To determine the independent and interactive associations among body mass index (BMI), physical activity (PA), and health-related quality of life (HRQoL) in breast, prostate, colorectal, bladder, uterine, and skin melanoma cancer survivors.
A total of 3241 cancer survivors completed a national cross-sectional survey that included PA questions and the RAND-36 Health Status Inventory.
Compared with healthy-weight survivors, obese breast, prostate, bladder, and skin melanoma cancer survivors were significantly less likely to meet the PA guideline. Furthermore, healthy-weight and/or overweight breast, prostate, colorectal, uterine cancer, and skin melanoma survivors reported significantly better physical functioning compared with their obese counterparts, whereas overweight colorectal cancer survivors reported significantly better mental health compared with obese survivors. Finally, hierarchical linear regressions showed that none of the BMI × PA interactions was significant for the physical or mental component composite scores across the cancer types.
The percentage of cancer survivors meeting the American Cancer Society's PA guideline seems to vary by weight status in breast, prostate, bladder, and skin melanoma cancer survivors. In addition, BMI and PA have independent associations with HRQoL; however, the interactive association of BMI and PA on HRQoL was negligible. Clarifying the relationship between BMI and PA across different cancer types will help identify potential target groups for future PA interventions that will help ameliorate the negative side effects of cancer and improve HRQoL.
To estimate the prevalence and correlates of meeting the public health strength exercise guidelines (=2 days/week) in colorectal cancer (CRC) survivors.
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.
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
The purpose of this study was to evaluate the theory of planned behavior as a framework for understanding exercise intention and behavior in survivors of breast and prostate cancer. Participants were 83 survivors of breast and 46 survivors of prostate cancer who were diagnosed within the previous 4 years and had completed treatment. Each participant completed a mailed self-administered questionnaire that assessed exercise during the previous week, demographic and medical variables, and the theory of planned behavior. For survivors of breast cancer, regression analyses indicated that attitude, subjective norm, and perceived behavioral control explained 45% of the variance in exercise intention with attitude, subjective norm, and perceived behavioral control each uniquely contributing to intention. Furthermore, exercise intention explained 30% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. For survivors of prostate cancer, attitudes, subjective norm, and perceived behavioral control explained 36% of the variance in exercise intention, but only perceived behavioral control made a significant unique contribution. Furthermore, intention explained 36% of the variance in exercise behavior; however, perceived behavioral control added no unique variance. Results suggest that nurses may use the theory of planned behavior as a model for understanding the determinants of exercise intentions and behavior in survivors of breast and prostate cancer.
To determine whether a stress management (SM) program could improve cessation rates when added to usual care (UC) among women attempting to quit smoking.
Randomized controlled trial conducted during a 12-month period.
Smoking cessation clinics located within two tertiary care centers in Ottawa, Ontario.
A total of 332 women smokers 19 years or older who smoked 10 or more cigarettes per day were recruited via advertisements. INTERVENTION. Either UC (physician advice and nicotine replacement therapy) or UC plus an eight-session group SM training program (coping skills development relevant to smoking-specific and generic stressors).
Point prevalence abstinence 2 and 12 months after study intake. A secondary outcome of interest was change in perceived stress during the intervention period.
On an intent-to-treat basis, the addition of SM to UC had no incremental effect on 2- or 12-month abstinence rates. Abstinence rates at 2 months were 26.2% vs. 31.7% in the UC and SM groups, respectively (p = .59). At 12 months, the rates were 18.5% vs. 20.7% (p = .86). When quit rates were compared including only participants who demonstrated adequate adherence to the intervention protocol, there was a significant difference between the UC and SM groups at 2 months (34.9% vs. 48.7%; adjusted odds ratio, 1.88; 95% confidence interval, 1.04-3.42; p = .04) but not at 12 months (23.0% vs. 28.2%; adjusted odds ratio, 1.24; 95% confidence interval, .64-2.41; p = .53). There was a significant reduction in perceived stress from preintervention to postintervention; however, this decrease was not moderated by group assignment.
The addition of SM in our setting neither increased abstinence rates nor reduced perceived stress over and above UC in women motivated to quit smoking. Poor attendance at the SM intervention undermined its effectiveness.
To identify the key physical activity (PA) programming and counseling preferences of colorectal cancer (CRC) survivors.
Population-based, cross-sectional mailed survey.
600 CRC survivors.
CRC survivors randomly identified through the Alberta Cancer Registry in Canada completed a mailed survey (34% response rate).
Self-reported PA, medical and demographic variables, and PA preferences.
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.
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.
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.
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.
This paper elicited context specific underlying beliefs for physical activity, fruit and vegetable consumption and smoke-free behaviour from the Theory of Planned Behaviour (TPB), and then determined whether the TPB explained significant variation in intentions and behaviour over a 1 month period in a sample of grade 7-9 (age 12-16 years) adolescents. Eighteen individual interviews and one focus group were used to elicit student beliefs. Analyses of this data produced behavioural, normative and control beliefs which were put into a TPB questionnaire completed by 183 students at time 1 and time 2. The Path analyses from the main study showed that the attitude/intention relationship was moderately large for fruit and vegetable consumption and small to moderate for being smoke free. Perceived behavioural control had a large effect on being smoke free and a moderately large effect for fruit and vegetable consumption and physical activity. Intention had a large direct effect on all three behaviours. Common (e.g. feel better, more energy) and behaviour-specific (e.g., prevent yellow fingers, control my weight) beliefs emerged across the three health behaviours. These novel findings, to the adolescent population, support the importance of specific attention being given to each of the behaviours in future multi-behavioural interventions.
The purposes of this study were to determine if a) gender moderated the relationship between self-efficacy and physical activity (PA) among youth in Alberta, Canada, and, alternatively b) if self-efficacy mediated the relationship between gender and PA.
A novel web-based tool was used to survey a regionally diverse sample of 4779 students (boys = 2222, girls = 2557) from 117 schools in grades 7 to 10 (mean age = 13.64 yrs.). Among other variables, students were asked about their PA and self-efficacy for participating in PA.
Based upon a series of multilevel analyses, self-efficacy was found to be a significantly stronger correlate of PA for girls. But, boys had significantly higher self-efficacy compared with girls, which resulted in significantly more PA.
Findings suggest self-efficacy is an important correlate of PA among adolescent girls but that boys are more physically active because they have more self-efficacy for PA.
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.
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.
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.
Promotion of sport participation may be a potentially fruitful strategy for increasing physical activity in CRC survivors.
: Previous studies have shown that moderate-to-vigorous physical activity (MVPA) levels during home-based cardiac rehabilitation (CR) have been problematic. Consequently, the present study examined the utility of the theory of planned behavior, protection motivation theory, and social cognitive theory in explaining physical activity (PA) during a Canadian home-based CR program.
: Patients (N = 280, mean age 62.8 years; 95.4% white, 72.5% male, 78.9% married, 52.3% retired, 48.0% income more than $60000; and 33.8% postmyocardial infarction) completed a questionnaire at program onset and a MVPA assessment at 3-month followup.
: Path analyses showed that each theory accounted for 28% to 34% of the variance in PA. The theory of planned behavior showed that perceived behavior control was the key predictor of 3-month MVPA (ß = .36), whereas protection motivation theory showed that intention (ß = .30) was the key predictor. Finally, barrier self-efficacy (ß = .21) and the availability of home PA equipment (ß = .15) were the key predictors of 3-month MVPA within social cognitive theory.
: All 3 theories appeared to be viable options to inform the development of a MVPA intervention during home-based CR. However, the key constructs to target within each theory varied, suggesting the need to potentially use multiple theories to inform intervention development.
We describe transitions between exercise stages of change in people with coronary artery disease (CAD) over a 6-month period following a CAD-related hospitalization and evaluate constructs from Protection Motivation Theory, Theory of Planned Behavior, Social Cognitive Theory, the Ecological Model, and participation in cardiac rehabilitation as correlates of stage transition. Seven hundred eighty-two adults hospitalized with CAD were recruited and administered a baseline survey including assessments of theory-based constructs and exercise stage of change. Mailed surveys were used to gather information concerning exercise stage of change and participation in cardiac rehabilitation 6 months later. Progression from pre-action stages between baseline and 6 month follow-up was associated with greater perceived efficacy of exercise to reduce risk of future disease, fewer barriers to exercise, more access to home exercise equipment, and participation in cardiac rehabilitation. Regression from already active stages between baseline and 6 month follow-up was associated with increased perceived susceptibility to a future CAD-related event, fewer intentions to exercise, lower self-efficacy, and more barriers to exercise.