Does Role Identity Mediate the Influence of Motivational Regulations on Physical Activity Behavior Among People 55 Years or Older?

The objective of this study was to estimate the extent to which motivational regulations influence physical activity behavior through role identity among people 55 years or older. Participants (N = 409; Mage = 66.29 years [SD = 7.06]) completed online questionnaires to measure motivational regulations, role identity, and the frequency of physical activity in a typical week and in the past month. Mediation analysis using ordinary least squares path analysis revealed that autonomous forms of motivational regulation (positively) and controlled forms of motivational regulation (negatively) influenced role identity, which then positively influenced physical activity behavior. Bootstrap confidence intervals (95%) for the indirect effects (a × b) based on 5,000 bootstrap samples were entirely above or below zero. These findings point to future experimental evaluations of interventions aiming at both increasing and decreasing autonomous and controlled motivational regulations, respectively, to promote physical activity behavior through role identity.

Co-occurrences of fall-related factors in adults aged 60 to 85 years in the United States National Health and Nutrition Examination Survey.

A broad set of factors are associated with falling (e.g., age, sex, physical activity, vision, health), but their co-occurrence is understudied. Our objectives were to quantify the number and pattern of co-occurring fall-related factors. Data were obtained from the U.S. National Health and Nutrition Examination Survey (N = 1,957, 60-85 years). Twenty fall-related factors were included (based on previous research), covering a wide range including cognitive, motor, sensory, health, and physical activity measures. The number and pattern of co-occurring fall-related factors were quantified with logistic regression and cluster analyses, respectively. Most participants (59%) had ≥4 fall-risk factors, and each additional risk factor increased the odds of reporting difficulty with falling by 1.28. The identified clusters included: (1) healthy, (2) cognitive and sensory impaired, and (3) health impaired. The mean number of co-occurring fall-related factors was 3.7, 3.8, and 7.2, for clusters 1, 2, and 3, respectively (p<0.001). These observations indicate that co-occurrence of multiple fall-risk factors was common in this national sample of U.S. older adults and the factors tended to aggregate into distinct clusters. The findings support the protective effect of physical activity on fall-risk, the association between gait speed and falls, and the detrimental effect of health-related factors on difficulty with falls (e.g., arthritis, prescription medications). Cluster analyses revealed a complex interplay between sex and BMI that may alter the role of BMI in the etiology of falls. Cluster analyses also revealed a large detrimental effect of health-related factors in cluster 3; it is important to extend current fall interventions (typically focused on balance, flexibility, strength, cognitive, fear factors) to include health-related interventions that target factors such as BMI and arthritis.

Measuring Physical Activity Regulatory Styles and Identity Among Adults 55 Years or Older.

Objectives. The purpose of this study was to examine the psychometric properties of modified versions of the Behavioral Regulation in Exercise Questionnaire and Exercise Identity Scale for use with adults ages ≥55 years to measure regulatory styles and identity related to physical activity. Methods. Participants [Mage = 66.29 years (SD = 7.06)] answered an online questionnaire twice across a four-week timescale. We assessed measurement invariance and convergent and divergent validity based on relations between regulatory styles, identity, and physical activity. Results. Both measures were invariant across gender and time, and findings support the convergent and divergent validity of the scales. Notably, a two-factor model of identity representing role identity and physical activity beliefs provided the best fit, and physical activity beliefs was more strongly related to introjected regulation. Discussion. Taken together, there is evidence that these modified scales are suitable for use with adults ages ≥55 years.

Purpose in life and personal growth: The unique and joint contribution of physical activity and basic psychological needs.

This study examined if physical activity (PA) and self-determination theory's basic psychological needs directly or interactively predict older adults' eudaimonic well-being. Participants aged ≥55 years completed five online surveys. At baseline (T1 ), participants (N = 430) reported on autonomy, competence, and relatedness experienced during PA. PA was assessed prospectively using the Physical Activity Scale for Elderly (recall period = 7 days) for four consecutive weeks (T2 , T3 , T4 , and T5 ); weekly PA scores were averaged. At T5 , purpose in life and personal growth were measured using Ryff's scales of psychological well-being. In regression analyses, PA was associated with purpose in life for those reporting low relatedness (b = .04, p = .02). Competence was associated with purpose in life only for those high in relatedness (b = .34, p < .001). Autonomy was positively associated with personal growth for those who also reported high competence. Multiple imputation analyses (N = 430) and sensitivity analyses (n = 304) yielded findings consistent with those from complete cases (n = 182). Encouraging older people to move more may not be sufficient to confer well-being. It may be necessary to help people engage in activities that support their basic psychological needs.

Exploring Peer Support Characteristics for Promoting Physical Activity Among Women Living Beyond a Cancer Diagnosis: A Qualitative Descriptive Study.

PURPOSE: To explore women's perceptions of and preferred peer characteristics for peer mentoring to support physical activity promotion. Understanding how women living beyond a cancer diagnosis perceive peers for physical activity may help guide further health behavior mentoring and support practices. PARTICIPANTS & SETTING: 16 English-speaking adult women living beyond a cancer diagnosis. METHODOLOGIC APPROACH: Following a qualitative descriptive approach, four in-person focus groups were conducted and discussions were analyzed using inductive content analysis. FINDINGS: Participants described four considerations for peer matching: (a) personal characteristics, (b) physical activity characteristics, (c) cancer characteristics, and (d) finding a peer. Similarities in age, life phase, location, history of physical activity, type of cancer, severity of cancer, and personality were integral. An online or mobile application and the ability to create multiple partnerships were preferred. IMPLICATIONS FOR NURSING: Understanding methods to promote physical activity is imperative for long-term survivorship outcomes. Nurses in oncology care settings may promote physical activity and social support for women living beyond cancer diagnoses by facilitating optimal peer matches.

Association between Fruit and Vegetable Intake and Physical Activity among Breast Cancer Survivors: A Longitudinal Study.

This study examines the association between rates of change in daily fruit and vegetable intake and in weekly levels of moderate-to-vigorous intensity physical activity (MVPA) over a 15-month period in women following primary treatment completion for breast cancer. Breast cancer survivors (N = 199) self-reported fruit and vegetable intake and wore an accelerometer for 7 consecutive days to measure levels of MVPA on five occasions every 3 months. Multivariate latent growth modeling revealed that the rate of change in fruit and vegetable intake was not associated with the rate of change in levels of MVPA. Baseline (Mean = 3.46 months post-treatment) levels of MVPA were not associated with the rate of change of daily fruit and vegetable intake; likewise, baseline fruit and vegetable intake was not associated with the rate of change in levels of MVPA. Behavioral interventions promoting fruit and vegetable intake should not be assumed to yield concomitant effects in promoting MVPA or vice versa.

Questions to Measure Enjoyment of and Satisfaction With Physical Activity: Are They Appropriate for Use in an Older Population?

BACKGROUND AND OBJECTIVES: Enjoyment of and satisfaction with physical activity have been proposed as two actionable mechanisms to promote sustained engagement in physical activity. An accurate understanding of how, why, and for whom these two mechanisms work (or not) in response to a particular intervention strategy is contingent on having suitable measures for the population of interest. This study aims to determine whether the Physical Activity Enjoyment Scale-8 and a novel approach to the measurement of satisfaction with physical activity are suitable for use among older adults (M age = 66.25 years; range = 55-91 years). RESEARCH DESIGN AND METHODS: Participants answered an online questionnaire twice across 4 weeks. Measurement invariance was assessed within a structural equation modeling framework; convergent validity was assessed by correlating the latent variables enjoyment and satisfaction with each other and with physical activity behavior. RESULTS: Both measures were invariant between gender and across time. Enjoyment and satisfaction were related to each other (r = 0.72) and to physical activity (r = 0.48 and 0.64, respectively). DISCUSSION AND IMPLICATIONS: Results support the suitability of these measures as tools to assess enjoyment of and satisfaction with physical activity among older adults.

Maintenance motives for physical activity among older adults: a systematic review and meta-analysis.

The purpose of this systematic review was to examine if the motives of satisfaction with outcomes, enjoyment of behavior, self-determination, and identity are related to physical activity (PA) maintenance in older adults. We also explored whether the strength of these associations varies as a function of sample characteristics (i.e., age, gender, physical health status) and maintenance context. Five electronic databases (PubMed, PsycINFO, SportDiscus, CINAHL, and ProQuest Dissertations and Theses) were searched, and sixteen studies (k) with a sample mean age ≥ 55 years were included. When the number of studies was ≥ 5 for a given motive, a pooled correlation coefficient was calculated using the inverse-variance method under the random-effects model assumption. Self-determination was positively associated with PA maintenance [r (95% CI) = 0.189 (0.127, 0.249); k = 11]. This association was stronger and more homogeneous for samples described as having a physical health condition (r = 0.212; k = 6) and studies judged to be at risk of bias due to missing data (r = 0.223; k = 8). Few studies (< 5) investigated satisfaction with outcomes, enjoyment of behavior, and identity, which precludes any summary judgment for these three motives. PROSPERO Registration Number: CRD42018088161.

What Keeps Them Going, and What Gets Them Back? Older Adults' Beliefs About Physical Activity Maintenance.

BACKGROUND AND OBJECTIVES: The overall purpose of this article was to investigate beliefs related to physical activity maintenance among adults aged 60 years or older. RESEARCH DESIGN AND METHODS: Study 1 identified modal, salient behavioral, normative, and control beliefs using a free-response format. Study 2 was designed to gain a deeper understanding about these beliefs through in-depth semistructured interviews. RESULTS: Findings indicate that perceived physical and emotional benefits, scheduling and having a physical activity routine, social support, and features of indoor and outdoor locations are facilitating of maintenance. Some beliefs appear more relevant to sustained engagement in physical activity, while others may be more helpful for reengagement after 1 week of inactivity. DISCUSSION AND IMPLICATIONS: This investigation raises new hypotheses for future research and provides insight for the use and adaptation of behavior change strategies that are potentially more acceptable and effective for the promotion of physical activity maintenance for older adults.

Maintenance motives for physical activity among older adults: a protocol for a systematic review and meta-analysis.

INTRODUCTION: Physical activity (PA) is an important aspect for health and well-being, yet many older adults do not maintain their PA long term. The identification of key factors that are associated with, and likely causally related to, older adults' PA maintenance is a crucial first step towards developing programmes that are effective at promoting long-term PA behaviour change. The purpose of this protocol is to outline a systematic review that will examine the relationship between four motives (ie, satisfaction, enjoyment, self-determination and identity) and older adults' PA maintenance. METHODS AND ANALYSIS: Studies that investigated PA maintenance with a sample mean age ≥55 years will be included. Five electronic databases (PubMed, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus, PsycINFO and ProQuest Dissertations and Theses) were searched on 6 April 2018 with no publication date limit (ie, from inception). One reviewer screened 100% of titles and abstracts (k=21 470) while a random subsample (20%) was screened independently by two reviewers. An update of the search was run on 1 October 2019. All studies for which the full text was retrieved will be independently screened by two reviewers. Data pertaining to study sample, design, motives, PA (eg, measurement validity evidence, study definition of maintenance) and essential bias domains (eg, bias due to missing data) will be extracted. Study-level effect sizes will be calculated, and if the number of studies is ≥5, a random-effects meta-analysis will be performed using inverse-variance methods; a narrative synthesis will be performed otherwise. ETHICS AND DISSEMINATION: The university's Human Research Protection Program determined that the proposed study qualifies as exempt from the Institutional Review Board review under Exemption Category 4 (PROPEL #: 80047007). Results will be published in a peer-review journal, and the findings will help inform future interventions with older adults. PROSPERO REGISTRATION NUMBER: CRD42018088161.

Promoting Healthy Eating and Physical Activity Behaviors: A Systematic Review of Multiple Health Behavior Change Interventions Among Cancer Survivors.

Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.

Physical Activity Preferences Among Older Adults: A Systematic Review.

The objective of this study was to identify preferences for physical activity among adults aged 65 years and over. A systematic review was conducted. A search strategy without language and date restriction (up until March 31, 2017) was developed for PubMed, CINAHL, PsycINFO, ERIC, and SPORTDiscus. Study selection and data extraction were performed independently by two reviewers. A total of 21 independent primary studies were included in the systematic review. Irrespective of the methodologies used and samples, a majority of older adults prefer to walk and engage in physical activity continuously for about 30 min. These findings are mainly generalizable to White females from the United States. Two-thirds of the studies were at high risk of selection bias, which suggests additional caution when interpreting the review findings. Nonetheless, policymakers, community organizations, and healthcare providers should consider walkability in their efforts to promote physical activity in older adults.

Changes in light-, moderate-, and vigorous-intensity physical activity and changes in depressive symptoms in breast cancer survivors: a prospective observational study.

PURPOSE: Despite the recommendations for cancer survivors to engage in either moderate or vigorous physical activity, light-intensity physical activity may also have beneficial effects on mental health. The purpose of this study was to examine the associations between light, moderate, and vigorous physical activity and depressive symptoms in breast cancer survivors over 1 year post-treatment. METHODS: Participants (N = 201) were a sample of breast cancer survivors who self-reported depressive symptoms and wore an accelerometer for seven consecutive days to measure physical activity, on five occasions every 3 months post-treatment for cancer. RESULTS: Based on the results of hierarchical linear modeling, relative to others (i.e., between-person effects) and to oneself (i.e., within-person effects), higher levels of light- and moderate-intensity physical activity, but not vigorous-intensity physical activity, were associated with lower scores of depressive symptoms. CONCLUSIONS: In the first year post-treatment, increases in light- and moderate-intensity physical activity, but not vigorous-intensity physical activity, were associated with lower scores of depressive symptoms in relation to other study participants (i.e., between-person effects) and when participants were compared to their own typical levels of physical activity (i.e., within-person effects). The findings may have implications for physical activity recommendations following treatment for breast cancer as light-intensity physical activity may play a role in mitigating depressive symptoms over the first year.

Validity of the Brazilian version of the Godin-Shephard Leisure-Time Physical Activity Questionnaire.

This study provides evidence of construct validity for the Brazilian version of the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), a 1-item instrument used among 236 participants referred for cardiopulmonary exercise testing. The Baecke Habitual Physical Activity Questionnaire (Baecke-HPA) was used to evaluate convergent and divergent validity. The self-reported measure of walking (QCAF) evaluated the convergent validity. Cardiorespiratory fitness assessed convergent validity by the Veterans Specific Activity Questionnaire (VSAQ), peak measured (VO2peak) and maximum predicted (VO2pred) oxygen uptake. Partial adjusted correlation coefficients between the GSLTPAQ, Baecke-HPA, QCAF, VO2pred and VSAQ provided evidence for convergent validity; while divergent validity was supported by the absence of correlations between the GSLTPAQ and the Occupational Physical Activity domain (Baecke-HPA). The GSLTPAQ presents level 3 of evidence of construct validity and may be useful to assess leisure-time physical activity among patients with cardiovascular disease and healthy individuals.

Validity of the Brazilian version of the Godin-Shephard Leisure-Time Physical Activity Questionnaire / Validade da versão brasileira do Godin-Shephard Leisure-Time Physical Activity Questionnaire / Validez de la versión brasileña del Godin-Shephard Leisure-Time Physical Activity Questionnaire

This study provides evidence of construct validity for the Brazilian version of the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), a 1-item instrument used among 236 participants referred for cardiopulmonary exercise testing. The Baecke Habitual Physical Activity Questionnaire (Baecke-HPA) was used to evaluate convergent and divergent validity. The self-reported measure of walking (QCAF) evaluated the convergent validity. Cardiorespiratory fitness assessed convergent validity by the Veterans Specific Activity Questionnaire (VSAQ), peak measured (VO2peak) and maximum predicted (VO2pred) oxygen uptake. Partial adjusted correlation coefficients between the GSLTPAQ, Baecke-HPA, QCAF, VO2pred and VSAQ provided evidence for convergent validity; while divergent validity was supported by the absence of correlations between the GSLTPAQ and the Occupational Physical Activity domain (Baecke-HPA). The GSLTPAQ presents level 3 of evidence of construct validity and may be useful to assess leisure-time physical activity among patients with cardiovascular disease and healthy individuals.

Este estudo fornece evidências de validade de construto da versão brasileira do Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), instrumento de 1 item usado entre 236 participantes encaminhados ao teste de esforço cardiopulmonar. O Questionário de Atividade Física Habitual de Baecke (AFH-Baecke) avaliou a validade convergente e divergente. A medida de autorrelato de caminhada (QCAF) acessou a validade convergente. A aptidão cardiorrespiratória avaliou a validade convergente por meio do Veterans Specific Activity Questionnaire (VSAQ), consumo pico (VO2pico) e máximo (VO2pred) de oxigênio. Coeficientes de correlação parciais ajustados entre o GSLTPAQ, Baecke-HPA, QCAF, VO2pred e VSAQ forneceram evidências de validade convergente; enquanto a validade divergente foi apoiada pela ausência de correlações entre a GSLTPAQ e o domínio Atividade Física Ocupacional (AFH-Baecke). O GSLTPAQ apresenta nível 3 de evidência de validade de construto e parece útil para avaliar a atividade física no tempo de lazer entre pacientes com doença cardiovascular e indivíduos saudáveis.

Este estudio proporciona evidencia de validez de constructo de la versión brasileña del Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ), instrumento de 1 ítem utilizado entre 236 participantes referidos a la prueba de esfuerzo cardiopulmonar. El Cuestionario de Actividad Física Habitual de Baecke (AFH-Baecke) se utilizó para evaluar la validez convergente y divergente. La medida de auto-reporte de caminar (QCAF) evaluó la validez convergente. Aptitud cardiorrespiratoria fue evaluada por el Veterans Specific Activity Questionnaire (VSAQ), medida pico (VO2pico) y máximo (VO2pred) del consumo de oxígeno. Coeficientes de correlación parciales ajustados entre el GSLTPAQ, AFH-Baecke, QCAF, VO2pred y VSAQ investigaran la validez convergente; y la validez divergente fue apoyada por ausencia de correlación entre GSLTPAQ y la Actividad Física Ocupacional (AFH-Baecke). El GSLTPAQ presenta nivel 3 de evidencia de validez de constructo y puede ser útil para valorar la actividad física en el tiempo libre entre los pacientes con enfermedad cardiovascular y individuos sanos.

The use of the Godin-Shephard Leisure-Time Physical Activity Questionnaire in oncology research: a systematic review.

BACKGROUND: The Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) is one of the most often used questionnaires in oncology research, yet modifications to the scale are done with little evidence of psychometric testing. This study aimed to (i) document the frequency of use of the questionnaire for ranking (i.e., level of activity) and classification (i.e., active versus insufficiently active) purposes, (ii) summarize how the GSLTPAQ is used in terms of item content and scoring, and (iii) evaluate the extent to which validity evidence supports the use of the scale among cancer survivors. METHODS: A systematic review was conducted with evidence drawn from English-written articles published between January 1(st) 1985 (year the GSLTPAQ was published) and December 31, 2014. A search of six databases, a scan of reference list of included articles, and a cited reference search identified articles that reported using the GSLTPAQ among cancer survivors. RESULTS: A total of 212 articles were retrieved. The GSLTPAQ was used for classifying cancer survivors into active and insufficiently active categories in 51 % of the articles. Moreover, a modified version of the questionnaire was used in 81 % of the research studies. Three studies reported validity evidence based on the relationship between the scores on the GSLTPAQ (i.e., leisure score index, LSI) and accelerometer or pedometer-derived activity data. Validity evidence supporting the use of the GSLTPAQ for assessing changes in LSI was computed from six randomized trials. CONCLUSIONS: The use of the GSLTPAQ for classification purpose in oncology research is common. Standardization in the use and interpretation of the GSLTPAQ in oncology research is warranted. Although limited, there is support for using the original form of the GSLTPAQ and interpreting the LSI for ranking cancer survivors from the lowest to highest levels of leisure-time physical activity.

The Godin-Shephard leisure-time physical activity questionnaire: validity evidence supporting its use for classifying healthy adults into active and insufficiently active categories.

This study provided validity evidence for the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) to classify respondents into active and insufficiently active categories. Members of a fitness center [45 women and 55 men; mean (SD) age=45.5 (10.6) yr.] completed the questionnaire. Using only moderate and strenuous scores, those with a leisure score index≥24 were classified as active; those with a score≤23 were classified as insufficiently active. VO2max, percentage of body fat, and electronic records of fitness center attendance were the validation variables. In a visit to the fitness center, participants completed the GSLTPAQ and a certified exercise specialist performed a physical fitness evaluation. A multivariate analysis of covariance (MANCOVA) indicated the group of respondents classified as active had higher VO2max and lower percentage of body fat than the group of respondents classified as insufficiently active. An analysis of covariance (ANCOVA) indicated the group of respondents classified as active had higher electronic records of fitness center attendance than the group of respondents classified as insufficiently active. Therefore, these pieces of validity evidence support the use of the questionnaire's classification system among healthy adults.

Validation of the Godin-Shephard Leisure-Time Physical Activity Questionnaire classification coding system using accelerometer assessment among breast cancer survivors.

PURPOSE: The aim of this research was to provide convergent validity evidence for the use of the Godin-Shephard Leisure-Time Physical Activity Questionnaire (GSLTPAQ) to classify breast cancer survivors into active and insufficiently active categories. METHODS: Data were collected among a sample of breast cancer survivors (N = 199; mean age = 55 years) to examine the association between physical activity assessed with a GT3X triaxial accelerometer and the use of the GSLTPAQ's coding system recently proposed by Godin (2011). Participants self-reported moderate and vigorous physical activity (MVPA) performed in a typical week on the GSLTPAQ and those with MVPA leisure score index ≥ 24 were classified as active. RESULTS: ANCOVA revealed that the adjusted mean [95% CI] number of recorded MVPA minutes was higher for respondents classified as active (145.54 [127.26; 163.83]) compared to respondents classified as insufficiently active (86.99 [74.04; 99.94]). The GSLTPAQ and accelerometer classified 33.8 and 27.2% of participants as active, respectively (agreement = 70.8%). Sensitivity and specificity values were 75.3 and 58.5%, respectively. CONCLUSION: The GSLTPAQ can be used to classify cancer survivors into active and insufficiently active categories in reference to cancer survivors' physical activity guidelines. However, it has greater capacity to correctly identify insufficiently active respondents. IMPLICATIONS FOR CANCER SURVIVORS: The use of the GSLTPAQ's classification coding in oncology research could improve the quality of physical activity recommendations and interventions handed out to cancer survivors.

Physical and psychological health among breast cancer survivors: interactions with sedentary behavior and physical activity.

BACKGROUND: Reducing sedentary behavior (SED) may be one promising strategy to reduce treatment-related side effects in breast cancer given the unique health benefits distinct from the beneficial effects of moderate-to-vigorous intensity physical activity (MVPA). OBJECTIVES: To examine the associations between SED and the late-effects symptoms of pain, fatigue, and depression among breast cancer survivors (BCS), and the interactive associations between SED, light PA, and MVPA on these symptoms. METHODS: One hundred and ninety-five BCS provided baseline data 3 to 4 months post-systemic treatment, as part of the Life After Breast Cancer: Moving On longitudinal study. Pain, fatigue, and depression symptoms were assessed using validated self-report questionnaires. Objective measures of MVPA, light PA, and SED (i.e. sitting time) were assessed by accelerometers over the same period. Self-reported demographic and medical variables were collected. RESULTS: In hierarchical multiple regression analyses, the interaction effect of MVPA by SED was significantly associated with pain (p = .02), fatigue (p = .01), and depression (p = .006). Follow-up simple slope analyses demonstrated that among BCS with lower levels of MVPA, higher levels of SED significantly predicted higher levels of fatigue (p < .001), higher levels of pain (p = .06), and higher levels of depression (p = .08). CONCLUSIONS: SED was associated with higher levels of fatigue, pain, and depression in BCS, and was more pronounced among those with lower levels of MVPA. However, SED was not associated with these symptoms among BCS with higher levels of MVPA. Pairing health promotion messages to reduce SED and increase MVPA are likely to result in better symptom management. Copyright © 2015 John Wiley & Sons, Ltd.