Demographic, medical, social-cognitive, and environmental correlates of meeting independent and combined physical activity guidelines in kidney cancer survivors

  • Allyson Tabaczynski
  • Dominick A. Strom
  • Jaime N. Wong
  • Edward McAuley
  • Kristian Larsen
  • Guy E. Faulkner
  • Kerry S. Courneya
  • Linda TrinhEmail author
Original Article



Guidelines for cancer survivors recommend both aerobic physical activity (PA) and strength training (ST). Few kidney cancer survivors (KCS) are meeting single-activity or combined guidelines; therefore, examining factors influencing PA participation is warranted. The purpose of this study is to examine demographic, medical, social-cognitive, and environmental correlates of meeting independent (i.e., aerobic-only, strength training (ST)-only) and combined guidelines (i.e., aerobic and ST) in KCS.


KCS (N = 651) completed self-reported measures of PA and demographic, medical, social-cognitive, and perceived environmental factors. Built environment was assessed using the geographic information systems (GIS). Multinomial logistic regressions were conducted to determine the correlates of meeting the combined versus independent guidelines.


Compared with meeting neither guideline, meeting aerobic-only guidelines was associated with higher intentions (p < .01) and planning (p < .01); meeting ST-only guidelines was associated with higher intentions (p = .02) and planning (p < .01), lower perceived behavioral control (PBC) (p = .03), healthy weight (p = .01), and older age (p < .01); and meeting the combined guidelines were associated with higher intentions (p < .01), planning (p = .02), higher instrumental attitudes (p < .01), higher education (p = .04), better health (p < .01), and localized cancer (p = .05). Additionally, compared with neither guideline, meeting aerobic-only (p < .01) and combined (p < .01) guidelines was significantly associated with access to workout attire. Compared with neither guideline, meeting aerobic-only guidelines was associated with proximity to retail (p = .02).


PA participation correlates may vary based on the modality of interest. Interventions may differ depending on the modality promoted and whether KCS are already meeting single-modality guidelines.


Aerobic activity Strength training Kidney cancer Correlates Social-cognitive Built environment 



GEF is supported by the Canadian Institutes of Health Research-Public Health Agency of Canada (CIHR-PHAC) Chair in Applied Public Health. KSC is supported by the Canada Research Chairs Program. We thank Carol Russell and Lorraine Cormier from the Alberta Cancer Registry for their assistance in conducting this study.

Compliance with ethical standards

Ethical approval was obtained from the Alberta Cancer Board Research Ethics Board and the University of Alberta Health Research Ethics Board.

Conflict of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Harding G, Cella D, Robinson D, Mahadevia PJ, Clark J, Revicki DA (2007) Symptom burden among patients with renal cell carcinoma (RCC): content for a symptom index. Health Qual Life Outcomes 5:34.
  2. 2.
    Gerritsen JKW, Vincent AJPE (2016) Exercise improves quality of life in patients with cancer: a systematic review and meta-analysis of randomised controlled trials. Br J Sports Med 50(13):796–803. CrossRefGoogle Scholar
  3. 3.
    Trinh L, Strom DA, Wong JN, Courneya KS (2018) Modality-specific exercise guidelines and quality of life in kidney cancer survivors: a cross-sectional study. Psychooncology 27:2419–2426.
  4. 4.
    Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen V, Schwartz AL (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426.
  5. 5.
    Cormie P, Zopf EM, Zhang X, Schmitz KH (2017) The impact of exercise on cancer mortality, recurrence, and treatment-related adverse effects. Epidemiol Rev 39(1):71–92.
  6. 6.
    Courneya KS, McKenzie DC, Mackey JR et al (2013) Effects of exercise dose and type during breast cancer chemotherapy: multicenter randomized trial. J Natl Cancer Inst 105(5):1821–1832.
  7. 7.
    Crawford JJ, Holt NL, Vallance JK, Courneya KS (2016) A new paradigm for examining the correlates of aerobic, strength, and combined exercise: an application to gynecologic cancer survivors. Support Care Cancer 24:3533–3541. CrossRefGoogle Scholar
  8. 8.
    Vallerand JR, Rhodes RE, Walker GJ, Courneya KS (2017) Correlates of meeting the combined and independent aerobic and strength exercise guidelines in hematologic cancer survivors. Int J Behav Nutr Phys Act 14(1):44.
  9. 9.
    Sallis JF, Owen N, Fisher EB (2008) Ecological models of health behavior. In: Glanz K, Rimer BK, Viswanath K (eds) Health behavior and health education: theory, research, and practice, 4th edn. Jossey-Bass, San Francisco, pp 465–482Google Scholar
  10. 10.
    Stokols D (1996) Translating social ecological theory into guidelines for community health promotion. Am J Health Promot 10:282–298CrossRefGoogle Scholar
  11. 11.
    Trinh L, Larsen K, Faulkner GE, Plotnikoff RC, Rhodes RE, North S, Courneya KS (2016) Social-ecological correlates of physical activity in kidney cancer survivors. J Cancer Surviv 10:164–175. CrossRefGoogle Scholar
  12. 12.
    Godin G, Shephard RJ (1985) A simple method to assess exercise behavior in the community. Can J Appl Sport Sci 10:141–146Google Scholar
  13. 13.
    Forbes C, Blanchard C, Mummery W, Courneya KS (2015) Prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors. Oncol Nurs Forum 42(2):118–127.
  14. 14.
    Ajzen I (1991) The theory of planned behavior. Organ Behav Hum Decis Process 50:179–211. CrossRefGoogle Scholar
  15. 15.
    Ajzen I (2002) Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior. J Appl Soc Psychol 32:665–683.
  16. 16.
    Rise J, Thompson M, Verplanken B (2003) Measuring implementation intentions in the context of the theory of planned behavior. Scand J Psychol 44:87–95. CrossRefGoogle Scholar
  17. 17.
    Cerin E, Saelens BE, Sallis JF, Frank LD (2006) Neighborhood environment walkability scale: validity and development of a short form. Med Sci Sports Exerc 38:1682–1691. CrossRefGoogle Scholar
  18. 18.
    Sallis JF, Bowles HR, Bauman A, Ainsworth BE, Bull FC, Craig CL et al (2009) Neighborhood environments and physical activity among adults in 11 countries. Am J Prev Med 36:484–490.
  19. 19.
    Bow CJD, Waters NM, Faris PD, Seidel JE, Galbraith PD, Knudtson ML, Ghali WA (2004) Accuracy of city postal code coordinates as a proxy for location of residence. Int J Health Geogr 3:5.
  20. 20.
    Frank LD, Schmid TL, Sallis JF, Chapman J, Saelens BE (2005) Linking objectively measured physical activity with objectively measured urban form: findings from SMARTRAQ. Am J Prev Med 28:117–125. CrossRefGoogle Scholar
  21. 21.
    Kemperman A, Timmerman H (2009) Influences of built environment on walking and cycling by latent segments of aging population. J Transp Res Board 2134:1–9Google Scholar
  22. 22.
    Statistics Canada (2019). Distribution of total income by census family type and age of older partner, parent or individual. Accessed June 2015
  23. 23.
    Trinh L, Plotnikoff RC, Rhodes RE, North S, Courneya KS (2011) Associations between physical activity and quality of life in a population-based sample of kidney cancer survivors. Cancer Epidemiol Biomark Prev 20:859–868. CrossRefGoogle Scholar
  24. 24.
    Lynch BM, Cerin E, Newman B, Owen N (2007) Physical activity, activity change, and their correlates in a population-based sample of colorectal cancer survivors. Ann Behav Med 34(2):135–143Google Scholar
  25. 25.
    Jones A, Paxton RJ (2015) Neighborhood disadvantage, physical activity barriers, and physical activity among African American breast cancer survivors. Prev Med Rep 2:622–627. CrossRefGoogle Scholar
  26. 26.
    Speed-Andrews AE, McGowan EL, Rhodes RE et al (2013) Correlates of strength exercise in colorectal cancer survivors. Am J Health Behav 37:162–170. CrossRefGoogle Scholar
  27. 27.
    D’Andrea AP, Fernandez CA, Tannenbaum SL et al (2014) Correlates of leisure time physical activity compliance in colorectal cancer survivors. Prev Med 62:78–82.
  28. 28.
    Liu FX, Flatt SW, Pakiz B, Sedjo RL, Wolin KY, Blair CK, Demark-Wahnefried W, Rock CL (2016) Physical activity levels of overweight or obese breast cancer survivors: correlates at entry into a weight loss intervention study. Support Care Cancer 24:173–180. CrossRefGoogle Scholar
  29. 29.
    Van Putten M, Husson O, Mols F et al (2016) Correlates of physical activity among colorectal cancer survivors: results from the longitudinal population-based profiles registry. Support Care Cancer 24:573–583. CrossRefGoogle Scholar
  30. 30.
    Donnelly CM, Blaney JM, Lowe-Strong A, Rankin JP, Campbell A, McCrum-Gardner E, Gracey JH (2011) A randomised controlled trial testing the feasibility and efficacy of a physical activity behavioural change intervention in managing fatigue with gynaecological cancer survivors. Gynecol Oncol 122:618–624. CrossRefGoogle Scholar
  31. 31.
    Guess N (2012) A qualitative investigation of attitudes towards aerobic and resistance exercise amongst overweight and obese individuals. BMC Res Notes 5:191–202.
  32. 32.
    Rogers LQ, Courneya KS, Robbins KT, Malone J, Seiz A, Koch L, Rao K (2008) Physical activity correlates and barriers in head and neck cancer patients. Support Care Cancer 16:19–27. CrossRefGoogle Scholar
  33. 33.
    Forbes CC, Blanchard CM, Mummery WK, Courneya KS (2014) A comparison of physical activity correlates across breast, prostate and colorectal cancer survivors in Nova Scotia, Canada. Support Care Cancer 22:891–903. CrossRefGoogle Scholar
  34. 34.
    Buffart LM, Thong MSY, Schep G, Chinapaw MJM, Brug J, van de Poll-Franse LV (2012) Self-reported physical activity: its correlates and relationship with health-related quality of life in a large cohort of colorectal cancer survivors. PLoS One 7(5):e36164.
  35. 35.
    Vallerand JR, Rhodes RE, Walker GJ, Courneya KS (2016) Understanding strength exercise intentions and behavior in hematologic cancer survivors: an analysis of the intention-behavior gap. J Cancer Surviv 10:945–955. CrossRefGoogle Scholar
  36. 36.
    Short CE, James EL, Vandelanotte C, Courneya KS, Duncan MJ, Rebar A, Plotnikoff RC (2014) Correlates of resistance training in post-treatment breast cancer survivors. Support Care Cancer 22:2757–2766. CrossRefGoogle Scholar
  37. 37.
    Harada K, Oka K, Shibata A, Ishii K, Nakamura Y, Inoue S, Shimomitsu T (2011) Strength-training behavior and perceived environment among Japanese older adults. J Aging Phys Act 19:262–272. CrossRefGoogle Scholar
  38. 38.
    Olson EA, Mullen SP, Rogers LQ, Courneya KS, Verhulst S, McAuley E (2014) Meeting physical activity guidelines in rural breast cancer survivors. Am J Health Behav 38:890–899.
  39. 39.
    Van Cauwenberg J, De Bourdeaudhuij I, De Meester F et al (2011) Relationship between the physical environment and physical activity in older adults: a systematic review. Health Place 17:458–469. CrossRefGoogle Scholar
  40. 40.
    Nadler M, Bainbridge D, Tomasone J, Cheifetz O, Juergens RA, Sussman J (2017) Oncology care provider perspectives on exercise promotion in people with cancer: an examination of knowledge, practices, barriers, and facilitators. Support Care Cancer 25:2297–2304. CrossRefGoogle Scholar
  41. 41.
    Hardcastle SJ, Kane R, Chivers P, Hince D, Dean A, Higgs D, Cohen PA (2018) Knowledge, attitudes, and practice of oncologists and oncology health care providers in promoting physical activity to cancer survivors: an international survey. Support Care Cancer 26:3711–3719. CrossRefGoogle Scholar
  42. 42.
    Ottenbacher A, Yu M, Moser RP, Phillips SM, Alfano C, Perna FM (2015) Population estimates of meeting strength training and aerobic guidelines, by gender and cancer survivorship status: findings from the Health Information National Trends Survey (HINTS). J Phys Act Health 12:675–679.

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of Kinesiology and Physical EducationUniversity of TorontoTorontoCanada
  2. 2.Department of Kinesiology and Community HealthUniversity of Illinois at Urbana-ChampaignUrbanaUSA
  3. 3.CAREX Canada, Faculty of Health SciencesSimon Fraser UniversityVancouverCanada
  4. 4.Department of Geography and PlanningUniversity of TorontoTorontoCanada
  5. 5.School of KinesiologyUniversity of British ColumbiaVancouverCanada
  6. 6.Faculty of Kinesiology, Sport, and RecreationUniversity of AlbertaEdmontonCanada

Personalised recommendations