Mediators of physical activity outcomes in a peer‐led intervention for breast cancer survivors

Abstract

Objectives Physical activity (PA) adoption can reduce treatment‐related sequelae of breast cancer. Peer‐led PA interventions are a promising and relatively inexpensive approach to scaling up interventions. The current study seeks to identify mediators of PA change amongst cancer survivors enrolled in a peer‐led behavior change intervention. The study team partnered with the American Cancer Society's Reach to Recovery program (RTR) whose volunteers' provided information and support to breast cancer survivors. Methods Participants were 76 survivors (mean age 55.6 years, 1.1 years since diagnosis) who were randomized to PA Plus RTR (12‐week PA telephone counseling delivered by RTR volunteers) or contact control. Data was collected on PA (self‐reported and objectively measured) and potential mediators (self‐efficacy, exercise decisional balance [ratio of the pros/advantages to the cons/disadvantages] and social support) at baseline and 12 weeks. Using a multiple mediation approach with bootstrapped standard errors, we examined mediators of the intervention effect on PA outcomes. Results Compared to control, PA Plus RTR participants had higher mean self‐efficacy, lower decisional balance cons and social support at 12 weeks controlling for baseline. Higher mean self‐efficacy was associated with greater minutes of self‐reported PA, whereas higher decisional balance pros was associated with higher objectively measured PA at 12 weeks. There were significant indirect effects of self‐efficacy on self‐reported PA and decisional balance on objectively measured PA. Conclusions PA Plus RTR increased self‐reported and objectively measured PA by changing theoretical constructs hypothesized to be associated with behavior change. Peers delivering a PA intervention should focus on increasing survivors' self‐efficacy for exercise especially in challenging circumstances such as being on vacation, and also help to overcome disadvantages of exercise such as taking time away from family.

Physical activity and exercise behavior of Japanese breast cancer survivors: A nationwide cross-sectional survey

“…Pinto et al reported that self-e cacy signi cantly mediated the effects of intervention on physical activity outcomes. (39) In the mentioned study, survivors who lacked motivation failed to satisfy the guideline recommendation. Given that increasing self-e cacy is known to improve motivation, (40) increasing it is certainly warranted.…”

Predicting Quality of Life in Women with Breast Cancer Who Engage in Physical Exercise: The Role of Psychological Variables

“…In addressing this issue, Bruno and Theran [45] proposed implementing interventions aimed at enhancing the motivation of individuals with breast cancer. Among these strategies, engaging in physical activity has been widely demonstrated as a beneficial approach [46,47].…”

“…Intrinsic motivation plays a crucial role in promoting adherence to physical activity among breast cancer patients. Several authors [28,[46][47][48][49] have highlighted that improved quality of life in breast cancer patients is associated with the physical and psychological benefits derived from regular physical activity. This can be achieved through various approaches such as supervised group programs [50] as well as telephone and online support [51,52].…”

Development of A Tailored Home-Based Exercise Program for Low-Income Cancer Survivors with Multiple Chronic Conditions: A Pilot Study

“…Studies have shown that a continuous aerobic moderate-intensity exercise program not only reduces fatigue, pain, [21,22] and improves AWB, [23,24], but also delays the onset and progression of other chronic conditions. In spite of the benefits of PA, evidence shows that less than 10-20% of patients with chronic conditions are active [25][26][27][28]. To overcome the barriers to exercise, home-based exercise programs have been developed and report promising effectiveness on pain, fatigue, and AWB of cancer survivors with several chronic conditions [29][30][31].…”