 min/week in the telephone-assisted implementation intention group (P = 0.35). CONCLUSIONS: A self-administered implementation intention intervention resulted in a meaningful short-term increase in physical activity. Supplementation with additional intervention strategies and more frequent intervention may improve longer-term exercise.

Physical activity preferences among a population-based sample of colorectal cancer survivors.

PURPOSE/OBJECTIVES: To identify the key physical activity (PA) programming and counseling preferences of colorectal cancer (CRC) survivors. DESIGN: Population-based, cross-sectional mailed survey. SETTING: Alberta, Canada. SAMPLE: 600 CRC survivors. METHODS: CRC survivors randomly identified through the Alberta Cancer Registry in Canada completed a mailed survey (34% response rate). MAIN RESEARCH VARIABLES: Self-reported PA, medical and demographic variables, and PA preferences. FINDINGS: Most CRC survivors indicated that they were interested and able to participate in a PA program. The most common PA preferences of CRC survivors were to receive PA counseling from a fitness expert at a cancer center, receive PA information in the form of print materials, start a PA program after cancer treatment, do PA at home, and walk in both the summer and winter. In addition, oncologists and nurses were identified as preferences from whom CRC survivors would like to receive PA information. Chi-square analyses identified that age, education, annual family income, and current PA were the demographic variables most consistently associated with PA preferences. CONCLUSIONS: The majority of CRC survivors expressed an interest in participating in a PA program and key PA preferences were identified. Those preferences may be useful for developing and implementing successful PA interventions for CRC survivors. IMPLICATIONS FOR NURSING: Oncology nurses are in a unique position to promote PA for CRC survivors. Therefore, understanding CRC survivor PA preferences is essential to assist nurses in making appropriate PA recommendations or referrals. KNOWLEDGE TRANSLATION: Although CRC survivors' PA participation rates are low, they may have an interest in receiving PA programming and counseling. CRC survivors have indicated a preference to receive PA information from individuals within their cancer support team (e.g., fitness specialist at a cancer center, oncologist, nurses). The PA preferences identified by CRC survivors are important for the development of successful PA interventions.

Sport participation in colorectal cancer survivors: an unexplored approach to promoting physical activity.

PURPOSE: Physical activity improves health outcomes in colorectal cancer (CRC) survivors, but participation rates are low. One understudied strategy for increasing physical activity in CRC survivors may be sport participation. Here, we report the sport participation rate, sport preferences, and correlates of sport participation among CRC survivors. METHODS: A provincial, population-based mailed survey of CRC survivors in Alberta, Canada was performed and included measures of sport participation, sport preferences, sport benefits and barriers, and medical and demographic variables. RESULTS: A total of 600 CRC survivors completed the survey (34 % response rate). Almost a quarter (23.0 %) of CRC survivors reported participating in a sport in the past month, with the most common sport being golf (58.7 %). In multivariate regression analysis, 33.0 % (p = 0.001) of the variance in sport participation was explained by being male (ß = 0.12; p = 0.006), in better general health (ß = 0.12; p = 0.006), and ≥ 5 years post-diagnosis (ß = 0.09; p = 0.031). The most common barriers to sport participation were time, age/agility, and no interest/dislike of sports. The most common anticipated benefits of sport participation were improved physical fitness, meeting people, and improved health. Over half (57.2 %) of CRC survivors were possibly interested in learning about sport participation opportunities. CONCLUSIONS: Promotion of sport participation may be a potentially fruitful strategy for increasing physical activity in CRC survivors.

Correlates of strength exercise in colorectal cancer survivors.

OBJECTIVE: To estimate the prevalence and correlates of meeting the public health strength exercise guidelines (≥2 days/week) in colorectal cancer (CRC) survivors. METHODS: A random sample of 600 CRC survivors in Alberta, Canada, completed a mailed questionnaire assessing medical, demographic, and behavioral variables and participation in strength exercise. RESULTS: About a quarter (25.5%) of CRC survivors were meeting strength exercise guidelines. In multivariate analysis, meeting guidelines was associated with being male (p = .052), married (p = .079), a drinker (p = .006), in better health (p < .001), nonsmoking (p = .023), and nonobese (p = .010). CONCLUSIONS: Interventions to increase strength exercise participation in CRC survivors are needed.

The effect of a multifaceted efficacy intervention on exercise behavior in relatives of colon cancer patients.

BACKGROUND: Regular physical activity (PA) provides health benefits; however, at least 60% of the population fails to engage in the recommended amount of PA required to produce these health benefits. PURPOSE: The primary purpose of the study was to examine over a 12-week structured exercise program the effect of a multifaceted efficacy intervention (MEI-i.e., task and specific types of self-regulatory efficacy) on objectively measured exercise behavior. Secondary purposes were to examine the effect of the MEI on both task and self-regulatory efficacy levels; and to determine whether efficacy beliefs could predict exercise behavior. METHODS: Relatives of colon cancer patients (N = 140) were enrolled in an exercise program, and were randomized to either a MEI or attention control condition, and took part in classroom sessions. Behavior was assessed throughout the 12-week program using objective measures of frequency, duration, and intensity of exercise, and dropout rates, while self-reported task, barrier, scheduling, goal-setting, and relapse prevention efficacy were assessed at baseline and weeks 4, 8, and 12. RESULTS: The MEI group exercised for longer duration in the early phase of the program (i.e., 0-4 weeks); however, no significant differences were noted for exercise frequency and intensity. Differential dropout was found favoring the MEI group at weeks 8 and 12. No treatment condition differences were found for reported efficacy beliefs. Proceeding self-efficacious beliefs were associated with objective measures of behavior. CONCLUSIONS: A MEI grounded in Social Cognitive Theory was partially effective in influencing colon cancer relatives' exercise behavior.

Colon cancer information as a source of exercise motivation for relatives of patients with colon cancer.

Using a Protection Motivation Theory (PMT) framework, this study examined whether factual colon cancer information is a meaningful source of exercise motivation for relatives of patients with colon cancer. One hundred sixty-six inactive relatives were randomly assigned to one of two treatment conditions: PMT group (intervention); and non-PMT group (attention control). At baseline (T1) participants completed demographic information, a questionnaire designed to assess their beliefs toward exercise and colon cancer as well as their exercise intentions. At T2 (one week following T1) participants watched one of two DVD videos that were created for the study. The intervention DVD contained exercise and colon cancer information that was yoked within the four major components of PMT: perceived vulnerability (PV); perceived severity (PS); response efficacy (RE); and self-efficacy (SE), while the attention control DVD contained general diet and cancer information. Immediately following watching the DVD, participants completed the same measures as in T1. Participants assigned to the PMT intervention group showed significant improvement in PV, RE, SE and exercise intentions, whereas participants assigned to the attention control group showed significant improvement only in RE. RE, SE, and PS made significant and unique contributions to prediction of exercise intention. Overall, the results of the present study demonstrate that a single exposure media intervention grounded in a PMT framework can change individuals' exercise and colon cancer beliefs, as well as change their exercise intentions. Implications of these findings and direction for future research are discussed.