Physical Activity among Nova Scotian Cancer Survivors

• Author / Creator

  Forbes, Cynthia Christine

• Background: Physical activity (PA) has been shown to improve health among cancer survivors yet the majority of survivors do not meet the recommended public health guidelines. In addition, research suggests that the influence of PA correlates may vary between cancer types but little research exists that directly compares correlates among groups. Recent PA behaviour change interventions among cancer survivors have used methods such as face-to-face, telephone counselling, email, and print-based materials, however, based on the broad reach and possible cost savings, internet-delivered programs may be a more viable option to achieve PA behaviour change. Purpose: The purpose of this dissertation was to examine and compare the correlates and preferences among cancer survivors living in Nova Scotia, and to develop an internet-delivered, home-based behaviour change program. Methods: Study I was a cross-sectional, population based survey that measured the PA, Theory of Planned Behaviour (TPB)-based social cognitive constructs, PA preferences, and demographic and medical characteristics of 741 breast, prostate, and colorectal cancer survivors. Study II was a randomized controlled behaviour change trial that examined the feasibility and preliminary efficacy of an internet-delivered behaviour change program designed to increase PA levels among 95 breast, prostate, and colorectal cancer survivors. Participants in the intervention group (n=48) visited a web site to track their PA and receive TPB based educational materials over 9 weeks. The usual care group (n=47) was asked to maintain their current routine. Assessments were conducted at baseline, post-intervention and 12-week follow-up. Study II secondary outcomes assessed quality of life (QoL) and motivational outcomes. Results: In Study I, it was found that the majority of survivors were insufficiently active for health benefits. There were differences found when assessing the correlates of PA among the three cancer groups, specifically intention was significantly associated with PA for colorectal cancer survivors only; planning was significantly associated with PA for breast and prostate cancer survivors only; and perceived behavioural control (PBC) was significantly associated with PA for prostate cancer survivors only (Paper 1). Study I also concluded there were differences in PA program and counselling preferences based on cancer group (Paper 2). Results showed low rates of strength exercise and correlates did not vary much between cancer groups (Paper 3). In Study II, we had a 23% recruitment rate with 88% and 84% retention at post-intervention and 12-week follow-up respectively. Engagement rate were low at 26% of participants completing the modules, however participant satisfaction was high (Paper 4). Non-significant increases in total PA were found between the groups, specifically among those who were not meeting PA guidelines at baseline (Paper 4). However, there were no changes for QoL outcomes (Paper 5). There were no positive changes in TPB outcomes, with negative effects found for self-efficacy, affective and instrumental attitude, and many underlying control beliefs (Paper 5). Conclusions: This dissertation demonstrates the importance of directly comparing cancer groups to determine differences in PA related correlates and preferences (Study I, Papers 1 and 2). Using this information to target specific correlates may help to increase the success of PA programs for these groups. For strength exercise, it appears that targeting motivational outcomes may be most successful. Study II determined that using web-based delivery for a PA behaviour change program may be feasible among cancer survivors. A trend towards increased PA was found for the intervention group. Despite this positive trend, there was no change in QoL outcomes (Study II, Paper 1) and a negative trend for motivational outcomes (Study II, Paper 2). Further research needs to focus on the best way to use web-delivery media to increase engagement and retention, as well as the best methods to elicit positive changes in motivation and self-efficacy. This dissertation adds valuable data to the very limited literature in web-based PA behaviour change among cancer survivors.

• Subjects / Keywords

  • Behaviour change
  • Internet delivery
  • Physical activity
  • Cancer survivor

• Graduation date

  Fall 2015

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/R3SQ8QV7J

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.