Abstract B21: Associations of physical activity with physical functioning and emotional distress among non-Hispanic white and Chinese-American breast cancer survivors
Authors: Kim Bang Hyun , Dash Chiranjeev , Gomez Scarlett Lin , Sheppard Vanessa B. , Allen Laura , Wang Yiru , Wang Judy Huei-yu 
Published: May 2019

Breast cancer is the most commonly diagnosed cancer and one of the leading causes of cancer deaths for Asian-American women. Asian-American breast cancer survivors often report higher rates of poor quality of life than Non-Hispanic White (NHW) survivors. While physical activities were found to improve breast cancer survivors' health related quality of life (HRQOL), knowledge regarding their quality of life and physical activity behaviors among Asian women is limited. This study examined the association of self-reported physical activity levels with HRQOL outcomes (i.e., physical function and emotional distress) among a sample of Non-Hispanic White (NHW) and Chinese-American breast cancer survivors. We also examined whether the association was modified by high-acculturated Chinese-American (HCA) versus low-acculturated Chinese-American (LCA). We obtained breast cancer cases from California Cancer Registries and recruited women who were over age 21, diagnosed with breast cancer at stage 0-III, and had completed primary treatment within 1-5 years with no recurrence. Acculturation was defined by Chinese-American women's English ability (high vs. low) and years of US residency (median=25 years). Cross-sectional survey data were collected from 381 breast cancer survivors (184 NHW, 68 HCA, and 129 LCA) via telephone. Physical activity was measured using the International Physical Activity Questionnaire (IPAQ) and physical functioning and emotional distress were measured using Patient Reported Outcomes Measurement Information System (PROMIS) items. GLM and multivariate logistic regression analysis was used to model relationships between physical activity levels and patient reported outcomes, controlling for covariates (e.g., body mass index and comorbidity). Results showed that NHW and acculturated Chinese survivors had higher physical functioning than low-acculturated Chinese survivors, although the three groups had no difference in emotional distress. For reported physical activity levels, 42% of NHWs reported high physical activity levels (&gt;150 minutes/week of moderate intensity) compared to the two Chinese-American groups (25% HCA and 13% LCA). Regardless of race, those who reported high physical activity levels were more likely to have higher physical functioning (OR: 3.07, CI: 1.53, 6.17) and lower depression (OR: 0.48, CI: 0.25, 0.91) and anxiety (OR: 0.47, CI: 0.25, 0.90). Specifically, higher levels of physical activity were strongly associated with higher levels physical functioning among NHW and HCA survivors, but this association was less evident for LCA survivors. Moreover, Chinese breast cancer survivors, regardless of acculturation level, those who reported higher levels of physical activities were less likely to report emotional stress compared to NHW women. Overall, results extend upon the importance of promoting physical activity to improve HRQOL outcomes in breast cancer survivors. Differences by race and acculturation status also warrants further investigation in future studies designed to improve HRQOL outcomes in breast cancer survivors, especially in immigrant populations with different acculturation status.

Citation Format: Bang Hyun Kim, Chiranjeev Dash, Scarlett Lin Gomez, Vanessa B. Sheppard, Laura Allen, Yiru Wang, Judy Huei-yu Wang. Associations of physical activity with physical functioning and emotional distress among non-Hispanic white and Chinese-American breast cancer survivors. [abstract]. In: Proceedings of the Twelfth Annual AACR International Conference on Frontiers in Cancer Prevention Research; 2013 Oct 27-30; National Harbor, MD. Philadelphia (PA): AACR; Can Prev Res 2013;6(11 Suppl): Abstract nr B21.