ASPO Abstracts
The Mediation Effect of Body Image on Physical Activity and Psychological Health in Older Female Cancer Survivors
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2019
Abstract Body:
Purpose: To quantify the association of physical activity, body image and psychological health among older female cancer survivors and to explore the mediation effect of body image on physical activity and psychological health.Methods: Secondary data analysis was conducted using the Women’s Health Initiative (WHI) Life and Longevity after Cancer (LILAC) Study. Surveys assessed body image (appearance, attractiveness, scars), physical activity (sedentary: no exercise/week; inactive/active: ≥1 days of exercise/week, due to limited women reported as active), and psychological health (depression, anxiety, distress). The natural indirect effect was used to estimate the mediation effect of body image concerns on the association between physical activity and psychological health.Results: Among 5336 female cancer survivors age 64-95 years, the average time since cancer diagnosis was 9.5±4.9 years, and 51% reported sedentary. Participants had depressive symptoms (16%), anxiety (70%), and psychological distress (60%); had body image concerns with appearance (3%), attractiveness (20%), and scars (21%). Compared to inactive/active women, sedentary women had a higher odds of concerns with appearance (OR=1.88, 95%CI: 1.32, 2.67) and a higher risk of depressive symptoms (RR=1.25, 95%CI: 1.09, 1.43). Compared to women with no appearance concerns, women with appearance concerns had a higher risk of depressive symptoms (RR=2.4, 95%CI: 1.89, 3.04), anxiety (RR=1.10, 95%CI: 1.01, 1.21), and distress (RR=1.29, 95%CI: 1.17, 1.42). Similar associations were observed for concerns with attractiveness and scars on depressive symptoms, anxiety, and distress. Body image concerns mediated the association between physical activity and psychological health: sedentary behavior was associated with increased probability that a woman was concerned about her appearance, which was associated with higher risk of depressive symptoms (P=0.008) and distress (P=0.016).Conclusion: Older, long-term female cancer survivors experienced body image concerns. Body image mediated the association between physical activity and psychological health. Our findings highlight the need for clinicians and researchers to address body image concerns in female cancer survivors to improve their psychological health.
Keywords: body image, psychological health, cancer survivorship