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Predictors of physical activity in colorectal cancer survivors after participation in a telephone-delivered multiple health behavior change intervention

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Abstract

Purpose

Physical activity improves the health outcomes of colorectal cancer (CRC) survivors, yet few are exercising at levels known to yield health benefits. Baseline demographic, clinical, behavioral, and psychosocial predictors of physical activity at 12 months were investigated in CRC survivors.

Methods

Participants were CRC survivors (n = 410) who completed a 12-month multiple health behavior change intervention trial (CanChange). The outcome variable was 12 month sufficient physical activity (≥150 min of moderate–vigorous physical activity/week). Baseline predictors included demographics and clinical variables, health behaviors, and psychosocial variables.

Results

Multivariate linear regression revealed that baseline sufficient physical activity (p < 0.001), unemployment (p = 0.004), private health insurance (p = 0.040), higher cancer-specific quality of life (p = 0.031) and higher post-traumatic growth (p = 0.008) were independent predictors of sufficient physical activity at 12 months. The model explained 28.6 % of the variance.

Conclusions

Assessment of demographics, health behaviors, and psychosocial functioning following a diagnosis of CRC may help to develop effective physical activity programs.

Implications for cancer survivors

Understanding the demographic, behavioral and psychosocial determinants of physical activity may facilitate the development and delivery of effective public health interventions designed to promote long term behavior change.

Trial Registration: ACTRN12608000399392

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Abbreviations

CRC:

Colorectal cancer

MVPA:

Moderate to vigorous physical activity

HC:

Health coaching

UC:

Usual care

BMI:

Body mass index

TV:

Television viewing

kJ:

Kilojoule

FACT:

Functional assessment of cancer therapy

FACIT:

Functional Assessment of Chronic Illness Therapy

FACT-C:

Functional Assessment of Cancer Therapy — Colorectal

FACT-G:

Functional Assessment of Cancer Therapy — General

FACIT-Sp:

Functional Assessment of Chronic Illness — Spirituality

FACIT-F:

Functional Assessment of Chronic Illness — Fatigue

BSI-18:

Brief Symptom Inventory-18

GSI:

Global Severity index

PTGI:

Post Traumatic Growth Inventory

AAQ-II:

Acceptance and Action Questionnaire-II

MAAS:

Mindful Attention Awareness Scale

SD:

Standard deviation

HRQoL:

Health-related quality of life

References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90.

    Article  PubMed  Google Scholar 

  2. Australian Institute of Health and Welfare & Australasian Association of Cancer Registries. Cancer in Australia: an overview, 2010 Cancer series no. 60. Cat. no. CAN 56. Canberra: AIHW; 2010.

    Google Scholar 

  3. Hewitt M, Ganz PA. (ed.) From cancer patient to cancer survivor — lost in transition: an American Society of Clinical Oncology and Institute of Medicine symposium. Washington DC: National Academies Press; 2006.

  4. Speck RM, Courneya KS, Masse LC, Duval S, Schmitz KH. An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. J Cancer Surviv. 2010;4(2):87–100.

    Article  PubMed  Google Scholar 

  5. Ferrer R, Heudo-Medina T, Johnson B, Ryan S, Pescatello L. Exercise interventions for cancer survivors: a meta-analysis of quality of life outcomes. Ann Behav Med. 2011;41:32–47.

    Article  PubMed Central  PubMed  Google Scholar 

  6. Meyerhardt JA, Giovannucci EL, Holmes MD, Chan AT, Chan JA, Colditz GA, et al. Physical activity and survival after colorectal cancer diagnosis. J Clin Oncol. 2006;24(22):3527–34.

    Article  PubMed  Google Scholar 

  7. Meyerhardt JA, Giovannucci EL, Ogino S, Kirkner GJ, Chan AT, Willett W, et al. Physical activity and male colorectal cancer survival. Arch Intern Med. 2009;169:2102–8.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, et al. Impact of physical activity on cancer recurrence and survival in patients with stage II colon cancer: findings from CALBG 89803. J Clin Oncol. 2006;24:3535–41.

    Article  PubMed  Google Scholar 

  9. Meyerhardt JA, Ogino S, Kirkner GJ, Chan AT, Wolpin B, Ng K, et al. Interaction of molecular markers and physical activity on mortality in patients with colon cancer. Clin Cancer Res. 2009;15:5931–6.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  10. Grimmett C, Bridgewater J, Steptoe A, Wardle J. Lifestyle and quality of life in colorectal cancer survivors. Qual Life Res. 2011;20(8):1237–45.

    Article  PubMed  Google Scholar 

  11. Courneya KS, Friedenreich CM. Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complement Med. 1997;3(3):215–26.

    Article  CAS  PubMed  Google Scholar 

  12. Courneya KS, Karvinen KH, McNeely ML, Campbell KL, Brar S, Woolcott CG, et al. Predictors of Adherence to Supervised and Unsupervised Exercise in the Alberta Physical Activity and Breast Cancer Prevention Trial. J Phys Act Health. 2011;9(6):857–66.

    PubMed  Google Scholar 

  13. Speed-Andrews AE, Rhodes RE, Blanchard CM, Culos-Reed SN, Friedenreich CM, Belanger LJ, et al. Medical, demographic and social cognitive correlates of physical activity in a population-based sample of colorectal cancer survivors. Eur J Cancer Care. 2012;21:187–96.

    Article  CAS  Google Scholar 

  14. Peddle CJ, Plotnikoff RC, Cameron Wild T, Au HJ, Courneya KS. Medical, demographic, and psychosocial correlates of exercise in colorectal cancer survivors: an application of self-determination theory. Support Care Cancer. 2008;16:9–17.

    Article  PubMed  Google Scholar 

  15. Pinto BM, Papandonatos GD, Goldstein MG, Marcus BH, Farrell N. Home-based physical activity intervention for colorectal cancer survivors. Psychooncology. 2011. doi:10.1002/pon.2047.

    PubMed  Google Scholar 

  16. Szymlek-Gay EA, Richards R, Egan R. Physical activity among cancer survivors: a literature review. N Z Med J. 2011;124(1337):77–89.

    PubMed  Google Scholar 

  17. Love C, Sabiston CM. Exploring the links between physical activity and posttraumatic growth in young adult cancer survivors. Psycho-Oncology. 2011;20:278–86.

    Article  PubMed  Google Scholar 

  18. Hawkes AL, Chambers SK, Pakenham KI, Patrao TA, Baade P, Lynch BM, et al. Effects of a telephone-delivered multiple health behavior change intervention on health and behavioral outcomes in colorectal cancer survivors (‘CanChange’): a randomized controlled trial. J Clin Oncol. 2013;31(18):2313–21.

    Article  PubMed  Google Scholar 

  19. Hawkes AL, Pakenham KI, Chambers SK, Patrao TA, Courneya KS. ‘CanChange’: randomized controlled trial of a lifestyle intervention for colorectal cancer survivors. Ann Behav Med. 2014. doi:10.1007/s12160-014-9610-2.

    Google Scholar 

  20. Department of Health and Ageing. National physical activity guidelines for Australians. Canberra: Australian Government; 1999.

    Google Scholar 

  21. Sallis JF, Owen N, Fisher EB. Ecological models of health behavior. In: Glanz K, Rimer BK, Viswanath K, editors. Health behavior and health education: theory, research, and practice. tth ed. San Francisco: Jossey-Bass; 2008. p. 465–82.

    Google Scholar 

  22. Department of Health and Ageing, National Health and Medical Research Council. Food for health. Dietary guidelines for Australians. A guide to healthy eating. Canberra: Australian Government; 2005.

    Google Scholar 

  23. What is a healthy weight? Available from http://www.health.gov.au/internet/healthyactive/publishing.nsf/Content/healthy-weight.

  24. Department of Health and Ageing: National tobacco strategy, 2004–2009: the strategy. In. Canberra; 2005.

  25. National Health and Medical Research Council. Australian alcohol guidelines: health risks and benefits. Canberra; 2001.

  26. Godin G, Shephard RJ. A simple method to assess exercise behaviour in the community. Can J Appl Sport Sci. 1985;10(3):141–6.

    CAS  PubMed  Google Scholar 

  27. Broderick JM, Ryan J, O’Donnell DM, Hussey J. A guide to assessing physical activity using accelerometry in cancer patients. Support Care Cancer. 2014;22(4):1121–30.

    Article  CAS  PubMed  Google Scholar 

  28. Krnjacki LJ, Baade PD, Lynch BM, Aitken JF. Reliability of collecting colorectal cancer stage information from pathology reports and general practitioners in Queensland. Aust N Z J Public Health. 2008;32(4):378–82.

    Article  PubMed  Google Scholar 

  29. Marcus BH, Selby VC, Niaura RS, Rossi JS. Self-efficacy and the stages of exercise behavior change. Res Q Exerc Sport. 1992;63(1):60–6.

    Article  CAS  PubMed  Google Scholar 

  30. Salmon J, Owen N, Crawford D, Bauman A, Sallis JF. Physical activity and sedentary behaviour: a population-based study of barriers, enjoyment and preference. Health Psychol. 2003;22(2):178–88.

    Article  PubMed  Google Scholar 

  31. Giles G, Ireland P. Dietary Questionnaire for Epidemiologic Studies (Version 2). In. Melbourne: The Cancer Council Victoria; 1996.

    Google Scholar 

  32. The Cancer Council New South Wales: Cancer-related knowledge and practices: recommended survey items. Newcastle 2006.

  33. Cella D: Manual of the Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System: Center on Outcomes, Research and Education (CORE), Evanston Northwestern Healthcare and Northwestern University; 1997.

  34. Ward WL, Hahn EA, Mo F, Hernandez L, Tulsky DS, Cella D. Reliability and validity of the Functional Assessment of Cancer Therapy-Colorectal (FACT-C) quality of life instrument. Qual Life Res. 1999;8:181–95.

    Article  CAS  PubMed  Google Scholar 

  35. Derogatis LR. BSI 18: Brief Symptom Inventory 18. Administration, scoring and procedures manual. Minneapolis: National Computer Systems Inc.; 2000.

    Google Scholar 

  36. Recklitis CJ, Parsons SK, Shih MC, Mertens A, Robison LL, Zeltzer L. Factor structure of the brief symptom inventory-18 in adult survivors of childhood cancer: results from the childhood cancer survivor study. Psychol Assess. 2006;18(1):22–32.

    Article  PubMed  Google Scholar 

  37. Zabora J, BrintzenhofeSzoc K, Jacobsen P, Curbow B, Piantadosi S, Hooker C, et al. A new psychosocial screening instrument for use with cancer patients. Psychosomatics. 2001;42(3):241–6.

    Article  CAS  PubMed  Google Scholar 

  38. Tedeschi RG, Calhoun LG. The Posttraumatic Growth Inventory: measuring the positive legacy of trauma. J Trauma Stress. 1996;9(3):455–71.

    Article  CAS  PubMed  Google Scholar 

  39. Jansen L, Hoffmeister M, Chang-Claude J, Brenner H, Arndt V. Benefit finding and post-traumatic growth in long-term colorectal cancer survivors: prevalence, determinants, and associations with quality of life. Br J Cancer. 2011;105(8):1158–65.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  40. Salsman JM, Segerstrom SC, Brechting EH, Carlson CR, Andrykowski MA. Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: a 3-month longitudinal examination of cognitive processing. Psychooncology. 2009;18(1):30–41.

    Article  PubMed Central  PubMed  Google Scholar 

  41. Peterman AH, Fitchett G, Brady MJ, Hernandez L, Cella D. Measuring spiritual well-being in people with cancer: the functional assessment of chronic illness therapy—Spiritual Well-being Scale (FACIT-Sp). Ann Behav Med. 2002;24(1):49–58.

    Article  PubMed  Google Scholar 

  42. Preliminary psychometric properties of the Acceptance and Action Questionnaire — II: A revised measure of psychological flexibility and acceptance. [http://www.contextualpsychology.org/acceptance_action_questionnaire_aaq_and_variations].

  43. Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol. 2003;84(4):822–48.

    Article  PubMed  Google Scholar 

  44. Carlson L, Brown KW. Validation of the Mindful Attention Awareness Scale in a cancer population. J Psychosom Res. 2005;58(1):29–33.

    Article  PubMed  Google Scholar 

  45. Sarason IG, Sarason BR, Shearin EN, Pierce GR. A brief measure of social support: Practical and theoretical implications. J Soc Pers Relationsh. 1987;4:497–510.

    Article  Google Scholar 

  46. Sarason IG, Levine HM, Basham RB, Sarason BR. Assessing social support: The Social Support Questionnaire. J Pers Soc Psychol. 1983;44:127–39.

    Article  Google Scholar 

  47. Courneya KS, Friedenreich CM, Reid RD, Gelmon K, Mackey JR, Ladha AB, et al. Predictors of follow-up exercise behavior 6 months after a randomized trial of exercise training during breast cancer chemotherapy. Breast Cancer Res Treat. 2009;114(1):179–87.

    Article  PubMed  Google Scholar 

  48. Vallance J, Plotnikoff RC, Karvinen KH, Mackey JR, Courneya KS. Understanding physical activity maintenance in breast cancer survivors. Am J Health Behav. 2010;34(2):225–36.

    Article  PubMed  Google Scholar 

  49. Trost SG, Owen N, Bauman A, Sallis JF, Brown W. Correlates of adults’ participation in physical activity: review and update. Med Sci Sports Exerc. 2002;34(12):1996–2001.

    Article  PubMed  Google Scholar 

  50. Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Fairey AS. Predictors of adherence and contamination in a randomized trial of exercise in colorectal cancer survivors. Psychooncology. 2004;13(12):857–66.

    Article  PubMed  Google Scholar 

  51. Giles-Corti B, Donovan RJ. Socioeconomic status differences in recreational physical activity levels and real and perceived access to a supportive physical environment. Prev Med. 2002;35(6):601–11.

    Article  PubMed  Google Scholar 

  52. Pink B: Australian social trends. In: ABS catalogue no 41020. Edited by Statistics ABo. Canberra; 2010.

  53. Hong S, Bardwell WA, Natarajan L, Flatt SW, Rock CL, Newman VA, et al. Correlates of physical activity level in breast cancer survivors participating in the Women’s Healthy Eating and Living (WHEL) Study. Breast Cancer Res Treat. 2007;101(2):225–32.

    Article  PubMed  Google Scholar 

  54. Ferriolli E, Skipworth RJE, Hendry P, Scott A, Stensteth J, Dahele M, et al. Physical activity monitoring: a responsive and meaningful patient-centered outcome for surgery, chemotherapy, or radiotherapy? J Pain Symptom Manag. 2012;43(6):1025–35.

    Article  Google Scholar 

  55. Courneya KS, Stevinson C, McNeely ML, Sellar CM, Friedenreich CM, Peddle-McIntyre CJ, et al. Predictors of follow-up exercise behavior 6 months after a randomized trial of supervised exercise training in lymphoma patients. Psychooncology. 2012;21:1124–31.

    Article  PubMed  Google Scholar 

  56. Courneya KS, Friedenreich CM, Quinney HA, Fields AL, Jones LW, Fairey AS. A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care (Engl). 2003;12(4):347–57.

    Article  CAS  Google Scholar 

  57. Lynch BM, Cerin E, Owen N, Hawkes AL, Aitken JF. Prospective relationships of physical activity with quality of life among colorectal cancer survivors. J Clin Oncol. 2008;26(27):4480–7.

    Article  PubMed  Google Scholar 

  58. Sabiston CM, McDonough MH, Crocker PR. Psychosocial experiences of breast cancer survivors involved in a dragon boat program: exploring links to positive psychological growth. J Sport Exerc Psychol. 2007;29(4):419–38.

    PubMed  Google Scholar 

  59. Tedeschi RG, Calhoun LG. Posttraumatic growth: conceptual foundations and empirical evidence. Psychol Inq. 2004;15:1–18.

    Article  Google Scholar 

  60. Rasmussen HN, Wrosch C, Scheier MF, Carver CS. Self-regulation processes and health: the importance of optimism and goal adjustment. J Pers. 2006;74(6):1721–47.

    Article  PubMed  Google Scholar 

  61. Kendzierski D. Exercise self-schemata: cognitive and behavioral correlates. Health Psychol. 1990;9(1):69–82.

    Article  CAS  PubMed  Google Scholar 

  62. Courneya KS, Stevinson C, McNeely ML, Sellar CM, Peddle CJ, Friedenreich CM, et al. Predictors of adherence to supervised exercise in lymphoma patients participating in a randomized controlled trial. Ann Behav Med. 2010;40(1):30–9.

    Article  PubMed  Google Scholar 

  63. Loprinzi PD, Cardinal BJ, Si Q, Bennett JA, Winters-Stone KM. Theory-based predictors of follow-up exericse behavior after a supervised exercise intervention in older breast cancer survivors. Support Care Cancer. 2012;20(10):2511–21.

    Article  PubMed Central  PubMed  Google Scholar 

  64. Aday L. Designing and conducting health surveys. San Francisco: Jossey-Bass; 1996.

    Google Scholar 

  65. Novick G. Is there a bias against telephone interviews in qualitative research? Res Nurs Health. 2008;31(4):391–8.

    Article  PubMed Central  PubMed  Google Scholar 

  66. Lynch BM, Dunstan DW, Vallance JK, Owen N. Don’t take cancer sitting down: a new survivorship research agenda. Cancer. 2013;119(11):1928–35.

    Article  PubMed  Google Scholar 

  67. Hawkes AL, Lynch BM, Youlden DR, Owen N, Aitken JF. Health behaviors of Australian colorectal cancer survivors, compared with noncancer population controls. Support Care Cancer. 2008;16(10):1097–104.

    Article  PubMed  Google Scholar 

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Acknowledgements

This study received funding from the Australian Government through Cancer Australia. The authors thank our study investigators Suzanne Chambers, Kenneth Pakenham, Joanne Aitken, Maree Colosimo, Victoria White and Muriel Wulff, as well as our study team (Rhianna Hardie, Susan Bell, Bernice Kelly, Sarah Mitchell and Marnie Dunn).

Informed consent

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.

Conflict of interests

A.L. Hawkes, T.A. Patrao, P. Baade, B.M. Lynch and K.S. Courneya declare that they have no competing interests.

Author information

Authors and Affiliations

  1. School of Public Health and Social Work, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Brisbane, 4059, Queensland, Australia

    A. L. Hawkes

  2. School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia

    A. L. Hawkes

  3. Menzies School of Health Research, Brisbane, Australia

    T. A. Patrao

  4. Viertel Centre for Research in Cancer Control, Cancer Council Queensland, Brisbane, Australia

    P. Baade

  5. Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, Melbourne, Australia

    B. M. Lynch

  6. Faculty of Physical Education and Recreation, University of Alberta, Edmonton, AB, Canada

    K. S. Courneya

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  1. A. L. Hawkes
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  2. T. A. Patrao
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  3. P. Baade
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  4. B. M. Lynch
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  5. K. S. Courneya
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Correspondence to A. L. Hawkes.

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Hawkes, A.L., Patrao, T.A., Baade, P. et al. Predictors of physical activity in colorectal cancer survivors after participation in a telephone-delivered multiple health behavior change intervention. J Cancer Surviv 9, 40–49 (2015). https://doi.org/10.1007/s11764-014-0389-8

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  • DOI: https://doi.org/10.1007/s11764-014-0389-8

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