# Exercise as it relates to Disease/Breast Cancer Survivors' Motives and Adherence to Community Based Activity Programs

This Wikibooks page is a fact sheet and analysis of the journal article "Breast cancer survivors' barriers and motives for participating in a group-based physical activity program offered in the community" by Wurz et al. (2014)

## What is the background of this

Breast cancer has been shown to be the most common cancer in women This study focuses on the importance of post treatment interventions to help improve health and quality of life of patients. Post treatment patients often report feeling a sense of social isolation or lack of social support following treatment. One of the ways survivors are offered support is through free community group-based exercise programs.

### Prevelance

Statistics show that in 2012, breast cancer accounted for 1.7 million or 11.9% of newly diagnosed cancer cases.
Traditional treatments for breast cancer include treatments such as chemotherapy, radiation, surgery and hormone replacement therapy. Although these treatments are vital to improving health they also come with their own adverse side effects.

### Post Treatment

Post treatment side effects may include psychosocial or physical effects and an increased risk of comorbid conditions.
Table 1a: Possible Adverse Effects of Breast Cancer Treatment :
| Psychosocial | Physical | Comorbid Conditions |
| Depression | Musculoskeletal Impairments | Metabolic Syndrome |
| Anxiety | Weight Gain | Heart disease |
| Social Isolation | Cardiopulmonary Impairments | |
Exercise has been shown to be key to combating several of the negative effects listed above. These findings highlight the importance of increasing participation in exercise for this population.

## Where is the research from?

This study was carried out by researchers from the University of Ottawa's school of human kinetics and was approved by the University research ethics board.

## What kind of research was this?

This research is an example of qualitative research. This type of research is used to gain an understanding of reasons and motives. Data was collected through questionnaires, interviews and self reporting. The data was then analysed using thematic analysis.
This type of research produces no concrete results, rather it presents an interpretation provided by the authors. Therefore this study can only be used as a guide for further research or program development rather than concrete evidence of what works and what does not. Other limitations of this research include the use of self reporting and the use of volunteers. Due to the bias nature of self reporting volunteer results may be skewed. The volunteers were also already signed up for the exercise program, therefore there is an already present motive to participate. Studying the general population of breast cancer survivors may show different trends to what was presented which may result in lower participation numbers overall. Further research should investigate ways to increase the number of participants who haven't already signed up for these programs as well as looking at the motives and barriers of adherence to the program.

## What did the research involve?

Seven volunteers who were signed up for an 8-week group-based exercise program provided through cancer survivorship care were interviewed before the first session and following the program. The interviews involved open ended questions regarding barriers and motives of participation in individual sessions and the program overall. Self reported attendance was also taken.

## What were the basic results?

The results presented are largely an analysis of the pre and post program interviews. The self reporting of attendance ranged from 69% attendance to 100% program attendance over the 8 weeks.
The analysis of the interviews were broken down into the following barriers and motives:
$_{Table1b:BarriersandMotivestoparticipationinprogram}$ :
| Barriers | Motives |
| Situational: Institutional Competing roles and responsibilities Community Distance of Centre Traffic | Situational: Interpersonal Receiving social support Networking Being around similar others |
| Internal Cancer- specific limitations | Internal Personal fulfilment Health benefits Recovery from cancer |

### Barriers

Location of the centre, parking, traffic and distance from the centre were all discussed as situational barriers. This discussion can be useful in planning future programs, i.e. where they may be held, to increase participation rates. However, a lot of this may be reliant on funding and availability and may be difficult to change.
Competing roles and responsibilities (e.g. medical appointments) were also discussed. A focus of future programs could be when the program is delivered- for example after work programs would be more beneficial as many of the participants were working full time.
Internal barriers included sickness from treatment or risk of transmitting a common cold/flu to other participants with weakened immune systems. These are serious risks in group based programs of this nature and need to be explored further.

### Motives

Providing more information to cancer patients about the benefits of exercise may be one strategy to increase participation in these programs. Motives mentioned from the participants included personal fulfilment and health benefits.

## How did the researchers interpret the results?

The researches believed that this research provides a deeper understanding of why or why not the participants engaged in the exercise program. They believe it is important to understand these reasons because of the underlying benefits of exercise to post treatment patients. Additionally these benefits will only be possible through consistent participation. The researchers also underline the importance of taking into consideration the different barriers and motives of participation when designing a program for a particular group.

## What conclusions should be taken away from this research?

This research enhances understanding of the underlying factors of participation and adherence for this type of program. The study outlines the importance of participation. Using strategies based off the information reported, an increase in participation would be likely. Availability of classes, parking, location of the sessions etc, can all be taken into account to allow for greater participation rates.
Motives for exercise could also be encouraged through supplying more information about the benefits of the exercise programs in regards to recovery and well being.

## What are the implications of this research?

Wurz et al, have outlined the importance of exercise for post cancer treatment health. The study analyses the most crucial aspect of benefiting from an exercise program, participation and adherence. Without these two things the program would have no benefit. The authors have given a better understanding of the underlying motives for participation in a group based physical activity program and most importantly have underlined the importance of assessing potential barriers when developing and delivering these programs to ensure maximal participation and minimal drop out rates.

## References

* 1 2 3 4 5 6 7 Wurz et al.(2015) 'Breast cancer survivors’ barriers and motives for participating in a group-based physical activity program offered in the community'. Supportive Care in Cancer, 1-10.
* 1 2 Jemal et al. (2011) 'Global Cancer Statistics'. CA Cancer J 2:69-90
* ↑ Siegel et al. (2014) 'Cancer treatment and survivorship statistics'. CA Cancer J 62:220-241
* 1 2 Ganz et al. (2011) 'Physical and Psychosocial recovery in the year after primary treatment of breast cancer.' J Clin Oncol 29(9): 1101-1109
* ↑ Compas et al. (2002) Psychological adjustment to breast cancer. Curr Dir Psychological Sci 11(3):111-114
* 1 2 Ballard-Barbash et al. (2012) 'Physical activity, biomarkers and disease outcomes in cancer surviviors'. J Natl Canc Inst 104(11):815-840
* 1 2 Loprinzi et al. (2012) 'Effects of Physical activity on common side effects of breast cancer treatment.' Breast cancer 19(1):4-10
* 1 2 Mishra et al.(2012) ' Exercise interventions on health-related quality of life for cancer survivors.' Cochrane Sys Rev 8