Predictors of attendance during an exercise program for cancer survivors

Abstract

Purpose

Exercise programs delivered in community- or clinic-based settings improve physical and psychosocial outcomes among cancer survivors; however, adherence is essential to achieve such benefits. This study examined predictors of attendance to an exercise program in a large, diverse sample of cancer survivors.

Methods

Participants (n = 302) were enrolled in BfitBwell, an exercise program for adults diagnosed with cancer, and currently receiving or within 6 months of completing chemotherapy or radiation therapy. Participants were offered two supervised aerobic and resistance exercise sessions per week for 3 months. Predictors of attendance included demographics, cancer-related information, quality of life (QOL), fatigue, physical fitness, activity level, and importance of making various changes (e.g., improving fitness). Univariate linear regression first explored associations between predictor variables and adherence, and any important variables (p < .10) were included in a multivariate linear regression model.

Results

Participants were M = 54.9 ± 13.9 years old, mostly female (67.3%), white (83.6%), and most commonly diagnosed with breast cancer (34.8%). Average attendance was 16.2 ± 6.6 exercise sessions. Six-minute walk test distance, QOL, and fatigue were associated with exercise session attendance (p < .05). The multivariable model revealed that higher QOL predicted higher attendance (β = .351, p = .005), and working full- or part-time significantly predicted lower attendance (β =− .221, p =.021).

Conclusions

Higher pre-program QOL and not working full- or part-time predicted higher exercise program attendance. Existing and future exercise programs for cancer survivors should consider ways to adapt program delivery to provide support to survivors who start with low QOL, and accommodate those who may face barriers to attending due to work schedule/conflict.

This is a preview of subscription content, access via your institution.

Data availability

These are not open source data.

References

  1. 1.

    Campbell KL, Winters-Stone KM, Wiskemann J et al (2019 Nov) Exercise guidelines for cancer survivors: consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc 51(11):2375–2390

    Article  Google Scholar 

  2. 2.

    Stout NL, Baima J, Swisher AK et al (2017) A systematic review of exercise systematic reviews in the cancer literature (2005-2017). PM R 9(9S2):S347–S384

    Article  Google Scholar 

  3. 3.

    Schmitz KH, Campbell AM, Stuiver MM et al (2019 Oct) Exercise is medicine in oncology: engaging clinicians to help patients move through cancer. CA Cancer J Clin 16

  4. 4.

    Mina DS, Sabiston CM, Au D et al (2018) Connecting people with cancer to physical activity and exercise programs: a pathway to create accessibility and engagement. Curr Oncol (Toronto, Ont) 25(2):149–162

    Article  Google Scholar 

  5. 5.

    Covington KR, Hidde MC, Pergolotti M, Leach HJ (2019 Dec) Community-based exercise programs for cancer survivors: a scoping review of practice-based evidence. Support Care Cancer 27(12):4435–4450

    Article  Google Scholar 

  6. 6.

    Phillips SM, Alfano CM, Perna FM, Glasgow RE (2014 May) Accelerating translation of physical activity and cancer survivorship research into practice: recommendations for a more integrated and collaborative approach. Cancer Epidemiol Biomark Prev 23(5):687–699

    Article  Google Scholar 

  7. 7.

    Ormel HL, van der Schoot GGF, Sluiter WJ, Jalving M, Gietema JA, Walenkamp AME (2018 Mar) Predictors of adherence to exercise interventions during and after cancer treatment: a systematic review. Psychooncology. 27(3):713–724

    CAS  Article  Google Scholar 

  8. 8.

    Marker RJ, Cox-Martin E, Jankowski CM, Purcell WT, Peters JC (2018 Jun) Evaluation of the effects of a clinically implemented exercise program on physical fitness, fatigue, and depression in cancer survivors. Support Care Cancer 26(6):1861–1869

    Article  Google Scholar 

  9. 9.

    Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J (1993 Mar) The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579

    CAS  Article  Google Scholar 

  10. 10.

    Yellen SB, Cella DF, Webster K, Blendowski C, Kaplan E (1997 Feb) Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. J Pain Symptom Manag 13(2):63–74

    CAS  Article  Google Scholar 

  11. 11.

    Schmidt K, Vogt L, Thiel C, Jäger E, Banzer W (2013 Jul) Validity of the six-minute walk test in cancer patients. Int J Sports Med 34(7):631–636

    CAS  Article  Google Scholar 

  12. 12.

    Bland KA, Neil-Sztramko SE, Kirkham AA, Bonsignore A, van Patten CL, McKenzie DC, Gelmon KA, Campbell KL (2018 Sep) Predictors of attendance to an oncologist-referred exercise program for women with breast cancer. Support Care Cancer 26(9):3297–3306

    Article  Google Scholar 

  13. 13.

    Witlox L, Velthuis MJ, Boer JH, Steins Bisschop CN, Wall E, Meulen WJTM, Schröder CD, Peeters PHM, May AM (2019) Attendance and compliance with an exercise program during localized breast cancer treatment in a randomized controlled trial: the PACT study. PLoS One 14(5):e0215517

    Article  Google Scholar 

  14. 14.

    Craike M, Gaskin CJ, Courneya KS, Fraser SF, Salmon J, Owen PJ, Broadbent S, Livingston PM (2016 May) Predictors of adherence to a 12-week exercise program among men treated for prostate cancer: ENGAGE study. Cancer Med 5(5):787–794

    Article  Google Scholar 

Download references

Funding

Leach is supported by a career development award from the American Cancer Society (131629-MRSG-18-021-01-CPPB).

Author information

Affiliations

Authors

Contributions

HJL conceived of the research idea, completed the data analyses, and wrote the article. RJM collected and managed the data and aided in interpreting results and worked on the manuscript. JJS collected and managed the data. JCP aided in interpreting results and worked on the manuscript. WTP conceived the original exercise program and is in charge of overall direction and planning of the program. All authors provided critical feedback on the manuscript and approved the final version that was submitted for publication.

Corresponding author

Correspondence to Heather J. Leach.

Ethics declarations

Ethics approval and consent to participate

This study was approved by the Colorado Multiple Institutional Review Board [COMIRB #17-033]. All participants completed a written, signed informed consent to approve the use of their data for research purposes.

Consent for publication

These data have not been presented or published elsewhere.

Conflict of interest

The authors declare no conflict of interest.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Leach, H.J., Marker, R.J., Scorsone, J.J. et al. Predictors of attendance during an exercise program for cancer survivors. Support Care Cancer (2021). https://doi.org/10.1007/s00520-021-06057-4

Download citation

Keywords

  • Adult
  • Cancer survivors
  • Exercise
  • Health behavior
  • Quality of life