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Objective: We conducted meta-analyses and meta-analytic structural equation modeling of longitudinal studies among cancer survivors to (a) quantify associations between psychosocial predictors and physical activity, (b) test how psychosocial predictors combine to influence physical activity, and (c) identify study, demographic, and clinical characteristics that moderate associations. Method: Eligible studies used a longitudinal, observational design, included a sample of cancer survivors, and measured both a psychosocial predictor at baseline and physical activity at a later time-point. Of 2,431 records located through computerized searches, 25 independent tests (N ϭ 5,897) met the inclusion criteria for the review. Random effects meta-analyses and meta-analytic structural equation modeling were conducted. Results: Eight psychosocial predictors of physical activity were identified. Self-efficacy (r ϩ ϭ 0.26) and intentions (r ϩ ϭ 0.33) were the strongest predictors in bivariate analyses. The structural equation models included attitudes, injunctive norms, self-efficacy, intentions, and physical activity (k ϭ 22, N ϭ 4,385). The model with the best fit, 2 (2) ϭ 0.11, p ϭ .95, root mean square error of approximation ϭ .00, comparative fit index ϭ 1.00, Tucker-Lewis index ϭ 1.00, indicated that all specified paths were significant. Intentions were the strongest predictor of physical activity (␤ ϭ 0.27, p Ͻ .001), and attitudes and self-efficacy were strong predictors of intentions (both ␤s ϭ 0.29, ps Ͻ .001). Few significant moderators were observed. Conclusion: This review indicates that self-efficacy and intentions are direct predictors of physical activity in cancer survivors. Further, attitudes and norms predict physical activity through intentions. Findings inform intervention development to increase physical activity engagement among cancer survivors.

Background Exercise is associated with decreased recurrence risk, improved survival and quality of life for breast cancer survivors. However only an estimated 17% - 37% of survivors adhere to the American Cancer Society exercise guidelines. A critical first step to increase exercise among survivors is to understand how they believe exercise will effect them. Objective To explore common exercise outcome expectations among 20 female survivors of stage IA – IIB breast cancer who completed adjuvant treatment and an exercise intervention. Interventions/Methods A mixed-method descriptive study consisting of semi-structured telephone interviews assessed exercise outcome expectations and how the experience of cancer and its treatment influenced expected outcomes of exercise. The qualitative data were analyzed using a summative content analysis procedure; means were calculated for each item of the exercise outcome questionnaire. The qualitative and quantitative data were compared and contrasted. Results The sample was 70% Caucasian and 30% African American with a mean age was 62 years (± 8.5) and average time since treatment completion of 4.2 years (± 1.3). Three themes emerged from the interviews: 1) prevalence of common expectations, 2) pervasive impact of fatigue, and 3) a brighter future. Overall, findings revealed that breast cancer survivors have low levels of agreement that exercise may mitigate late and long-term cancer and treatment effects. Conclusions In general, breast cancer survivors (even those who are motivated to exercise) do not hold strong beliefs that exercise will decrease late and long-term treatment effects. Implications for Practice Clinicians can educate survivors about exercise benefits.

Purpose: Patients undergoing a hematopoietic stem cell transplantation (HCT) have varied symptoms during their hospitalization. This study examined whether daily symptom reporting (with electronic patient-reported outcomes [PROs]) in an inpatient bone marrow transplant clinic reduced symptom burden on post-transplant days +7, +10, and +14. Methods:A prospective, single-institution1:1 pilot randomized, two-arm study recruited HCT patients. HCT inpatients (N=76) reported daily on 16 common symptoms using the PRO version of the Common Terminology for Adverse Events (PRO-CTCAE). Fisher's exact test was used to examine differences in the proportion of patients reporting individual symptoms. Multivariable linear regression modeling was used to examine group differences in peak symptom burden, while controlling for symptom burden at baseline, age, comorbidity, and transplantation type (autologous or allogeneic).Results: HCT patients receiving the PRO intervention also experienced lower peak symptom burden (average of 16 symptoms) at days +7, +10, and +14 (10.4 vs 14.5, p =0.03).Conclusions: Daily use of electronic symptom reporting to nurses in an inpatient bone marrow transplant clinic reduced peak symptom burden and improved individual symptoms during the two weeks post-transplant. A multi-site site trial is warranted to demonstrate the generalizability, efficacy, and value of this intervention. Keywordssymptoms; electronic symptom reporting; patient-reported outcomes; autologous stem cell transplantation; allogeneic stem cell transplantation; cancer Peak Symptom Burden Groups Upper left: Mean symptom severities at days 7 (n=40), 10 (n=25), and 14 (n=20) of patients under 'Autologous' transplant. Upper right: Mean symptom severities at days 7 (n=23), 10 (n=17), and 14 (n=19) of patients under 'Allogenic' (right) transplant. Lower left: Mean symptom severities at days 7 (n=28), 10 (n=14), and 14 (n=15) of patients under 'Control' (no feedback). Lower right: Mean symptom severities at days 7 (n=35), 10 (n=28), and 14 (n=24) of patients under 'Intervention' (with feedback) Bryant et al.

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