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Yan H, Shuying C, Yuege L, Han K. Barriers and Facilitators Related to Undertaking Physical Activities in Colorectal Cancer Patients: A Scoping Review. Oncol Rev 2024; 18:1360480. [PMID: 39309606 PMCID: PMC11414545 DOI: 10.3389/or.2024.1360480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 02/22/2024] [Indexed: 09/25/2024] Open
Abstract
Background Colorectal cancer (CRC) and its treatments cause significant acute, chronic, or latent adverse effects, leading to decreased physical function and quality of life. Robust evidence supports the positive effects of physical activity (PA) on various health outcomes in CRC patients. However, there is limited understanding regarding the factors that influence PA engagement, including facilitators, preferences, and barriers in this population. Purpose This scoping review aims to document the breadth and depth of literature concerning the various aspects of PA participation among patients with CRC. We conducted a scoping review of PA among CRC patients. Methods We searched several databases, including PubMed, Web of Science, Embase, and Cochrane, from their inception to 25 July 2023. Multiple reviewers were involved in all screening and data abstractions. The search yielded 834 individual citations after removing duplicates. After screening the titles and abstracts, 20 articles underwent full-text review, and 11 were included. Results Our research findings indicate that among CRC patients, the most prevalent facilitators/preferences for PA are understanding its importance and perceiving its benefits, whereas treatment-related effects and lack of time are the most common barriers. Conclusion CRC patients have unique facilitators and barriers concerning PA. Further research and clinical interventions are required to support and encourage this population to participate in and maintain regular PA.
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Affiliation(s)
- Hu Yan
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Chang Shuying
- Henan Provincial People’s Hospital, Zhengzhou, China
| | - Li Yuege
- School of Nursing and Health, Henan University, Kaifeng, China
| | - Kong Han
- School of Nursing and Health, Henan University, Kaifeng, China
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Agirre-Elordui S, Fernández-Landa J, Olasagasti-Ibargoien J, Castañeda-Babarro A. Physical activity maintenance in colorectal cancer survivors after an exercise intervention applying behaviour change techniques: a systematic review and meta-analysis. J Cancer Surviv 2024:10.1007/s11764-024-01654-8. [PMID: 39098882 DOI: 10.1007/s11764-024-01654-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 07/26/2024] [Indexed: 08/06/2024]
Abstract
PURPOSE The purpose of this systematic review and meta-analysis is to determine the long-term effect of combined physical activity (PA) and behaviour change techniques (BCT) interventions in PA maintenance of colorectal cancer survivors (CRCS) and identify the most frequent BCT implemented in them. METHODS PRISMA recommendations were followed. Databases were searched for randomized controlled trials up to October 2023. Studies in which CRCS completed a PA intervention based on any Theoretical Model of Behaviour Change (TMBC) and a subsequent follow-up period were included. Between-group differences at baseline and after follow-up were pooled for meta-analysis. BCT codification was performed using the BCT taxonomy v1. Methodological quality and evidence certainty were also assessed. RESULTS Five studies involving 906 CRCS met the inclusion criteria. PA interventions applying BCT showed a significant change with a small positive effect (pooled SMD = 0.22 (0.09, 0.35)) on the PA after a follow-up period between 3 and 12 months. Twenty-two different BCTs were identified (mean 17.2, range 15-19) of which 12 were common across all interventions. CONCLUSIONS PA and BCT interventions have been found to be effective in improving the long-term maintenance of PA in CRCS. Further studies with higher methodological quality are needed to confirm these findings. IMPLICATIONS FOR CANCER SURVIVORS Aerobic exercise, pedometers, PA diaries and educational materials seem to be important aspects to achieve sustainable adherence to an active lifestyle over time. Supervision, access to fitness areas and applying some BCT appear to be differentiating features to obtain more successful PA maintenance.
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Affiliation(s)
- Saioa Agirre-Elordui
- Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
| | - Julen Fernández-Landa
- Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, Bilbao, Spain
| | - Jurgi Olasagasti-Ibargoien
- Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, Donostia, Spain
| | - Arkaitz Castañeda-Babarro
- Department of Physical Activity and Sports, Faculty of Education and Sport, University of Deusto, Bilbao, Spain.
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Cannavale KL, Xu L, Nau CL, Armenian SH, Bhatia S, Wong FL, Huang PYS, Cooper R, Chao CR. Neighborhood factors associated with late effects among survivors of adolescent and young adult cancer. J Cancer Surviv 2024:10.1007/s11764-024-01596-1. [PMID: 38839694 DOI: 10.1007/s11764-024-01596-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/05/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE The purpose of this study is to evaluate the associations between neighborhood income, education, and neighborhood racial composition (measured as a low percentage of white residents) and risk of developing cardiovascular diseases (CVD), diabetes (DM), and severe depression among survivors of AYA cancer and matched non-cancer peers. METHODS Two-year survivors of AYA cancers diagnosed at age 15-39 yrs at Kaiser Permanente Southern California (diagnosed 2000-2012) and individually matched (1:13) non-cancer subjects were included. The development of CVD, DM, and severe depression was ascertained via electronic health records. Neighborhood characteristics were obtained from census-based geocoded data. Cox regression evaluated associations between neighborhood characteristics and the health outcomes of interest among both the cancer survivors and the non-cancer comparison cohort and effect modification by cancer survivor status on these relationships. RESULTS Among cancer survivors (n = 6774), living in mostly non-white neighborhoods, was associated with risk of CVD (hazard ratio (HR) = 1.54 (95% CI 1.00-2.36)), while lower education level (HR = 1.41 (95% CI 1.02-1.94)) was associated with risk of severe depression. None of the neighborhood characteristics were associated with risk of DM. Effect modification was found for neighborhood education and risk of DM and severe depression. CONCLUSION When jointly considered, cancer survivors who resided in the most disadvantaged neighborhoods were at the highest risk of developing these health outcomes compared to other subgroups. IMPLICATIONS FOR CANCER SURVIVORS Our findings may inform screening strategy and addressing social determinants of health among AYA cancer survivors.
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Affiliation(s)
- Kimberly L Cannavale
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Lanfang Xu
- MedHealth Analytics Inc., Sugar Land, TX, USA
| | - Claudia L Nau
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Saro H Armenian
- Department of Population Sciences, City of Hope, Duarte, CA, USA
- Department of Pediatrics, City of Hope, Duarte, CA, USA
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - F Lennie Wong
- Department of Population Sciences, City of Hope, Duarte, CA, USA
| | - Po-Yin Samuel Huang
- Department of Family Medicine, Los Angeles Medical Center, Kaiser Permanente Southern California, Los Angeles, CA, USA
| | - Robert Cooper
- Department of Pediatric Oncology, Los Angeles Medical Center, Kaiser Permanente Southern California, Los Angeles, CA, USA
| | - Chun R Chao
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
- Department of Health Systems Science, Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, USA.
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Smit KC, Derksen JWG, Stellato RK, VAN Lanen AS, Wesselink E, Belt EJT, Balen MCVAN, Coene PPLO, Dekker JWT, DE Groot JW, Haringhuizen AW, VAN Halteren HK, VAN Heek TT, Helgason HH, Hendriks MP, DE Hingh IHJT, Hoekstra R, Houtsma D, Janssen JJB, Kok N, Konsten JLM, Los M, Meijerink MR, Mekenkamp LJM, Peeters KCMJ, Polée MB, Rietbroek RC, Schiphorst AHW, Schrauwen RWM, Schreinemakers J, Sie MPS, Simkens L, Sonneveld EJA, Terheggen F, Iersel LVVAN, Vles WJ, Wasowicz-Kemps DK, DE Wilt JHW, Kok DE, Winkels RM, Kampman E, VAN Duijnhoven FJB, Koopman M, May AM. Determinants of Physical Activity among Patients with Colorectal Cancer: From Diagnosis to 5 Years after Diagnosis. Med Sci Sports Exerc 2024; 56:623-634. [PMID: 38079324 DOI: 10.1249/mss.0000000000003351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2024]
Abstract
INTRODUCTION Physical activity (PA) is associated with higher quality of life and probably better prognosis among colorectal cancer (CRC) patients. This study focuses on determinants of PA among CRC patients from diagnosis until 5 yr postdiagnosis. METHODS Sociodemographic and disease-related factors of participants of two large CRC cohort studies were combined. Moderate-to-vigorous PA during sport and leisure time (MVPA-SL) was measured at diagnosis (T0) and 6, 12, 24, and 60 months (T6 to T60) postdiagnosis, using the SQUASH questionnaire. Mixed-effects models were performed to identify sociodemographic and disease-related determinants of MVPA-SL, separately for stage I-III colon (CC), stage I-III rectal cancer (RC), and stage IV CRC (T0 and T6 only). Associations were defined as consistently present when significant at ≥4 timepoints for the stage I-III subsets. MVPA-SL levels were compared with an age- and sex-matched sample of the general Dutch population. RESULTS In total, 2905 CC, 1459 RC and 436 stage IV CRC patients were included. Patients with higher fatigue scores, and women compared with men had consistently lower MVPA-SL levels over time, regardless of tumor type and stage. At T6, having a stoma was significantly associated with lower MVPA-SL among stage I-III RC patients. Systemic therapy and radiotherapy were not significantly associated with MVPA-SL changes at T6. Compared with the general population, MVPA-SL levels of CRC patients were lower at all timepoints, most notably at T6. CONCLUSIONS Female sex and higher fatigue scores were consistent determinants of lower MVPA-SL levels among all CRC patients, and MVPA-SL levels were lowest at 6 months postdiagnosis. Our results can inform the design of intervention studies aimed at improving PA, and guide healthcare professionals in optimizing individualized support.
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Affiliation(s)
- Karel C Smit
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Jeroen W G Derksen
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Rebecca K Stellato
- Department of Data Science and Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Anne-Sophie VAN Lanen
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Evertine Wesselink
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Eric J Th Belt
- Department of Surgery, Albert Schweitzer Hospital, Dordrecht, THE NETHERLANDS
| | | | | | | | | | | | - Henk K VAN Halteren
- Department of Medical Oncology, Admiraal de Ruyter Hospital, Goes, THE NETHERLANDS
| | - Tjarda T VAN Heek
- Department of Surgery, Ziekenhuis Gelderse Vallei, Ede, THE NETHERLANDS
| | - Helgi H Helgason
- Department of Medical Oncology, Haaglanden Medical Center, Den Haag, THE NETHERLANDS
| | - Mathijs P Hendriks
- Department of Medical Oncology, Northwest Clinics, Alkmaar, THE NETHERLANDS
| | | | - Ronald Hoekstra
- Department of Medical Oncology, Ziekenhuisgroep Twente, Hengelo, THE NETHERLANDS
| | - Danny Houtsma
- Department of Medical Oncology, Haga Hospital, Den Haag, THE NETHERLANDS
| | - Johan J B Janssen
- Department of Medical Oncology, Canisius Wilhelmina Hospital, Nijmegen, THE NETHERLANDS
| | - Niels Kok
- Department of Gastrointestinal Oncology, Antoni Van Leeuwenhoek-Netherlands Cancer Institute, Amsterdam, THE NETHERLANDS
| | | | - Maartje Los
- Department of Medical Oncology, St. Antonius Hospital, Nieuwegein, THE NETHERLANDS
| | - Martijn R Meijerink
- Department of Radiology and Nuclear Medicine, VU Medical Center, Amsterdam, THE NETHERLANDS
| | - Leonie J M Mekenkamp
- Department of Medical Oncology, Medisch Spectrum Twente, Enschede, THE NETHERLANDS
| | - Koen C M J Peeters
- Department of Surgery, Leiden University Medical Center, University of Leiden, Leiden, THE NETHERLANDS
| | - Marco B Polée
- Department of Medical Oncology, Medical Center Leeuwarden, Leeuwarden, THE NETHERLANDS
| | - Ron C Rietbroek
- Department of Medical Oncology, Rode Kruis Hospital, Beverwijk, THE NETHERLANDS
| | | | - Ruud W M Schrauwen
- Department of Gastroenterology and Hepatology, Bernhoven Hospital, Uden, THE NETHERLANDS
| | | | - Mark P S Sie
- Department of Medical Oncology, ZorgSaam Hospital, Terneuzen, THE NETHERLANDS
| | - Lieke Simkens
- Department of Medical Oncology, Maxima Medical Center, Eindhoven, THE NETHERLANDS
| | | | - Frederiek Terheggen
- Department of Medical Oncology, Bravis Hospital, Roosendaal, THE NETHERLANDS
| | - Liselot Valkenburg-VAN Iersel
- Maastricht University Medical Center, Department of Internal Medicine, Division of Medical Oncology, GROW, Maastricht University, Maastricht, THE NETHERLANDS
| | - Wouter J Vles
- Department of Surgery, Ikazia Hospital, Rotterdam, THE NETHERLANDS
| | | | - Johannes H W DE Wilt
- Department of Surgery, Radboud University Medical Center, University of Nijmegen, Nijmegen, THE NETHERLANDS
| | - Dieuwertje E Kok
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Renate M Winkels
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | - Ellen Kampman
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, THE NETHERLANDS
| | | | - Miriam Koopman
- Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
| | - Anne M May
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, THE NETHERLANDS
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Byeon JY, Lee MK, Park DH, Yeon SJ, Jee SH, Lee CW, Yang SY, Kim NK, Vallance J, Courneya KS, Jeon JY. A qualitative exploration of exercise motivation among colorectal cancer survivors: an application of the theory of planned behavior. Support Care Cancer 2024; 32:176. [PMID: 38381248 DOI: 10.1007/s00520-024-08362-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 02/10/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE The purpose of this qualitative study was to use semi-structured interviews and thematic analysis to elicit key influencing factors (i.e., behavioral, normative, and control beliefs) related to physical activity and exercise in colorectal cancer survivors. METHODS Colorectal cancer survivors (N = 17) were recruited from exercise programs designed for colorectal cancer survivors at the Yonsei Cancer Center, Seoul, South Korea. A purposive sampling method was used. Interview questions were informed by the theory of planned behavior (TPB). Semi-structured face-to-face interviews were conducted, and open-ended questions addressed the research question. Interviews were transcribed verbatim and analyzed using thematic analysis. RESULTS Participants were on average 2.2 years post-treatment. The mean age of the sample was 55.9 years. Key behavioral, normative, and control beliefs emerged in the data. For behavioral beliefs, colorectal cancer survivors believed that exercise would result in physical and psychological improvements, and improve their bowel problems. For normative beliefs, most colorectal cancer survivors wanted their oncologists' approval for participation of exercise. Family members, more specifically the spouse, were also influencing factors for colorectal cancer survivors adopting physical activity. The most frequently mentioned control belief was that supervised exercise with an exercise specialist made exercise participation easier. CONCLUSIONS AND IMPLICATIONS Beliefs identified in this study can inform TPB-based physical activity interventions tailored for colorectal cancer survivors. While information alone may not lead to behavior change, integrating these beliefs with other influential factors can potentially enhance intervention efficacy and promote physical activity in this population.
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Affiliation(s)
- Ji Yong Byeon
- Department of Sport Industry Studies, Yonsei University, Seoul, Korea
| | - Mi Kyung Lee
- Frontier Research Institute of Convergence Sports Science, FRICSS, Yonsei University, Seoul, Korea
| | - Dong-Hyuk Park
- Department of Sport Industry Studies, Yonsei University, Seoul, Korea
| | - Su Jin Yeon
- Department of Sport Industry Studies, Yonsei University, Seoul, Korea
| | - Sun Ha Jee
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Chul Won Lee
- Department of Sport Industry Studies, Yonsei University, Seoul, Korea
| | - Seung Yoon Yang
- Department of Surgery, Yonsei University College of Medicine, Yonsei University, Seoul, Korea
| | - Nam-Kyu Kim
- Department of Surgery, Yonsei University College of Medicine, Yonsei University, Seoul, Korea
| | - Jeff Vallance
- Faculty of Health Disciplines, Athabasca University, Athabasca, Canada
| | - Kerry S Courneya
- Faculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Justin Y Jeon
- Department of Sport Industry Studies, Yonsei University, Seoul, Korea.
- Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, Korea.
- Cancer Prevention Center, Yonsei Cancer Center, Seoul, Korea.
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Pichardo MS, Ferrucci LM, Molina Y, Esserman DA, Irwin ML. Structural Racism, Lifestyle Behaviors, and Obesity-related Cancers among Black and Hispanic/Latino Adults in the United States: A Narrative Review. Cancer Epidemiol Biomarkers Prev 2023; 32:1498-1507. [PMID: 37650844 PMCID: PMC10872641 DOI: 10.1158/1055-9965.epi-22-1147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 05/02/2023] [Accepted: 08/29/2023] [Indexed: 09/01/2023] Open
Abstract
One in three adults in the United States has obesity; a chronic disease that is implicated in the etiology of at least 14 cancers. Cancer is the leading cause of death among U.S. Hispanic/Latino adults and the second most common cause of death, after cardiovascular disease, for Black adults. Our country's legacy in overt discrimination (e.g., slavery, segregation) generated inequities across all spheres in which people function as defined by the socioecological model-biological, individual, community, structural-and two of the many areas in which it manifests today are the disproportionate burden of obesity and obesity-related cancers in populations of color. Inequities due to environmental, social, and economic factors may predispose individuals to poor lifestyle behaviors by hindering an individual's opportunity to make healthy lifestyles choices. In this review, we examined the evidence on obesity and the lifestyle guidelines for cancer prevention in relation to cancer risk and outcomes for Black and Hispanic/Latino adults. We also discussed the role of structural and societal inequities on the ability of these two communities to adopt and maintain healthful lifestyle behaviors in accordance with the lifestyle guidelines for cancer prevention and control.
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Affiliation(s)
- Margaret S. Pichardo
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, 06520
- Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania Health System, Philadelphia, PA 19104
| | - Leah M. Ferrucci
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, 06520
- Yale Cancer Center, New Haven, CT 06520
| | - Yamile Molina
- School of Public Health, University of Illinois Chicago and Cancer Center University of Illinois Chicago, 60607
| | - Denise A. Esserman
- Department of Biostatistics, Yale School of Public Health, New Haven, CT 06520
| | - Melinda L. Irwin
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, 06520
- Yale Cancer Center, New Haven, CT 06520
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Liu VN, Zuniga KB, Paciorek A, Zhang L, Chan JM, Carroll PR, Van Loon K, Laffan A, Venook A, Van Blarigan EL, Kenfield SA. Barriers and confidence among colorectal and prostate cancer survivors participating in two behavioral intervention studies. Support Care Cancer 2023; 31:453. [PMID: 37428241 DOI: 10.1007/s00520-023-07901-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 06/23/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE Exercise and healthy diet are key components of cancer survivorship. We sought to explore perceived barriers to engaging in healthy diet and exercise, and whether these barriers change throughout remote-based behavioral interventions. METHODS Smart Pace (SP) and Prostate 8 (P8) were two 12-week pilot randomized controlled trials (RCTs) among 42 colorectal cancer (CRC) survivors and 76 prostate cancer (PC) survivors, respectively, that encouraged participants to implement exercise (both) and healthy diet (P8 only) through text messaging and wearable fitness monitors; P8 also included web materials. Participants completed surveys on perceived barriers and confidence in their ability to implement healthy behaviors at enrollment and 12 weeks; P8 also included a 52-week assessment. RESULTS At enrollment, CRC survivors commonly reported a lack of discipline/willpower (36%), time (33%), and energy (31%); PC survivors often reported a lack of knowledge about healthy dietary behaviors (26%). Not having anyone with whom to exercise with was a common barrier among both groups (21% in CRC, 20% in PC). Among the intervention groups in both studies, various enrollment barriers (overall, functional/psychological disability, aversiveness, excuses, and inconveniences) were associated with change in behavior over time. CONCLUSIONS Among CRC and PC survivors, there are multiple potential barriers related to motivation, time, social support, and lack of knowledge, that can be addressed and overcome to improve healthy behaviors. Tailoring lifestyle interventions to participants' individual barriers and confidence is needed to promote and sustain behavior change long-term.
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Affiliation(s)
- Vivian N Liu
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States.
| | - Kyle B Zuniga
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
- David Geffen School of Medicine, University of California, Los Angeles, United States
| | - Alan Paciorek
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
| | - Li Zhang
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, United States
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, United States
| | - June M Chan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
- Department of Urology, University of California, San Francisco, United States
| | - Peter R Carroll
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, United States
| | - Katherine Van Loon
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, United States
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, United States
| | - Angela Laffan
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, United States
| | - Alan Venook
- Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, United States
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, United States
| | - Erin L Van Blarigan
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
- Department of Urology, University of California, San Francisco, United States
| | - Stacey A Kenfield
- Department of Epidemiology and Biostatistics, University of California, San Francisco, United States
- Department of Urology, University of California, San Francisco, United States
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Depenbusch J, Haussmann A, Wiskemann J, Tsiouris A, Schmidt L, Sieverding M, Ungar N, Steindorf K. The Relationship between Exercise Self-Efficacy, Intention, and Structural Barriers for Physical Activity after a Cancer Diagnosis. Cancers (Basel) 2022; 14:cancers14102480. [PMID: 35626083 PMCID: PMC9139255 DOI: 10.3390/cancers14102480] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/09/2022] [Accepted: 05/17/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Despite numerous benefits of physical activity for cancer patients, the majority is insufficiently active. Previous research has shown that structural barriers negatively affect patients’ physical activity behavior. Identifying underlying mechanisms could help to develop effective strategies that alleviate those barriers and increase physical activity levels. In the current survey study, we investigated whether cancer patients’ self-efficacy, i.e., their confidence in their ability, and their intention to exercise mediated the relationship between structural barriers and physical activity. The results revealed a negative relation between structural barriers and patients’ self-efficacy. Lower self-efficacy, in turn, decreased patients’ intention and their likelihood to engage in physical activity. This mediating effect especially applied to those individuals who were sufficiently active before the diagnosis. Thus, the findings suggest that interventions directly addressing the perception of structural barriers or patients’ self-efficacy in dealing with these barriers might be effective in improving the physical activity levels of cancer patients. Abstract Previous research has shown that structural barriers negatively influence the physical activity (PA) behavior of cancer patients, but underlying mechanisms are unclear. The aim of the current study was to explore the potential mediating role of social-cognitive factors, namely PA self-efficacy and PA intention in this context. A total of 856 cancer patients completed a questionnaire on sociodemographic and medical characteristics, pre- and post-diagnosis PA, PA self-efficacy, PA intention, and PA impediment by structural barriers. A serial mediation model was used to test whether the association between structural barriers and post-diagnosis PA was mediated by PA self-efficacy and/or PA intention, in the overall sample and in subsamples defined by individuals’ pre-diagnosis PA. The results confirmed that structural barriers were not directly (95%CI [−0.45; 0.10]) but indirectly associated with post-diagnosis PA. Higher impediment by structural barriers decreased the likelihood of sufficient post-diagnosis PA via lower PA self-efficacy (95%CI [−0.25; −0.06]) and via the serial pathway of lower PA self-efficacy and lower PA intention (95%CI [−0.19; −0.05]). Investigating differences in these mediations by pre-diagnosis PA yielded significance only among previously active cancer patients. Both structural barriers and PA self-efficacy might hence be relevant target points for interventions aiming to improve PA behavior, especially among pre-diagnosis active cancer patients.
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Affiliation(s)
- Johanna Depenbusch
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (J.D.); (A.H.)
- Medical Faculty, Heidelberg University, Im Neuenheimer Feld 672, 69120 Heidelberg, Germany
| | - Alexander Haussmann
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (J.D.); (A.H.)
| | - Joachim Wiskemann
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Clinic Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany; (J.W.); (A.T.)
| | - Angeliki Tsiouris
- Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and University Clinic Heidelberg, Im Neuenheimer Feld 460, 69120 Heidelberg, Germany; (J.W.); (A.T.)
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Untere Zahlbacher Straße 8, 55131 Mainz, Germany
| | - Laura Schmidt
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117 Heidelberg, Germany; (L.S.); (M.S.); (N.U.)
| | - Monika Sieverding
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117 Heidelberg, Germany; (L.S.); (M.S.); (N.U.)
| | - Nadine Ungar
- Institute of Psychology, Heidelberg University, Hauptstraße 47-51, 69117 Heidelberg, Germany; (L.S.); (M.S.); (N.U.)
- Faculty of Healthcare and Nursing, Catholic University of Applied Sciences Mainz, Saarstraße 3, 55122 Mainz, Germany
| | - Karen Steindorf
- Division of Physical Activity, Prevention and Cancer, National Center for Tumor Diseases (NCT) Heidelberg and German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120 Heidelberg, Germany; (J.D.); (A.H.)
- Correspondence: ; Tel.: +49-6221-422351
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Impact and Determinants of Structural Barriers on Physical Activity in People with Cancer. Int J Behav Med 2021; 29:308-320. [PMID: 34550527 PMCID: PMC9166881 DOI: 10.1007/s12529-021-10014-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/15/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND A better understanding of the role of structural barriers for physical activity (PA) after a cancer diagnosis could help to increase PA among people with cancer. Thus, the present study aimed to identify determinants of structural barriers to PA in people with cancer and investigate the association between structural barriers and insufficient post-diagnosis PA, taking different PA change patterns into account. METHODS A total of 1299 people with breast, prostate, or colorectal cancer completed a questionnaire assessing their socio-demographic and medical characteristics, pre- and post-diagnosis PA, and perceived PA impediment by seven structural barriers. Regression analyses were used to investigate determinants of the perception of structural barriers and to examine the association between structural barriers and insufficient post-diagnosis PA, also with regard to different pre-diagnosis PA levels. RESULTS Overall 30-60% of participants indicated to feel impeded by structural barriers. The analyses revealed a younger age, higher BMI, lower educational level, no current work activity, co-morbidities, and lacking physicians' exercise counseling as significant determinants of the perception of structural barriers. Individuals reporting stronger impediments by structural barriers were significantly less likely to be meeting PA guidelines post-diagnosis, particularly those with sufficient pre-diagnosis PA levels. CONCLUSIONS The study highlights the need for tailored PA programs for people with cancer as well as for more guidance and support in overcoming structural barriers to improve PA behavior. The study has been registered under NCT02678832 at clinicaltrials.gov on February 10th 2016.
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Namin S, Zhou Y, Neuner J, Beyer K. Neighborhood Characteristics and Cancer Survivorship: An Overview of the Current Literature on Neighborhood Landscapes and Cancer Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7192. [PMID: 34281129 PMCID: PMC8297243 DOI: 10.3390/ijerph18137192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 06/21/2021] [Accepted: 07/02/2021] [Indexed: 12/18/2022]
Abstract
There is a growing literature on the association between neighborhood contexts and cancer survivorship. To understand the current trends and the gaps in the literature, we aimed to answer the following questions: To what degree, and how, has cancer survivorship research accounted for neighborhood-level effects? What neighborhood metrics have been used to operationalize neighborhood factors? To what degree do the neighborhood level metrics considered in cancer research reflect neighborhood development as identified in the Leadership for Energy and Environmental Design for Neighborhood Development (LEED-ND) guidelines? We first conducted a review guided by PRISMA extension for scoping review of the extant literature on neighborhood effects and cancer survivorship outcomes from January 2000 to January 2021. Second, we categorized the studied neighborhood metrics under six main themes. Third, we assessed the findings based on the LEED-ND guidelines to identify the most relevant neighborhood metrics in association with areas of focus in cancer survivorship care and research. The search results were scoped to 291 relevant peer-reviewed journal articles. Results show that survivorship disparities, primary care, and weight management are the main themes in the literature. Additionally, most articles rely on neighborhood SES as the primary (or only) examined neighborhood level metric. We argue that the expansion of interdisciplinary research to include neighborhood metrics endorsed by current paradigms in salutogenic urban design can enhance the understanding of the role of socioecological context in survivorship care and outcomes.
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Affiliation(s)
- Sima Namin
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Y.Z.); (K.B.)
| | - Yuhong Zhou
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Y.Z.); (K.B.)
| | - Joan Neuner
- General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI 53226, USA;
| | - Kirsten Beyer
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (Y.Z.); (K.B.)
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11
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Wolfson JA. Poverty and Survival in Childhood Cancer: A Framework to Move Toward Systemic Change. J Natl Cancer Inst 2021; 113:227-230. [PMID: 33227815 DOI: 10.1093/jnci/djaa108] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 07/24/2020] [Indexed: 12/30/2022] Open
Affiliation(s)
- Julie Anna Wolfson
- Division of Pediatric Hematology-Oncology, Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, USA
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12
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Correlates of Physical Activity in Colorectal Cancer Patients Based on Health Promotion Model. Cancer Nurs 2020; 43:E264-E272. [PMID: 32813487 DOI: 10.1097/ncc.0000000000000725] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Increasing attention is being given to physical activity in colorectal cancer patients. Some studies have explored a few correlates of physical activity separately. A contemporary study based on the Health Promotion Model may systematically broaden the understanding of physical activity in colorectal cancer patients. OBJECTIVE To understand the status of physical activity in Chinese colorectal cancer patients and to explore the correlated factors. METHODS A total of 168 adults with colorectal cancer were recruited at 3 tertiary hospitals in China. Participant data were collected on demographics, physical activity, biological factors, anxiety and depression, benefits/barriers to physical activity, self-efficacy, and social support. SAS 8.2 was used for statistical analysis, including descriptive analysis, correlation analysis, single factor analysis, and multiple stepwise regression analysis. RESULTS Only 25.60% of colorectal cancer survivors reached the requirements of the Colorectal Cancer Survivorship Care Guidelines. Employment states, number of complications, fatigue, body image, depression, perception of benefits/barriers, and self-efficacy were closely correlated with physical activity in Chinese colorectal cancer patients. CONCLUSIONS The physical activity status of patients with colorectal cancer is not optimal. The correlated factors that nurses can take measures to improve are fatigue, body image, depression, perception of benefits/barriers, and self-efficacy, which may improve physical activity in colorectal cancer patients in China. Additional research is needed to determine if improving factors correlated with physical activity will assist with directly increasing physical activity. IMPLICATIONS FOR PRACTICE Nurses should evaluate physical activity of colorectal cancer patients timely and play an active role in health promotion programs to improve colorectal cancer patients' physical activity.
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Romero-Elías M, Beltrán-Carrillo VJ, González-Cutre D, Jiménez-Loaisa A. Barriers to physical activity participation in colorectal cancer patients during chemotherapy treatment: A qualitative study. Eur J Oncol Nurs 2020; 46:101769. [PMID: 32506009 DOI: 10.1016/j.ejon.2020.101769] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/29/2020] [Accepted: 05/08/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE To explore the barriers that colorectal cancer patients (stage II and III) perceive to participate in physical activity (PA) when involved in adjuvant chemotherapy. Views of relatives and physicians concerning this issue were also included. METHOD Qualitative data from ten patients, ten relatives, and ten health professionals were obtained through semi-structured interviews (n = 30). RESULTS Two main themes were identified after data analysis: (a) barriers to PA related to ostomy and adjuvant chemotherapy and (b) barriers related to perceived lack of support for PA. In regard to the first theme, participants reported difficulties associated with the ostomy, limitations of the intravenous chemotherapy device, fatigue and reduced physical fitness, and focusing on cancer and restructuring priorities. Concerning the perceived lack of support for PA, participants referred to their families' overprotection, the health professionals' lack of knowledge and time to prescribe PA, and the lack of PA services in health centres. CONCLUSIONS Further information from health professionals about the recommendations of PA and its benefits during adjuvant chemotherapy could palliate these PA barriers. The offer of specific PA programmes for these patients is also recommended.
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Affiliation(s)
- María Romero-Elías
- Department of Sport Sciences. Sport Research Centre. Miguel Hernández University of Elche, Spain.
| | | | - David González-Cutre
- Department of Sport Sciences. Sport Research Centre. Miguel Hernández University of Elche, Spain.
| | - Alejandro Jiménez-Loaisa
- Department of Sport Sciences. Sport Research Centre. Miguel Hernández University of Elche, Spain.
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14
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McGettigan M, Cardwell CR, Cantwell MM, Tully MA. Physical activity interventions for disease-related physical and mental health during and following treatment in people with non-advanced colorectal cancer. Cochrane Database Syst Rev 2020; 5:CD012864. [PMID: 32361988 PMCID: PMC7196359 DOI: 10.1002/14651858.cd012864.pub2] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Colorectal cancer is the third most commonly diagnosed cancer worldwide. A diagnosis of colorectal cancer and subsequent treatment can adversely affect an individuals physical and mental health. Benefits of physical activity interventions in alleviating treatment side effects have been demonstrated in other cancer populations. Given that regular physical activity can decrease the risk of colorectal cancer, and cardiovascular fitness is a strong predictor of all-cause and cancer mortality risk, physical activity interventions may have a role to play in the colorectal cancer control continuum. Evidence of the efficacy of physical activity interventions in this population remains unclear. OBJECTIVES To assess the effectiveness and safety of physical activity interventions on the disease-related physical and mental health of individuals diagnosed with non-advanced colorectal cancer, staged as T1-4 N0-2 M0, treated surgically or with neoadjuvant or adjuvant therapy (i.e. chemotherapy, radiotherapy or chemoradiotherapy), or both. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 6), along with OVID MEDLINE, six other databases and four trial registries with no language or date restrictions. We screened reference lists of relevant publications and handsearched meeting abstracts and conference proceedings of relevant organisations for additional relevant studies. All searches were completed between 6 June and 14 June 2019. SELECTION CRITERIA We included randomised control trials (RCTs) and cluster-RCTs comparing physical activity interventions, to usual care or no physical activity intervention in adults with non-advanced colorectal cancer. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, performed the data extraction, assessed the risk of bias and rated the quality of the studies using GRADE criteria. We pooled data for meta-analyses by length of follow-up, reported as mean differences (MDs) or standardised mean differences (SMDs) using random-effects wherever possible, or the fixed-effect model, where appropriate. If a meta-analysis was not possible, we synthesised studies narratively. MAIN RESULTS We identified 16 RCTs, involving 992 participants; 524 were allocated to a physical activity intervention group and 468 to a usual care control group. The mean age of participants ranged between 51 and 69 years. Ten studies included participants who had finished active treatment, two studies included participants who were receiving active treatment, two studies included both those receiving and finished active treatment. It was unclear whether participants were receiving or finished treatment in two studies. Type, setting and duration of physical activity intervention varied between trials. Three studies opted for supervised interventions, five for home-based self-directed interventions and seven studies opted for a combination of supervised and self-directed programmes. One study did not report the intervention setting. The most common intervention duration was 12 weeks (7 studies). Type of physical activity included walking, cycling, resistance exercise, yoga and core stabilisation exercise. Most of the uncertainty in judging study bias came from a lack of clarity around allocation concealment and blinding of outcome assessors. Blinding of participants and personnel was not possible. The quality of the evidence ranged from very low to moderate overall. We did not pool physical function results at immediate-term follow-up due to considerable variation in results and inconsistency of direction of effect. We are uncertain whether physical activity interventions improve physical function compared with usual care. We found no evidence of effect of physical activity interventions compared to usual care on disease-related mental health (anxiety: SMD -0.11, 95% confidence interval (CI) -0.40 to 0.18; 4 studies, 198 participants; I2 = 0%; and depression: SMD -0.21, 95% CI -0.50 to 0.08; 4 studies, 198 participants; I2 = 0%; moderate-quality evidence) at short- or medium-term follow-up. Seven studies reported on adverse events. We did not pool adverse events due to inconsistency in reporting and measurement. We found no evidence of serious adverse events in the intervention or usual care groups. Minor adverse events, such as neck, back and muscle pain were most commonly reported. No studies reported on overall survival or recurrence-free survival and no studies assessed outcomes at long-term follow-up We found evidence of positive effects of physical activity interventions on the aerobic fitness component of physical fitness (SMD 0.82, 95% CI 0.34 to 1.29; 7 studies, 295; I2 = 68%; low-quality evidence), cancer-related fatigue (MD 2.16, 95% CI 0.18 to 4.15; 6 studies, 230 participants; I2 = 18%; low-quality evidence) and health-related quality of life (SMD 0.36, 95% CI 0.10 to 0.62; 6 studies, 230 participants; I2 = 0%; moderate-quality evidence) at immediate-term follow-up. These positive effects were also observed at short-term follow-up but not medium-term follow-up. Only three studies reported medium-term follow-up for cancer-related fatigue and health-related quality of life. AUTHORS' CONCLUSIONS The findings of this review should be interpreted with caution due to the low number of studies included and the quality of the evidence. We are uncertain whether physical activity interventions improve physical function. Physical activity interventions may have no effect on disease-related mental health. Physical activity interventions may be beneficial for aerobic fitness, cancer-related fatigue and health-related quality of life up to six months follow-up. Where reported, adverse events were generally minor. Adequately powered RCTs of high methodological quality with longer-term follow-up are required to assess the effect of physical activity interventions on the disease-related physical and mental health and on survival of people with non-advanced colorectal cancer. Adverse events should be adequately reported.
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Affiliation(s)
| | - Chris R Cardwell
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Marie M Cantwell
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Mark A Tully
- Institute of Mental Health Sciences, School of Health Sciences, Ulster University, Newtownabbey, UK
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DeGuzman PB, Chu C, Keim-Malpass J. Built and Natural Environment Barriers and Facilitators to Physical Activity in Rural, Suburban, and Small Urban Neighborhoods. Oncol Nurs Forum 2020; 46:545-555. [PMID: 31424449 DOI: 10.1188/19.onf.545-555] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To explore built and natural environment barriers and facilitators to walking for exercise in cancer survivors. PARTICIPANTS & SETTING Cancer survivors (N = 7) living in rural, suburban, and small urban neighborhoods in central Virginia. METHODOLOGIC APPROACH The authors used a qualitative descriptive design with photovoice to explore the cancer survivors' experience with residential walkability. FINDINGS The following three themes were identified from the data. IMPLICATIONS FOR NURSING Clinicians should consider an evaluation of the built and natural environment to support walking in cancer survivors. These findings may be used in conjunction with known individual-level barriers to physical activity to develop guidance for oncology nurses to help survivors safely achieve physical activity goals.
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Socio-ecological correlates of physical activity in breast and colon cancer survivors 4 years after participation in a randomized controlled exercise trial (PACT study). PLoS One 2020; 15:e0231663. [PMID: 32298326 PMCID: PMC7161977 DOI: 10.1371/journal.pone.0231663] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Accepted: 03/27/2020] [Indexed: 11/19/2022] Open
Abstract
Background Having a physically active lifestyle after cancer diagnosis is beneficial for health, and this needs to be continued into survivorship to optimize long-term benefits. We found that patients, who participated in an 18-week exercise intervention, reported significant higher physical activity (PA) levels 4 years after participation in a randomized controlled trial of supervised exercise delivered during chemotherapy (PACT study). This study aimed to identify social-ecological correlates of PA levels in breast and colon cancer survivors 4 years after participation in the PACT study. Methods Self-reported PA levels and potential correlates (e.g. physical fitness, fatigue, exercise history, and built environment) were assessed in 127 breast and colon cancer survivors shortly after diagnosis (baseline), post-intervention and 4 years later. Multivariable linear regression analyses were performed to identify social-ecological correlates of PA 4 years post-baseline. Results The final model revealed that lower baseline physical fatigue (β = -0.25, 95% CI -0.26; -0.24) and higher baseline total PA (0.06, 95% CI, 0.03; 0.10) were correlated with higher total PA levels 4 years post-baseline. Higher baseline leisure and sport PA (0.02, 95% CI 0.01; 0.03), more recreational facilities within a buffer of 1 km (4.05, 95% CI = 1.28; 6.83), lower physical fatigue at 4-year follow-up (-8.07, 95% CI -14.00; -2.13), and having a positive change in physical fatigue during the intervention period (0.04, 95% CI 0.001; 0.07) were correlates of sport and leisure PA levels 4 years post-baseline. Conclusions This study suggests that baseline and 4-year post-baseline physical fatigue, and past exercise behaviour, were significant correlates of PA 4 years after participation in an exercise trial. Additionally, this study suggests that the built environment should be taken into account when promoting PA. Understanding of socio-ecological correlates of PA can provide insights into how future exercise interventions should be designed to promote long-term exercise behaviour. Trial registration Current Controlled Trials ISRCTN43801571, Dutch Trial Register NTR2138. Trial registered on 9 December 2009, http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2138
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Parker NH, Lee RE, O'Connor DP, Ngo-Huang A, Petzel MQB, Schadler K, Wang X, Xiao L, Fogelman D, Simpson R, Fleming JB, Lee JE, Tzeng CWD, Sahai SK, Basen-Engquist K, Katz MHG. Supports and Barriers to Home-Based Physical Activity During Preoperative Treatment of Pancreatic Cancer: A Mixed-Methods Study. J Phys Act Health 2019; 16:1113-1122. [PMID: 31592772 PMCID: PMC8390122 DOI: 10.1123/jpah.2019-0027] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 07/12/2019] [Accepted: 08/27/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Physical activity and exercise appear to benefit patients receiving preoperative treatment for cancer. Supports and barriers must be considered to increase compliance with home-based exercise prescriptions in this setting. Such influences have not been previously examined. METHODS The authors used quantitative and qualitative methods to examine potential physical activity influences among patients who were prescribed home-based aerobic and strengthening exercises concurrent with preoperative chemotherapy or chemoradiation for pancreatic cancer. Physical activity was measured using exercise logs and accelerometers. Social support for exercise and perceived neighborhood walkability were measured using validated surveys. Relationships between influences and physical activity were evaluated using linear regression analyses and qualitative interviews. RESULTS Fifty patients received treatment for a mean of 16 (9) weeks prior to planned surgical resection. Social support from friends and neighborhood esthetics were positively associated with physical activity (P < .05). In interviews, patients confirmed the importance of these influences and cited encouragement from health care providers and desire to complete and recover from treatment as additional motivators. CONCLUSIONS Interpersonal and environmental motivators of exercise and physical activity must be considered in the design of future home-based exercise interventions designed for patients receiving preoperative therapy for cancer.
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18
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O'Neill L, Bennett AE, Guinan E, Reynolds JV, Hussey J. Physical recovery in the first six months following oesophago-gastric cancer surgery. Identifying rehabilitative needs: a qualitative interview study. Disabil Rehabil 2019; 43:1396-1403. [PMID: 31524528 DOI: 10.1080/09638288.2019.1663946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE To investigate patients' perspectives of their physical recovery in the first six months post oesophago-gastric cancer surgery. MATERIALS AND METHODS Semi-structured interviews were held at St James's Hospital, Dublin, with participants who were 4 weeks to 6 months post-oesophagectomy/gastrectomy. Interviews were an average of 14 min and included questions pertaining to physical recovery post-oesophagectomy/gastrectomy. Interviews were audio-taped, transcribed verbatim, and analyzed by thematic analysis. RESULTS Twenty participants (mean age 63.35(7.50) years) were recruited. Four themes were identified: i) challenges of recovery and impact on physical activity, ii) facilitators of, and barriers to, returning to physical activity, iii) physical challenges of returning to pre-operative societal roles, iv) recommendations for health services on measures which may enhance the return to physical activity. Post-operative barriers to physical activity included dietary issues, continuing treatments, pain, breathlessness, muscle weakness, fatigue, and anxiety. Participants identified that strategies such as a gradual return to activities, rest, and family support facilitated return to physical activity. Participants highlighted the need for i) greater physiotherapy input, ii) psycho-social support, and iii) fatigue management may aid physical recovery. CONCLUSIONS Following oesophago-gastric cancer surgery, patients experience physical and psychosocial difficulties which can hamper recovery, but many of which are amenable to rehabilitative intervention. Accordingly, rehabilitative measures throughout the early stages of recovery require investigation.Implications for RehabilitationCurative treatment for oesophageal and gastric cancer is associated with significant risk of post-operative morbidity, resulting in a myriad of physical and nutritional challenges which may impact on post-operative physical recovery.Greater provision of physiotherapy services to counteract physical impairments post oesophago-gastric cancer surgery is required.Physical recovery may also be aided through the enhanced provision of other supportive care services such as fatigue management and psychological support.
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Affiliation(s)
- Linda O'Neill
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
| | | | - Emer Guinan
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - John V Reynolds
- Trinity Translational Medicine Institute, Department of Surgery, Trinity College Dublin and St. James's Hospital, Dublin, Ireland
| | - Juliette Hussey
- Discipline of Physiotherapy, School of Medicine, Trinity College Dublin, Dublin, Ireland
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Saunders S, Brunet J. A qualitative study exploring what it takes to be physically active with a stoma after surgery for rectal cancer. Support Care Cancer 2018; 27:1481-1489. [PMID: 30368673 DOI: 10.1007/s00520-018-4516-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 10/16/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Many adults must cope with the adverse effects of cancer and adjuvant therapies, which may limit their engagement in health-enhancing behaviors such as physical activity (PA). Furthermore, the placement of a stoma during surgery for rectal cancer may cause additional challenges to being physically active. The aim of this study was to explore the experiences of rectal cancer survivors who were living with a stoma and the impact on their engagement in PA. METHODS Interpretive phenomenological analysis was used as the approach for this qualitative study. Fifteen rectal cancer survivors took part in a semi-structured interview post-chemotherapy, and thematic analysis was used to identify themes within their accounts. RESULTS Three themes captured participants' personal lived experience: (1) reasons for engaging in PA, (2) deterrents to engaging in PA, and (3) practical implications. CONCLUSIONS Participants' accounts offered insight into both their cancer and stoma-related experiences, highlighting both reasons for and deterrents to engaging in PA. Further, findings helped to identify tangible strategies that those learning to be physically active with a stoma may find useful.
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Affiliation(s)
- Stephanie Saunders
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, 125 University Private, MNT 339, Ottawa, ON, K1N 6N5, Canada
| | - Jennifer Brunet
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, 125 University Private, MNT 339, Ottawa, ON, K1N 6N5, Canada. .,Institut du savoir Montfort, Hôpital Montfort, Ottawa, Canada. .,Cancer Therapeutic Program, Ottawa Hospital Research Institute, Ottawa, Canada.
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Eyl RE, Koch-Gallenkamp L, Jansen L, Walter V, Carr P, Hoffmeister M, Chang-Claude J, Brenner H, Arndt V. Potential determinants of physical inactivity among long-term colorectal cancer survivors. J Cancer Surviv 2018; 12:679-690. [PMID: 30097853 DOI: 10.1007/s11764-018-0705-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 07/18/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE Since physical activity (PA) has been shown to be associated with better prognosis and quality of life (QOL) in colorectal cancer (CRC) patients, this study focuses on the barriers of PA among CRC survivors. METHODS This study is based on a population-based study from Germany of 1343 women and men, diagnosed with CRC between 2003 and 2008 and being alive five years later. Multivariable logistic regression was used to explore associations between baseline as well as five-year follow-up (5YFU) characteristics and physical inactivity (PIA) at 5YFU. Quartiles were calculated based on metabolic equivalent hours per week of PA at baseline and at 5YFU. Participants in quartile 1 were defined as physically inactive, and patients in quartile 2 to quartile 4 were defined as physically active. RESULTS Cancer-specific factors such as having a stoma (odds ratio (OR) = 1.51, 95% confidence interval (CI) = 1.12-2.04), demographic factors such as living in a small town or city (OR = 1.46, 95% CI = 1.05-2.02; OR = 1.42, 95% CI = 1.01-2.02), older age (OR = 1.44, 95% CI = 0.80-2.58), or being divorced (OR = 1.72, 95% CI = 0.96-3.07), as well as lifestyle factors such as being a current smoker (OR = 1.54, 95% CI = 1.04-2.29) or being obese (OR = 1.43, 95% CI = 0.96-2.13) were associated with PIA at 5YFU. Subgroup analyses showed that the association between body mass index and PIA was stronger in women than in men. Baseline PA was identified as a strong predictor of PIA at 5YFU. CONCLUSIONS Findings suggest that predominately patients with a stoma, patients living in a more populated area, being older, divorced, a current smoker, or obese were more likely to be physically inactive and therefore could be targeted to be more physically active. IMPLICATIONS FOR CANCER SURVIVORS Addressing barriers for PA might help to develop specific, individually tailored PA interventions to overcome PIA and improve the long-term outcome of CRC survivors.
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Affiliation(s)
- Ruth Elisa Eyl
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
- Medical Faculty Heidelberg, University of Heidelberg, Im Neuenheimer Feld 672, 69120, Heidelberg, Germany
| | - Lena Koch-Gallenkamp
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Lina Jansen
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Viola Walter
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Prudence Carr
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Michael Hoffmeister
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Jenny Chang-Claude
- Unit of Genetic Epidemiology, Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany
- Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
- German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Volker Arndt
- Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.
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Eng L, Pringle D, Su J, Shen X, Mahler M, Niu C, Charow R, Tiessen K, Lam C, Halytskyy O, Naik H, Hon H, Irwin M, Pat V, Gonos C, Chan C, Villeneuve J, Harland L, Shani RM, Brown MC, Selby P, Howell D, Xu W, Liu G, Alibhai SMH, Jones JM. Patterns, perceptions, and perceived barriers to physical activity in adult cancer survivors. Support Care Cancer 2018; 26:3755-3763. [DOI: 10.1007/s00520-018-4239-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 04/26/2018] [Indexed: 11/28/2022]
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Crespel C, Brami C, de Boissieu P, Mazza C, Chauvet K, Lemoine A, Gavlak B, Léandri C, Brasseur M, Bertin E, Bouché O. [Evaluation of the feasibility of a program of adapted physical activity in day hospital of digestive oncology: From the point of view of patients]. Bull Cancer 2018; 105:228-233. [PMID: 29426740 DOI: 10.1016/j.bulcan.2017.11.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/22/2017] [Accepted: 11/08/2017] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Adapted physical activity (APA) is recognized as an effective supportive care for asthenia and quality of life in oncology. Before an APA program was organized, the feasibility of such a program was evaluated among the patients. METHODS Descriptive, prospective, semi-qualitative, single-center study over a 3-month period in patients treated with ambulatory chemotherapy for digestive cancer. A self-questionnaire was offered to all patients to evaluate their practice and knowledge about APA. In ten patients, fatigue, anxiety and depression were assessed, before and after 9 weeks of hospital-based APA. The scores were compared by matched Student test. RESULTS Of the 123 patients treated, 80 questionnaires (65%) were exploitable. Before the diagnosis of cancer, 40 patients (50%) were physically active, 20% after (n=16). The reasons for not practicing were: lack of interest/not the idea (42%), lack of time (34%), do not believe in profit (9%), too expensive (8%). Fifty-three patients (66%) were interested in the program. In 10 patients, the APA program significantly reduced the depression score (P=0.024) and a non-significant improvement in anxiety and fatigue. DISCUSSION This study shows that patients treated with chemotherapy are unaware of the usefulness of APA and that medical information can improve adherence to such a program. The establishment of an intra-hospital APA program proved to be possible and relevant.
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Affiliation(s)
- Céline Crespel
- CHU de Reims, department of gastroenterology, avenue du General-Koenig, 51092 Reims cedex, France
| | - Cloé Brami
- CHU de Reims, department of gastroenterology, avenue du General-Koenig, 51092 Reims cedex, France
| | - Paul de Boissieu
- CHU de Reims, department of research and innovation, avenue du General-Koenig, 51092 Reims cedex, France
| | - Camille Mazza
- CHU de Reims, department of gastroenterology, avenue du General-Koenig, 51092 Reims cedex, France
| | - Kevin Chauvet
- CHU de Reims, department of gastroenterology, avenue du General-Koenig, 51092 Reims cedex, France
| | - Amélie Lemoine
- CHU de Reims, department of gastroenterology, avenue du General-Koenig, 51092 Reims cedex, France
| | - Benoit Gavlak
- CHU de Reims, department of gastroenterology, avenue du General-Koenig, 51092 Reims cedex, France
| | - Chloé Léandri
- CHU de Reims, department of gastroenterology, avenue du General-Koenig, 51092 Reims cedex, France
| | - Mathilde Brasseur
- CHU de Reims, department of gastroenterology, avenue du General-Koenig, 51092 Reims cedex, France
| | - Eric Bertin
- CHU de Reims, department of nutrition, avenue du General-Koenig, 51092 Reims cedex, France
| | - Olivier Bouché
- CHU de Reims, department of gastroenterology, avenue du General-Koenig, 51092 Reims cedex, France.
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Lin KY, Denehy L, Frawley HC, Wilson L, Granger CL. Pelvic floor symptoms, physical, and psychological outcomes of patients following surgery for colorectal cancer. Physiother Theory Pract 2018; 34:442-452. [PMID: 29308963 DOI: 10.1080/09593985.2017.1422165] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Little has been published regarding general and pelvic floor-related health status in patients who have undergone surgery for colorectal cancer (CRC). OBJECTIVE The objective of the study was to assess changes in pelvic floor symptoms, physical activity levels, psychological status, and health-related quality of life (HRQoL) in patients with CRC from pre- to 6 months postoperatively. METHODS Pelvic floor symptoms, physical activity levels, anxiety and depression, and HRQoL of 30 participants who were undergoing surgery for stages I-III CRC were evaluated pre- and 6 months postoperatively. RESULTS Six months postoperatively, there were no significant changes in severity of pelvic floor symptoms, or other secondary outcomes (physical activity levels, depression, global HRQoL) compared to preoperative levels (p > 0.05). However, fecal incontinence (p = 0.03) and hair loss (p = 0.003) measured with the HRQoL instrument were significantly worse. Participants were engaged in low levels of physical activity before (42.3%) and after surgery (47.4%). CONCLUSION The findings of a high percentage of participants with persistent low physical activity levels and worse bowel symptoms after CRC surgery compared to preoperative levels suggest the need for health-care professionals to provide information about the benefits of physical activity and bowel management at postoperative follow-ups. Further investigation in larger studies is warranted.
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Affiliation(s)
- Kuan-Yin Lin
- a Department of Physiotherapy, School of Health Sciences , University of Melbourne , Melbourne , Australia.,b Department of Physiotherapy , Royal Melbourne Hospital , Melbourne , Australia.,c Centre for Allied Health Research and Education, Cabrini Health , Melbourne , Australia
| | - Linda Denehy
- a Department of Physiotherapy, School of Health Sciences , University of Melbourne , Melbourne , Australia.,e Institute for Breathing and Sleep , Melbourne , Victoria , Australia
| | - Helena C Frawley
- c Centre for Allied Health Research and Education, Cabrini Health , Melbourne , Australia.,d Physiotherapy, School of Allied Health , La Trobe University , Melbourne , Australia
| | - Lisa Wilson
- f Department of General Surgery , The Royal Melbourne Hospital , Melbourne , Victoria , Australia
| | - Catherine L Granger
- a Department of Physiotherapy, School of Health Sciences , University of Melbourne , Melbourne , Australia.,b Department of Physiotherapy , Royal Melbourne Hospital , Melbourne , Australia.,e Institute for Breathing and Sleep , Melbourne , Victoria , Australia
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McGettigan M, Cardwell CR, Cantwell MM, Tully MA. Physical activity and exercise interventions for disease-related physical and mental health during and following treatment in people with non-advanced colorectal cancer. Cochrane Database Syst Rev 2017. [DOI: 10.1002/14651858.cd012864] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Maresa McGettigan
- Cancer Focus Northern Ireland; Cancer Prevention; 40-44 Eglantine Avenue Belfast County Antrim UK BT9 6DX
| | - Chris R Cardwell
- Queen's University Belfast; Centre for Public Health; School of Medicine Dentistry and Biomedical Sciences Belfast Northern Ireland UK BT12 6BJ
| | - Marie M Cantwell
- Queen's University Belfast; Centre for Public Health; School of Medicine Dentistry and Biomedical Sciences Belfast Northern Ireland UK BT12 6BJ
| | - Mark A Tully
- Queen's University Belfast; UKCRC Centre of Excellence for Public Health (Northern Ireland), Centre for Public Health; Grosvenor Road Belfast Northern Ireland UK BT12 6BJ
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Physical activity, bowel function, and quality of life among rectal cancer survivors. Qual Life Res 2017; 26:3131-3142. [PMID: 28677077 DOI: 10.1007/s11136-017-1641-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2017] [Indexed: 12/17/2022]
Abstract
PURPOSE Physical activity (PA) is positively associated with numerous health benefits among cancer survivors. This study examined insufficiently investigated relationships among PA, health-related quality of life (HRQOL), and bowel function (BF) in rectal cancer survivors. METHODS RC survivors (n = 1063) ≥5 years from diagnosis in two Kaiser permanente regions were mailed a multidimensional survey to assess HRQOL and BF. PA was assessed by a modified Godin Leisure-Time Exercise Questionnaire. PA minutes were categorized into weighted categories based on guidelines: (1) not active (zero PA minutes); (2) insufficiently active (1-149 PA minutes); (3) meeting guidelines (150-299 PA minutes); and (4) above guidelines (≥300 PA minutes). Relationships of PA with HRQOL and BF were evaluated using multiple linear regression, stratified by sex and ostomy status for BF. Types of PA identified as helpful for BF and symptoms addressed were summarized. RESULTS Response rate was 60.5%. Of 557 participants, 40% met or exceeded PA guidelines, 34% were not active, and 26% were insufficiently active. Aerobic activities, specifically walking and cycling, were most commonly reported to help BF. Higher PA was associated with better psychological wellbeing and multiple SF12 scales, worse BF scores in men with ostomies, and better BF scores in women. CONCLUSIONS Meeting or exceeding PA guidelines was associated with higher HRQOL. Although the BF findings are exploratory, they suggest women may benefit from increased PA, whereas men with ostomies may face challenges that require more study. Identifying PA strategies that will lead to improved patient compliance and benefit are needed.
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McGowan EL, Fuller D, Cutumisu N, North S, Courneya KS. The role of the built environment in a randomized controlled trial to increase physical activity among men with prostate cancer: the PROMOTE trial. Support Care Cancer 2017; 25:2993-2996. [PMID: 28656468 DOI: 10.1007/s00520-017-3798-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 06/12/2017] [Indexed: 11/24/2022]
Abstract
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 (β = 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).
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Affiliation(s)
- Erin L McGowan
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, Physical Education Building (PE 2022B), St. John's, NL, A1C 5S7, Canada.
| | - Daniel Fuller
- School of Human Kinetics and Recreation, Memorial University of Newfoundland, Physical Education Building (PE 2022B), St. John's, NL, A1C 5S7, Canada
| | - Nicoleta Cutumisu
- Centre INRS-Institut Armand-Frappier, 531 Boul des Prairies, Laval, QC, H7V 1B7, Canada
| | - Scott North
- Medical Oncology, Department of Oncology, University of Alberta, Cross Cancer Institute, 11560 University Avenue, Edmonton, AB, T6G 1Z2, Canada
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, 1-113 University Hall, Van Vliet Complex, University of Alberta, Edmonton, AB, T6G 2H9, Canada
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Golsteijn RHJ, Bolman C, Volders E, Peels DA, de Vries H, Lechner L. Development of a computer-tailored physical activity intervention for prostate and colorectal cancer patients and survivors: OncoActive. BMC Cancer 2017. [PMID: 28651586 PMCID: PMC5485671 DOI: 10.1186/s12885-017-3397-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Cancer and cancer treatment coincide with substantial negative physical, psychological and psychosocial problems. Physical activity (PA) can positively affect the negative effects of cancer and cancer treatment and thereby increase quality of life in CPS. Nevertheless, only a minority of CPS meet PA guidelines. We developed the OncoActive (OncoActief in Dutch) intervention: a computer-tailored PA program to stimulate PA in prostate and colorectal CPS, because to our knowledge there are only a few PA interventions for these specific cancer types in the Netherlands Methods The OncoActive intervention was developed through systematic adaptation of a proven effective, evidence-based, computer-tailored PA intervention for adults over fifty, called Active Plus. The Intervention Mapping (IM) protocol was used to guide the systematic adaptation. A literature study and interviews with prostate and colorectal CPS and health care professionals revealed that both general and cancer-specific PA determinants are important and should be addressed. Change objectives, theoretical methods and applications and the actual program content were adapted to address the specific needs, beliefs and cancer-related issues of prostate and colorectal CPS. Intervention participants received tailored PA advice three times, on internet and with printed materials, and a pedometer to set goals to improve PA. Pre- and pilot tests showed that the intervention was highly appreciated (target group) and regarded safe and feasible (healthcare professionals). The effectiveness of the intervention is being evaluated in a randomized controlled trial (RCT) (n = 428), consisting of an intervention group and a usual care waiting-list control group, with follow-up measurements at three, six and twelve months. Participants are recruited from seventeen hospitals and with posters, flyers and calls in several media. Discussion Using the Intervention Mapping protocol resulted in a systematically adapted, theory and evidence-based intervention providing tailored PA advice to prostate and colorectal CPS. If the intervention turns out to be effective in increasing PA, as evaluated in a RCT, possibilities for nationwide implementation and extension to other cancer types will be explored. Trial registration The study is registered in the Dutch Trial Register (NTR4296) on November 23rd 2013 and can be accessed at http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4296.
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Affiliation(s)
- R H J Golsteijn
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands.
| | - C Bolman
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands
| | - E Volders
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands
| | - D A Peels
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands
| | - H de Vries
- Department of Health Promotion, Maastricht University, Maastricht, The Netherlands
| | - L Lechner
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, PO, Box 2960, 6401 DL Heerlen, The Netherlands
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Lee MS, Small BJ, Jacobsen PB. Rethinking barriers: a novel conceptualization of exercise barriers in cancer survivors. PSYCHOL HEALTH MED 2017; 22:1248-1255. [PMID: 28470090 DOI: 10.1080/13548506.2017.1325503] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Previous research suggests different types of barriers may demonstrate different relationships with intention to engage in health behaviors. This study explored global, practical, and health-related barriers' relationships with exercise intention and behavior among cancer survivors. The mediating role of intention in the barriers-behavior relationships was also evaluated. Cancer survivors (N = 152) completed self-report measures of exercise barriers, intention, and behavior at baseline and of exercise behavior two months later. Global barriers were negatively related (p < .01) and practical and health-related barriers were unrelated (ps ≥ .07) to exercise intention. Global and practical barriers were negatively related (ps < .01) and health-related barriers were unrelated (p = .48) to subsequent exercise behavior. Exercise intention did not mediate any barriers-behavior relationships. Results suggest that global and practical barriers should be targeted in barriers reduction interventions and highlight the intention-behavior gap problem. Future research should explore multidimensionality of barriers for other health behaviors.
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Affiliation(s)
- Morgan S Lee
- a Department of Psychology , University of South Florida , Tampa , FL , USA.,b Department of Health Sciences , University of Colorado Colorado Springs , Colorado Springs , CO , USA
| | - Brent J Small
- c School of Aging Studies , University of South Florida , Tampa , FL , USA
| | - Paul B Jacobsen
- a Department of Psychology , University of South Florida , Tampa , FL , USA.,d Division of Cancer Control and Population Sciences at the National Cancer Institute , Bethesda , MD , USA
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Physical Activity Correlates, Barriers, and Preferences for Women With Gynecological Cancer. Int J Gynecol Cancer 2016; 26:1530-7. [DOI: 10.1097/igc.0000000000000790] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
ObjectivePhysical activity is associated with improved health outcomes for people with cancer. We aimed to identify physical activity correlates, barriers, and preferences among women with gynecological cancer.Methods and MaterialsA self-administered questionnaire was completed by 101 women diagnosed with gynecological cancer (mostly ovarian cancer [59%] and endometrial cancer [23%]) within the previous 2 years, at 2 major hospitals in Sydney, Australia. Physical activity was measured for the past 7 days. Thirteen potential barriers were scored on a 5-point scale. Associations with physical activity were assessed using Spearman correlations (rs) and multivariate logistic regression.ResultsFactors associated with being sufficiently active (≥150 min/wk physical activity) were being in the follow-up phase of the cancer trajectory (odds ratio [OR], 7.0; 95% confidence interval [CI], 1.5 to 33.4 compared with other phases) and prediagnosis physical activity (OR, 4.6; 95% CI, 1.1 to 18.5 for the highest vs lowest tertile). The most common barriers were “too tired” and “not well enough,” and both were associated with lower physical activity (rs, −0.20 and −0.22, respectively). The odds of having disease-specific barriers was higher for women with ovarian cancer (OR, 4.6; P = 0.04) and women receiving chemotherapy or radiation therapy (OR, 8.3; P = 0.008). “Lack of interest” (rs, −0.26) and “never been active” (rs, −0.23) were also inversely correlated with physical activity, although less common. Forty-three percent of women indicated that they were extremely or very interested to have a one-to-one session with an exercise physiologist. Participants’ preferred time of starting a physical activity program was 3 to 6 months after treatment (26%) or during treatment (23%). Walking was the preferred type of physical activity.ConclusionsStrategies to increase physical activity among women with gynecological cancer should include a focus on reducing disease-specific barriers and target women who have done little physical activity in the past or who are in the treatment phases of care.
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Maxwell-Smith C, Zeps N, Hagger MS, Platell C, Hardcastle SJ. Barriers to physical activity participation in colorectal cancer survivors at high risk of cardiovascular disease. Psychooncology 2016; 26:808-814. [PMID: 27478009 DOI: 10.1002/pon.4234] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 07/22/2016] [Accepted: 07/26/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Lifestyle factors including inadequate physical activity may contribute to increased risk of developing cardiovascular disease in colorectal cancer survivors. Identification of the barriers to physical activity is important for forming an evidence base of factors to target in future physical activity programs aimed at improving cardiovascular health in this population. METHODS Colorectal cancer survivors (N = 24) from St. John of God Subiaco Hospital participated in semi-structured interviews about their current physical activity behaviors and perceived barriers to physical activity. RESULTS Inductive thematic analysis of interviews revealed 5 overarching themes relating to barriers to physical activity: psychological barriers, environmental barriers, knowledge of guidelines, lack of practitioner support, and energy/age barriers. CONCLUSIONS Novel findings revealed participants' dependence on practitioner support, including a reliance on practitioners to recommend lifestyle change. Survivors also revealed that regular checkups to monitor cardiovascular risk replaced the need for healthy lifestyle changes. IMPLICATIONS With survivors holding the advice of clinicians in high regard, an opportunity exists for clinicians to facilitate lifestyle change. Health care professionals such as nurses can implement motivational strategies and provide additional health information during follow-up visits, to ensure long-term adherence. Individuals who reported psychological, motivational, and environmental barriers may benefit from interventions to improve self-regulation, planning, and problem-solving skills.
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Affiliation(s)
- Chloe Maxwell-Smith
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Nik Zeps
- Department of Oncology, St. John of God Hospital, Perth, Western Australia, Australia
| | - Martin S Hagger
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
| | - Cameron Platell
- Department of Oncology, St. John of God Hospital, Perth, Western Australia, Australia
| | - Sarah J Hardcastle
- Health Psychology and Behavioural Medicine Research Group, School of Psychology and Speech Pathology, Curtin University, Perth, Western Australia, Australia
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Abstract
BACKGROUND Performing regular exercise of at least 150 minutes weekly has benefits for colorectal cancer survivors. However, barriers inhibit these survivors from performing regular exercise. OBJECTIVES The aim of this study was to explore exercise behaviors and significant factors influencing weekly exercise time of more than 150 minutes in colorectal cancer survivors. METHODS A cross-sectional study design was used to recruit participants in Taiwan. Guided by the ecological model of health behavior, exercise barriers were assessed including intrapersonal, interpersonal, and environment-related barriers. A multiple logistic regression was used to explore the factors associated with the amount of weekly exercise. RESULTS Among 321 survivors, 57.0% of them had weekly exercise times of more than 150 minutes. The results identified multiple levels of significant factors related to weekly exercise times including intrapersonal factors (occupational status, functional status, pain, interest in exercise, and beliefs about the importance of exercise) and exercise barriers related to environmental factors (lack of time and bad weather). No interpersonal factors were found to be significant. CONCLUSIONS Colorectal cancer survivors experienced low levels of physical and psychological distress. Multiple levels of significant factors related to exercise time including intrapersonal factors as well as exercise barriers related to environmental factors should be considered. IMPLICATIONS FOR PRACTICE Healthcare providers should discuss with their patients how to perform exercise programs; the discussion should address multiple levels of the ecological model such as any pain problems, functional status, employment status, and time limitations, as well as community environment.
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Wu YP, Yi J, McClellan J, Kim J, Tian T, Grahmann B, Kirchhoff AC, Holton A, Wright J. Barriers and Facilitators of Healthy Diet and Exercise Among Adolescent and Young Adult Cancer Survivors: Implications for Behavioral Interventions. J Adolesc Young Adult Oncol 2015; 4:184-91. [PMID: 26697268 PMCID: PMC4684662 DOI: 10.1089/jayao.2015.0028] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study uses qualitative methods to identify barriers to and facilitators of exercise and healthy eating among adolescent and young adult (AYA) cancer survivors (survivors currently aged 18-39 years and diagnosed with cancer anytime in their lives), as reported by survivors and their primary supporters. METHODS Survivors (M(age) = 27.6 years, SD = 6.6 years) had completed active cancer therapy. Survivors and supporters (i.e., nominated by survivors as someone who was a main source of support) attended separate focus group sessions (five survivor focus groups, five supporter focus groups) and were asked to complete a self-reported questionnaire assessing demographic and cancer history and engagement in exercise and healthy eating. RESULTS In total, 25 survivors and 19 supporters participated. The three overarching themes identified were barriers to exercise and healthy eating (e.g., lack of resources, negative thoughts and feelings, negative social and environmental influences), facilitators of exercise and healthy eating (e.g., cognitive motivators, tools for health behavior implementation, social relationships), and intervention implications (e.g., informational needs, desire for social support). CONCLUSION AYA cancer survivors and their supporters identified barriers to and facilitators of healthy lifestyle behaviors, which should be considered when designing interventions to improve the long-term health of survivors.
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Affiliation(s)
- Yelena P. Wu
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
- Department of Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah
| | - Jaehee Yi
- College of Social Work, University of Utah, Salt Lake City, Utah
| | - Jessica McClellan
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
| | - Jonghee Kim
- College of Social Work, University of Utah, Salt Lake City, Utah
| | - Tian Tian
- College of Social Work, University of Utah, Salt Lake City, Utah
| | - Bridget Grahmann
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, Utah
| | - Anne C. Kirchhoff
- Department of Cancer Control and Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Avery Holton
- Department of Communication, University of Utah, Salt Lake City, Utah
| | - Jennifer Wright
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
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Mas S, Quantin X, Ninot G. Barriers to, and Facilitators of Physical Activity in Patients Receiving Chemotherapy for Lung Cancer: An exploratory study. J Palliat Care 2015. [PMID: 26201210 DOI: 10.1177/082585971503100204] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIM Physical activity (PA) has a positive effect on the cardiorespiratory fitness, lung cancer symptoms, and quality of life of lung cancer patients. The aim of our study was to identify barriers to, and facilitators of PA in lung cancer patients. METHODS We collected data from five patients diagnosed with primary, advanced non-small-cell lung cancer (NSCLC) who were receiving chemotherapy. Choosing a qualitative approach, we conducted an exploratory analysis using the thematic analysis technique to process the data. RESULTS Seven barriers to, and facilitators of PA were identified and grouped into four categories. We found that psychological and social factors affect patients' willingness and ability to engage in PA, while physiological and environmental factors have an impact on the duration, intensity, and regularity of their PA. CONCLUSION Our study highlighted some of the effects that the barriers to PA have on the practice of it in our patient group. Our findings may be used by professionals to design adapted PA programs.
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Perceived barriers and benefits to physical activity in colorectal cancer patients. Support Care Cancer 2015; 24:903-910. [PMID: 26268781 PMCID: PMC4689774 DOI: 10.1007/s00520-015-2860-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 07/17/2015] [Indexed: 12/26/2022]
Abstract
Purpose There is emerging evidence for the benefits of physical activity (PA) post-diagnosis for colorectal cancer (CRC) survivors. However, population studies suggest activity levels in these patients are very low. Understanding perceived barriers and benefits to activity is a crucial step in designing effective interventions. Methods Patients who were between 6 months and 5 years post-diagnosis with non-metastasised disease were identified from five London (UK) hospitals. Four hundred and ninety five completed a lifestyle survey that included open-ended questions on their perceived barriers (what things would stop you from doing more physical activity?) and benefits (what do you think you would gain from doing more physical activity?). Patients also recorded their activity levels using the Godin Leisure Time Exercise Questionnaire, along with sociodemographic and treatment variables. Results The most commonly reported barriers related to cancer and its treatments (e.g. fatigue). Age and mobility-related comorbidities (e.g. impaired mobility) were also frequently cited. Those who reported age and mobility as barriers, or reported any barrier, were significantly less active even after adjustment for multiple confounders. The most frequently reported benefits were physiological (e.g. improving health and fitness). Cancer-related benefits (such as prevention of recurrence) were rarely reported. Those perceiving physiological benefits or perceiving any benefits were more active in unadjusted models, but associations were not significant in adjusted models. Conclusions We have identified important barriers and facilitators in CRC survivors that will aid in the design of theory-based PA interventions.
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van Putten M, Husson O, Mols F, Luyer MDP, van de Poll-Franse LV, Ezendam NPM. Correlates of physical activity among colorectal cancer survivors: results from the longitudinal population-based profiles registry. Support Care Cancer 2015; 24:573-583. [PMID: 26173977 PMCID: PMC4689770 DOI: 10.1007/s00520-015-2816-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 05/25/2015] [Indexed: 02/01/2023]
Abstract
Purpose Physical activity can improve health of cancer survivors. To increase physical activity levels among colorectal cancer (CRC) survivors, we need to understand which factors affect physical activity. Therefore, this study examined the longitudinal relationship between symptom-related, functioning-related, and psychological barriers and socio-demographic and clinical factors with physical activity among CRC survivors. Methods CRC survivors identified from the population-based Eindhoven Cancer Registry (ECR) diagnosed between 2000 and 2009 were included. Survivors completed validated questionnaires measuring moderate-to-vigorous physical activity (MVPA) and barriers in 2010(T1), 2011(T2), and 2012(T3). Linear-mixed models and linear regression techniques were used. Results Response rates were 74 % (N = 2451, T1); 47 % (N = 1547, T2); and 41 % (N = 1375, T3). Several factors were negatively associated with MVPA: symptom-related barriers (e.g., fatigue, dyspnea, chemotherapy side effects, pain, appetite loss, and weight loss); psychological barriers (i.e., depressive symptoms and anxiety); functioning-related barriers (e.g., low physical or role functioning, unfavorable future perspective); socio-demographic (i.e., older age, female, no partner); and clinical factors (i.e., obesity). However, no within-subject effects were significantly associated with MVPA. Groups of functioning-related barriers, socio-demographic factors, symptom-related barriers, psychological barriers, and clinical factors explained 11, 3.9, 3.8, 2.4, and 2.2 % of the variance in MVPA at T1, respectively. Conclusions Several functioning-related and symptom-related barriers and few socio-demographic factors were associated with physical activity among CRC survivors. Future interventions to promote physical activity among CRC survivors could benefit by taking into account functioning aspects and symptoms of cancer and its treatment, and assess the causal direction of these associations.
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Affiliation(s)
- Margreet van Putten
- Department of Research, Netherlands Comprehensive Cancer Organization, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands
| | - Olga Husson
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Floortje Mols
- Department of Research, Netherlands Comprehensive Cancer Organization, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands.,CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Misha D P Luyer
- Department of Gastrointestinal and Oncological Surgeon, Catharina Hospital, Eindhoven, The Netherlands
| | - Lonneke V van de Poll-Franse
- Department of Research, Netherlands Comprehensive Cancer Organization, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands.,CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Nicole P M Ezendam
- Department of Research, Netherlands Comprehensive Cancer Organization, P.O. Box 231, 5600 AE, Eindhoven, The Netherlands. .,CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.
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Kang DW, Chung JY, Lee MK, Lee J, Park JH, Kim DI, Jones LW, Ahn JB, Kim NK, Jeon JY. Exercise barriers in Korean colorectal cancer patients. Asian Pac J Cancer Prev 2015; 15:7539-45. [PMID: 25292025 DOI: 10.7314/apjcp.2014.15.18.7539] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND To identify barriers to exercise in Korean colorectal cancer patients and survivors, and to analyze differences in exercise barriers by age, gender, treatment status, and physical activity level. MATERIALS AND METHODS A total of 427 colorectal cancer patients and survivors from different stages and medical status completed a self-administered questionnaire that surveyed their barriers to exercise and exercise participation. RESULTS The greatest perceived exercise barriers for the sampled population as a whole were fatigue, low level of physical fitness, and poor health. Those under 60-years old reported lack of time (p=0.008), whereas those over 60 reported low level of physical fitness (p=0.014) as greater exercise barriers than their counterparts. Women reported fatigue as a greater barrier than men (p<0.001). Those who were receiving treatment rated poor health (p=0.0005) and cancer-related factors as greater exercise barriers compared to those who were not receiving treatment. A multivariate model found that other demographic and medical status were not potential factors that may affect exercise participation. Further, for those who were not participating in physical activity, tendency to be physically inactive (p<0.001) and lack of exercise skill (p<0.001) were highly significant barriers, compared to those who were participating in physical activity. Also, for those who were not meeting ACSM guidelines, cancer-related exercise barriers were additionally reported (p<0.001), compared to those who were. CONCLUSIONS Our study suggests that fatigue, low level of physical fitness, and poor health are most reported exercise barriers for Korean colorectal cancer survivors and there are differences in exercise barriers by age, sex, treatment status, and physical activity level. Therefore, support for cancer patients should be provided considering these variables to increase exercise participation.
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Affiliation(s)
- Dong-Woo Kang
- Department of Sport and Leisure Studies, Yonsei University, Seoul, Korea E-mail : ,
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Trinh L, Larsen K, Faulkner GE, Plotnikoff RC, Rhodes RE, North S, Courneya KS. Social-ecological correlates of physical activity in kidney cancer survivors. J Cancer Surviv 2015; 10:164-75. [PMID: 26048546 DOI: 10.1007/s11764-015-0462-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 05/27/2015] [Indexed: 01/31/2023]
Abstract
PURPOSE Previous studies in cancer survivors have examined behavioral correlates of physical activity (PA), but no study to date has adopted a broader social-ecological framework in understanding PA. This study examined the associations among demographic, medical, social-cognitive, and environmental correlates of meeting PA guidelines among kidney cancer survivors (KCS). METHODS All 1985 KCS diagnosed between 1996 and 2010 identified through a Canadian provincial registry were mailed a survey that consisted of medical, demographic, and social-cognitive measures, as well as PA as measured by the Godin Leisure Time Exercise Questionnaire. Environmental constructs were also assessed for both self-report and objective measures using geographic information systems (GIS). A series of binary logistic regression analyses were conducted in this cross-sectional study. RESULTS Completed surveys with geographical information were received from 432 KCS with M age = 64.4 ± 11.1 years, 63.2 % male, and 82.2 % having localized kidney cancer. In the final multivariate model, meeting PA guidelines was associated with disease stage (OR = 0.25, p = .005), having drug therapy (OR = 3.98, p = .009), higher levels of instrumental attitudes (OR = 1.66, p = .053), higher levels of intention (OR = 1.72, p = .002), and the perceived presence of many retail shops in the neighborhood (OR = 1.37, p = .032). CONCLUSIONS Meeting PA guidelines in KCS were associated with various aspects of the social-ecological model. IMPLICATIONS FOR CANCER SURVIVORS Understanding the social-ecological correlates for PA can provide insight into future interventions designed to increase PA in KCS. Prime targets for PA promotion should consider treatment-related factors, promote the benefits of PA, and enhance positive perceptions of the built environment.
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Affiliation(s)
- Linda Trinh
- Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, Canada, M5S 2W6. .,Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada.
| | - Kristian Larsen
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.,Department of Geography, University of Toronto, Mississauga, Canada
| | - Guy E Faulkner
- Faculty of Kinesiology & Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario, Canada, M5S 2W6
| | - Ronald C Plotnikoff
- Priority Research Center in Physical Activity and Nutrition, University of Newcastle, Callaghan, Australia
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, Canada
| | - Scott North
- Department of Medicine, Cross Cancer Institute, Edmonton, Canada
| | - Kerry S Courneya
- Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Canada
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Gomez SL, Shariff-Marco S, DeRouen M, Keegan THM, Yen IH, Mujahid M, Satariano WA, Glaser SL. The impact of neighborhood social and built environment factors across the cancer continuum: Current research, methodological considerations, and future directions. Cancer 2015; 121:2314-30. [PMID: 25847484 DOI: 10.1002/cncr.29345] [Citation(s) in RCA: 228] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 02/03/2015] [Accepted: 02/04/2015] [Indexed: 12/13/2022]
Abstract
Neighborhood social and built environments have been recognized as important contexts in which health is shaped. The authors reviewed the extent to which these neighborhood factors have been addressed in population-level cancer research by scanning the literature for research focused on specific social and/or built environment characteristics and their association with outcomes across the cancer continuum, including incidence, diagnosis, treatment, survivorship, and survival. The commonalities and differences in methodologies across studies, the current challenges in research methodology, and future directions in this research also were addressed. The assessment of social and built environment factors in relation to cancer is a relatively new field, with 82% of the 34 reviewed articles published since 2010. Across the wide range of social and built environment exposures and cancer outcomes considered by the studies, numerous associations were reported. However, the directions and magnitudes of associations varied, in large part because of the variation in cancer sites and outcomes studied, but also likely because of differences in study populations, geographic regions, and, importantly, choice of neighborhood measures and geographic scales. The authors recommend that future studies consider the life-course implications of cancer incidence and survival, integrate secondary and self-report data, consider work neighborhood environments, and further develop analytical and statistical approaches appropriate to the geospatial and multilevel nature of the data. Incorporating social and built environment factors into research on cancer etiology and outcomes can provide insights into disease processes, identify vulnerable populations, and generate results with translational impact of relevance for interventionists and policy makers.
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Affiliation(s)
- Scarlett Lin Gomez
- Cancer Prevention Institute of California, Fremont, California
- Department of Health Research and Policy (Epidemiology), School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Salma Shariff-Marco
- Cancer Prevention Institute of California, Fremont, California
- Department of Health Research and Policy (Epidemiology), School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Mindy DeRouen
- Cancer Prevention Institute of California, Fremont, California
| | - Theresa H M Keegan
- Cancer Prevention Institute of California, Fremont, California
- Department of Health Research and Policy (Epidemiology), School of Medicine, and Stanford Cancer Institute, Stanford, California
| | - Irene H Yen
- School of Medicine, University of California-San Francisco, San Francisco, California
| | - Mahasin Mujahid
- School of Public Health, University of California-Berkeley, Berkeley, California
| | - William A Satariano
- School of Public Health, University of California-Berkeley, Berkeley, California
| | - Sally L Glaser
- Cancer Prevention Institute of California, Fremont, California
- Department of Health Research and Policy (Epidemiology), School of Medicine, and Stanford Cancer Institute, Stanford, California
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Bower JE, Bak K, Berger A, Breitbart W, Escalante CP, Ganz PA, Schnipper HH, Lacchetti C, Ligibel JA, Lyman GH, Ogaily MS, Pirl WF, Jacobsen PB. Screening, assessment, and management of fatigue in adult survivors of cancer: an American Society of Clinical oncology clinical practice guideline adaptation. J Clin Oncol 2014; 32:1840-50. [PMID: 24733803 DOI: 10.1200/jco.2013.53.4495] [Citation(s) in RCA: 413] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
PURPOSE This guideline presents screening, assessment, and treatment approaches for the management of adult cancer survivors who are experiencing symptoms of fatigue after completion of primary treatment. METHODS A systematic search of clinical practice guideline databases, guideline developer Web sites, and published health literature identified the pan-Canadian guideline on screening, assessment, and care of cancer-related fatigue in adults with cancer, the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines In Oncology (NCCN Guidelines) for Cancer-Related Fatigue and the NCCN Guidelines for Survivorship. These three guidelines were appraised and selected for adaptation. RESULTS It is recommended that all patients with cancer be evaluated for the presence of fatigue after completion of primary treatment and be offered specific information and strategies for fatigue management. For those who report moderate to severe fatigue, comprehensive assessment should be conducted, and medical and treatable contributing factors should be addressed. In terms of treatment strategies, evidence indicates that physical activity interventions, psychosocial interventions, and mind-body interventions may reduce cancer-related fatigue in post-treatment patients. There is limited evidence for use of psychostimulants in the management of fatigue in patients who are disease free after active treatment. CONCLUSION Fatigue is prevalent in cancer survivors and often causes significant disruption in functioning and quality of life. Regular screening, assessment, and education and appropriate treatment of fatigue are important in managing this distressing symptom. Given the multiple factors contributing to post-treatment fatigue, interventions should be tailored to each patient's specific needs. In particular, a number of nonpharmacologic treatment approaches have demonstrated efficacy in cancer survivors.
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Affiliation(s)
- Julienne E Bower
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Kate Bak
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Ann Berger
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - William Breitbart
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Carmelita P Escalante
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Patricia A Ganz
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Hester Hill Schnipper
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Christina Lacchetti
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Jennifer A Ligibel
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Gary H Lyman
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Mohammed S Ogaily
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - William F Pirl
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
| | - Paul B Jacobsen
- Julienne E. Bower and Patricia A. Ganz, University of California at Los Angeles, Los Angeles, CA; Kate Bak and Christina Lacchetti, American Society of Clinical Oncology, Alexandria, VA; Ann Berger, National Institutes of Health Clinical Center, Bethesda, MD; William Breitbart, Memorial Sloan-Kettering Cancer Center, New York, NY; Carmelita P. Escalante, University of Texas MD Anderson Cancer Center, Houston, TX; Hester Hill Schnipper, Beth Israel Deaconess Medical Center; Jennifer A. Ligibel, Dana-Farber Cancer Institute; William F. Pirl, Massachusetts General Hospital, Boston, MA; Gary H. Lyman, Fred Hutchinson Cancer Research Center and the University of Washington, Seattle, WA; Mohammed S. Ogaily, Oakwood Center for Hematology and Oncology-Downriver, Brownstown, MI; and Paul B. Jacobsen, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
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Dennis DL, Waring JL, Payeur N, Cosby C, Daudt HML. Making lifestyle changes after colorectal cancer: insights for program development. ACTA ACUST UNITED AC 2013; 20:e493-511. [PMID: 24311950 DOI: 10.3747/co.20.1514] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Healthy lifestyle behaviours may improve outcomes for people with colorectal cancer (crc), but the intention to take action and to change those behaviours may vary with time and resource availability. We aimed to estimate the prevalence of current lifestyle behaviours in people with and without crc in our community, and to identify their desire to change and their resource preferences. METHODS A mixed-methods survey was completed by people diagnosed with crc who were pre-treatment (n = 54), undergoing treatment (n = 62), or done with treatment for less than 6 months (n = 67) or for more than 6 months (n = 178), and by people without cancer (n = 83). RESULTS Current lifestyle behaviours were similar in all groups, with the exception of vigorous physical activity levels, which were significantly lower in the pre-treatment and ongoing treatment respondents than in cancer-free respondents. Significantly more crc respondents than respondents without cancer had made lifestyle changes. Among the crc respondents, dietary change was the change most frequently made (39.3%), and increased physical activity was the change most frequently desired (39.1%). Respondents wanted to use complementary and alternative medicine (cam), reading materials, self-efficacy, and group activities to make future changes. CONCLUSIONS Resources for lifestyle change should be made available for people diagnosed with crc, and should be tailored to address physical activity, cam, and diet. Lifestyle programs offered throughout the cancer trajectory and beyond treatment completion might be well received by people with crc.
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Affiliation(s)
- D L Dennis
- Clinical Research, BC Cancer Agency-Vancouver Island Centre, Victoria, BC. ; Supportive Care Research Centre, The Alex and Jo Campbell Patient and Family Support Centre, BC Cancer Agency-Vancouver Island Centre, Victoria, BC
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Danilack VA, Weston NA, Richardson CR, Mori DL, Moy ML. Reasons persons with COPD do not walk and relationship with daily step count. COPD 2013; 11:290-9. [PMID: 24152213 DOI: 10.3109/15412555.2013.841670] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Physical activity (PA) is significantly reduced in persons with COPD. Assessing reasons why persons with COPD do not engage in PA can guide development of effective interventions to promote PA. METHODS We queried 102 participants with stable COPD about disease-related and general reasons why they do not walk more. The StepWatch Activity Monitor (Orthocare Innovations, Mountlake Terrace, WA, USA) assessed daily step count, a direct measure of PA. Regression models assessed daily step count by response categories, adjusting for age and FEV1 % predicted. RESULTS Subjects had mean age 72 ± 8 years and mean FEV1 1.48 ± 0.55 L (52 ± 19% predicted). COPD-related worries of becoming short of breath (SOB), needing to use inhalers, or oxygen level becoming low were endorsed by 31, 14, and 12 subjects, respectively. Controlling for age and FEV1% predicted, those who worried about becoming SOB walked an average of 1,329 fewer steps per day than those who did not worry (p = 0.020). Those who worried about needing to use inhalers walked an average of 1,806 fewer steps per day than those who did not worry (p = 0.016). Subjects who were the most motivated and confident walked significantly more than those who were the least motivated and confident. CONCLUSIONS Presence of COPD-related reasons and lower motivation and confidence are associated with lower daily step count. Management of dyspnea and education about medication use during exercise, and strategies to increase motivation and confidence could facilitate walking in COPD.
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Affiliation(s)
- Valery A Danilack
- 1Brown University School of Public Health, Department of Epidemiology , Providence, RI , USA
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Appleton L, Goodlad S, Irvine F, Poole H, Wall C. Patients' experiences of living beyond colorectal cancer: A qualitative study. Eur J Oncol Nurs 2013; 17:610-7. [DOI: 10.1016/j.ejon.2013.01.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 12/20/2012] [Accepted: 01/05/2013] [Indexed: 01/11/2023]
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Ottenbacher AJ, Day RS, Taylor WC, Sharma SV, Sloane R, Snyder DC, Kraus WE, Demark-Wahnefried W. Exercise among breast and prostate cancer survivors--what are their barriers? J Cancer Surviv 2011; 5:413-9. [PMID: 21598023 DOI: 10.1007/s11764-011-0184-8] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 05/07/2011] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Despite proven benefits of regular physical activity, estimates indicate that few cancer survivors meet physical activity guidelines. The purpose of this paper is to identify and compare exercise barriers among cancer survivors, both cross-sectionally and longitudinally as they undergo home-based behavioral interventions. METHODS Data on a sample of 452 breast and prostate cancer survivors who completed the FRESH START trial were analyzed collectively, as well as separately by cancer type. RESULTS More total barriers (3.5 vs. 2.4; p < 0.01) were reported among breast cancer survivors compared with prostate cancer survivors. Commonly reported baseline exercise barriers among both groups were "too busy" (breast, 52% and prostate, 45%) and "no willpower" (breast, 51% and prostate, 44%). At baseline, breast cancer survivors who reported "no willpower" also reported 18.7 fewer minutes of physical activity compared with those not reporting this barrier (p < 0.01). Among prostate cancer survivors, this difference was 39.5 min (p < 0.01). Change in barriers was not associated with change in minutes of physical activity from baseline to post-intervention in either cancer survivor group. CONCLUSIONS This is the largest study evaluating barriers and physical activity over time among cancer survivors. There are similarities and differences that both need to be taken into consideration when promoting physical activity among subgroups of survivors. IMPLICATIONS FOR CANCER SURVIVORS Knowledge concerning barriers associated with reported physical activity may be helpful in designing optimally targeted physical activity interventions among breast and prostate cancer survivors.
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