Abstract
Goals of work
Although exercise has gained recognition as an effective supportive care intervention for cancer survivors, exercise participation rates are low. The present study examined the determinants of exercise in bladder cancer survivors using the Theory of Planned Behavior (TPB).
Patients and methods
Bladder cancer survivors (N = 397) residing in Alberta, Canada completed a mailed questionnaire at baseline that assessed demographic, medical, behavioral, and social cognitive variables and a second questionnaire 3 months later that assessed exercise. Multiple regression was the primary analysis.
Main results
Adjuvant therapy (r = −0.10, p = 0.021), cancer invasiveness (r = −0.10, p = 0.051), and age (r = −0.11, p = 0.037) were all negatively associated with exercise. Intention (β = 0.25, p < 0.001), perceived behavioral control (β = 0.18, p = 0.001), and planning (β = 0.12, p = 0.018) explained 20.9% of the variance in exercise over a 3-month period. Perceived behavioral control (β = 0.32, p < 0.001), affective attitude (β = 0.18, p = 0.002), instrumental attitude (β = 0.15, p = 0.025) and descriptive norm (β = 0.10, p = 0.032) explained 39.1% of the variability in exercise intention. Constructs from the TPB mediated the associations between adjuvant therapy, cancer invasiveness, age, and exercise. Age and adjuvant therapy also moderated some of the associations within the TPB.
Conclusions
Some medical and demographic variables predict exercise behavior in bladder cancer survivors, but these associations are mediated by the TPB. Interventions based on the TPB may be effective for promoting exercise in this cancer survivor population.
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Acknowledgments
This study was funded by a University of Alberta–EFF Support for the Advancement of Scholarship Small Faculties Research Grant and a Research Team Grant from the National Cancer Institute of Canada (NCIC) with funds from the Canadian Cancer Society (CCS) and the NCIC/CCS Sociobehavioral Cancer Research Network. At the time of this study, Kristina H. Karvinen was supported by a Health Studentship from the Alberta Heritage Foundation for Medical Research. Kristina H. Karvinen is now with the Department of Exercise and Sport Science, East Carolina University, Greenville, North Carolina. Kerry S. Courneya is supported by the Canada Research Chairs Program. Ronald C. Plotnikoff is supported by the Alberta Heritage Foundation for Medical Research (Health Scholar) and the Canadian Institutes of Health Research (Applied Public Health Chair).
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Karvinen, K.H., Courneya, K.S., Plotnikoff, R.C. et al. A prospective study of the determinants of exercise in bladder cancer survivors using the Theory of Planned Behavior. Support Care Cancer 17, 171–179 (2009). https://doi.org/10.1007/s00520-008-0471-8
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DOI: https://doi.org/10.1007/s00520-008-0471-8