ASPO Abstracts
Impact of the built environment on physical activity in rural cancer survivors
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Purpose: Cancer survivors (CS) residing in rural areas are less likely to meet physical activity (PA) recommendations and are more likely to report poor health than those residing in urban areas. Ecologic models suggest that the built environment affects PA, thereby influencing cancer survivorship. The purpose of this study was to examine the impact of the home and neighborhood environment on PA in rural CS. Methods: CS were recruited to a cross-sectional study to explore factors related to PA in CS in central Pennsylvania. Participants completed questionnaires assessing sociodemographics, the home environment for exercise, perceived neighborhood environment, walkability, and PA. Logistic regression models were used to examine the associations between environmental correlates and the likelihood of meeting PA recommendations (≥150 minutes of moderate-to-vigorous intensity PA). Results: CS (n=258) completed a brief demographic questionnaire, and 215 (83.3%) participants opted to complete a more in-depth questionnaire assessing the environment and PA. Nearly half of participants were prostate (21.9%) or breast (21.9%) CS, and 21.9% of participants reported multiple cancer diagnoses. Participants were mostly women (59.1%), in their mid-60s (M age=64.7±12.0 years), overweight (M BMI=29.7±6.8 kg/m^2), and self-rated their health as good or better (84.3%). Over half (62.0%) of CS reported meeting PA recommendations. More equipment in the home for exercise (OR=1.3, 95% CI: 1.1-1.6) and greater environmental support for PA (OR=1.3, 95% CI: 1.1-1.6) were associated with a higher likelihood of meeting PA recommendations, after adjusting for age, gender, income, BMI, and cancer type. In the adjusted multivariate model, meeting PA recommendations was associated with lower street connectivity (OR=0.5, 95% CI: 0.2-1.0), higher neighborhood aesthetics (OR=2.8, 95% CI: 1.1-7.1), and the home environment (OR=1.3, 95% CI: 1.1-1.6). Conclusions: Findings suggest that the home and neighborhood environment impact PA in rural CS and point to the need for interventions designed to meet the unique built environmental needs of rural CS in an effort to increase PA, improve cancer survivorship outcomes, and reduce cancer health disparities.
Keywords: Physical activity, cancer health disparities, cancer survivorship