ASPO Abstracts
Multilevel determinants of physical activity adoption and maintenance in rural breast cancer survivors
Category: Cancer Health Disparities
Conference Year: 2022
Abstract Body:
Purpose: Ecologic frameworks account for multilevel factors related to leisure-time physical activity (LTPA) and may be used to develop or adapt effective interventions for cancer survivors residing in rural and underserved areas. This study used a mixed-methods design to explore multilevel determinants of LTPA in rural breast cancer survivors (BCS).Methods: Cancer survivors (n=219) were recruited to the Partnering to Prevent and Control Cancer (PPCC) study and completed questionnaires assessing LTPA, self-efficacy, motivational readiness, psychosocial distress, social support [SS], and home and neighborhood environments for LTPA. Logistic regression models were used to explore associations between multilevel determinants and LTPA. BCS who completed questionnaires (n=67) were invited to participate in a semi-structured in-depth interview to better understand determinants of LTPA. Interviews were completed with 38 BCS, and qualitative findings were integrated with quantitative data to summarize individual, social, and environmental determinants of LTPA adoption and maintenance in rural BCS.Results: Participants were in their 60s (M age=62.0±13.1 years), and most were women (98.5%), had completed college (54.6%), and were >12 weeks post-treatment (93.9%). Nearly half (49.2%) of BCS reported their health as very good/excellent, and 46.2% reported meeting LTPA guidelines. Participants reporting higher exercise self-efficacy (OR=1.1), motivational readiness (OR=4.6), and SS for LTPA from family (OR=1.1) and friends (OR=1.1) and lower perceived stress (OR=0.9) and depressive symptoms (OR=0.9) were more likely to be active (ps<.05). Interviewees discussed individual and social determinants that influenced PA adoption, including their LTPA history, engagement in social activities, and SS. Multilevel barriers for engaging in LTPA included lack of SS and physical and financial resources, a lack of places nearby to do PA, and feeling isolated from people and places. Conclusions: Findings highlight the multilevel, interactive complexities that influence LTPA in rural BCS and the need for multilevel approaches for increasing LTPA adoption and maintenance in this underserved population.
Keywords: rural disparities, physical activity, cancer survivorship