Exploring cancer survivors’ physical activity engagement and perceptions: A mixed methods study

Garcia, Veronica

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https://hdl.handle.net/2142/116063 Copy

Description

Title

Exploring cancer survivors’ physical activity engagement and perceptions: A mixed methods study

Author(s)

Garcia, Veronica

Issue Date

2022-07-12

Director of Research (if dissertation) or Advisor (if thesis)

Gothe, Neha P

Committee Member(s)

Trinh, Linda

Department of Study

Kinesiology & Community Health

Discipline

Kinesiology

Degree Granting Institution

University of Illinois at Urbana-Champaign

Degree Name

M.S.

Degree Level

Thesis

Keyword(s)

Cancer survivor, physical activity, Social Cognitive Theory, Remote, Feasibility

Abstract

As cancer survivors face unique health complications and experiences, supportive care interventions are needed to mitigate cancer and post-treatment-related side effects. One such intervention is physical activity. Although regular physical activity engagement offers benefits to survivors, cancer survivors are insufficiently active and engage in more sedentary time when compared to the non-cancer population with survivors engaging in more sedentary behaviors and less light-intensity physical activity compared to a sample of non-cancer survivors (Thraen-Borowski et al., 2017). Physical activity has the potential to mitigate several treatment-related and cancer-related side effects, so it is important that we understand why survivors may not be engaging in enough physical activity, and how we can help them to increase their engagement. The purpose of this thesis was to first explore inactive adult cancer survivors’ physical activity barriers and motivators which were then used to design a Social-Cognitive Theory (SCT) -based remote 12-week independent physical activity promotion program for adult survivors. There were two phases. Phase 1 included three small, theory-based focus groups which targeted discussion on the unique individual, interpersonal, and environmental barriers cancer survivors may face, and facilitators to physical activity engagement. Phase 2 implemented strategies to overcome barriers discussed in Phase 1 and maximize any facilitators to physical activity – through the Strides trial. The Strides trial was a remote 12-week physical activity promotion program which consisted of two groups- the Social Cognitive Theory (SCT) instruction group- which received SCT-related modules and activities, and the PA control group which received readily available physical activity information. The overall purpose of the Strides trial was to examine the feasibility of an SCT-based remote program in bettering survivors’ physical activity behaviors and perceptions compared to the control group. In Phase 1, N = 15 inactive adult cancer survivors took part in focus groups to examine their physical activity perceptions and engagement before and after their cancer diagnosis. A thematic qualitative analysis was conducted to create themes surrounding physical activity barriers and facilitators. Phase 2 was designed to target some of the more common barriers to physical activity identified by the sample of mixed cancer survivors in Phase 1. In Phase 2, although 29 survivors were randomized, n = 18 inactive adult cancer survivors of all types and stages fully completed a 12-week remote independent physical activity promotion program to examine the feasibility of an SCT-based remote physical activity program with various program elements. Participants were randomized to either 1) an SCT-focused instruction group which received SCT-specific information and strategies based on different constructs of the theory to help with their physical activity behaviors, or 2) a physical activity (PA) control group which received resources related to physical activity from sources such as the CDC for 12-weeks. SCT and physical activity instruction was given for the first 6 weeks. Feasibility of the trial was recorded at the end of the intervention using self-reported measures of program quality and rankings of program elements, in addition to program adherence. Repeated measures MANOVAs were used to examine changes in their physical activity perceptions via self-reported questionnaires, differences in their self-reported physical activity levels, and pedometer-based average weekly steps from baseline, 6-weeks, and 12-weeks. Results of Phase 1 showed that many of the barriers to physical activity were related to the interpersonal and intrapersonal levels of the SEM. Results of Phase 2 showed that a remote 12-week intervention is of interest in this population. Overall, the quality and helpfulness of the Strides program was ranked highly by participants, adherence to Strides was modest given the sample size with 62% of the originally enrolled participants fully completing the 12-week program. Participants’ most preferred program elements included the weekly step goals, and the Zoom discussions. When examining SCT-related outcomes, no significant group*time effects for any of the SCT-related measures were observed. Results of self-reported leisure time physical activity using the GLTEQ at baseline compared to 6-weeks, and baseline compared to 12-weeks showed significant differences among both groups. However, due to the small sample size, our analysis was underpowered and should be interpreted with caution. Conclusion: Overall, the feasibility of a 12-week remote physical activity program for survivors showed positive and promising effects of several of the program components offered. Survivors ranked the program highly and specified some of the most helpful program aspects to be the weekly step goals and weekly group discussions. In examining the effectiveness of SCT instruction in changing survivors’ physical activity levels, the independent 12-week program may have been an insufficient duration for survivors to gain the confidence show significant improvement. Overall, larger scale remote interventions can provide insight into the effectiveness of virtual physical activity programs for cancer survivors given that they are feasible.

Graduation Semester

2022-08

Type of Resource

Thesis

Copyright and License Information

Copyright 2022 Veronica Garcia

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