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Purpose Kidney cancer survivors spend large quantities of time sedentary and little time physically active, which negatively impacts quality of life (QoL). This study examined (1) the association of reallocating sedentary time to sleep, light physical activity (PA), or moderate-to-vigorous PA (MVPA) on QoL in kidney cancer survivors and (2) the threshold at which results are clinically meaningful. Methods Kidney cancer survivors ( N  = 463) completed a survey including the Godin Leisure-Time Exercise Questionnaire, sitting time, sleep duration, and Functional Assessment of Cancer Therapy (FACT) scales. Isotemporal substitution analyses estimated associations of reallocating sedentary time to PA and sleep on QoL. Results Reallocating 10 min/day of sedentary time to MVPA was significantly associated with higher scores on the Trial Outcome Index-Fatigue ( B  = 0.60, SE = 0.25, p  = 0.02), FACT-Fatigue ( B  = 0.71, SE = 0.32, p  = 0.03), functional well-being ( B  = 0.18, SE = 0.08, p  = 0.02), and fatigue subscales ( B  = 0.35, SE = 0.15, p  = 0.02). Reallocating sedentary time to sleep was significantly associated with higher FACT-General ( B  = 0.15, SE = 0.08, p  = 0.04) and functional well-being subscale ( B  = 0.06, SE = 0.03, p  = 0.049) scores. Reallocating sedentary time to light PA was significantly associated with higher fatigue subscale scores ( B  = 0.46, SE = 0.23, p  = 0.045). Kidney cancer survivors would need to reallocate a minimum of about 83, 200, and 65 min/day of MVPA, sleep, and light PA, respectively, for associations to be clinically meaningful. Conclusions Reallocating sedentary time to MVPA, light PA, or sleep at higher doses is associated with better fatigue and physical aspects of QoL. Interventions should consider replacing sedentary time with MVPA or light PA in a gradual manner, and improve sleep quality for kidney cancer survivors.

Breast cancer survivors (BCS) engage in more sedentary behavior (SED) than those without cancer. However, the context in which SED is accrued is unknown. The purpose of this study is to examine differences in total and domain-specific SED of BCS and healthy controls. 20 BCS and 20 age-matched, healthy controls wore ActiGraph GT3X + accelerometers to measure SED and activity. Participants self-reported SED for transportation, occupational, screen time and leisure purposes. Multiple linear regressions were used to estimate differences in SED between BCS and controls. BCS spent significantly more time watching TV (152.4 vs. 60.3; p < 0.01) and less time in total SED (490.8 vs. 587.4; p = 0.046) and other leisure activities (57.6 vs. 106.9; p < 0.01) than healthy controls. BCS engage in more TV watching and less time in other leisure activities than controls, thus interventions should focus on reducing TV time. Understanding facilitators of TV viewing is needed to determine specific intervention targets.

PurposeExercise is beneficial for people living with and beyond cancer (LWBC); however, many people LWBC fail to meet the exercise guidelines. Having an identity related to exercise, a component of one’s self-concept, correlates with exercising more frequently in general adult populations. Understanding how exercise identity influences exercise behaviors in people LWBC is warranted due to the many barriers people LWBC face in relation to physical activity. The purpose of this study was to explore the perceived impact of an exercise identity of the exercise behaviors and motivations among people LWBC.MethodsThirteen participants of mixed diagnoses (Mage = 60.8 ± 10.8 years) in the early survivorship period (i.e., within five years of primary treatment completion or diagnosis) participated in semi-structured interviews to identify influences of exercise identity on exercise behavior. Interviews were transcribed verbatim and analyzed using thematic analysis.ResultsFindings demonstrated that people LWBC with a strong exercise identity engage in high and varied exercise behaviors. Despite barriers such as changes in motivations and ability to engage in exercise, participants maintained exercise throughout cancer by constant adaptation of their outlook and behaviors related to exercise. These results demonstrate a maintenance of physical activity in relation to a strong exercise identity.Implications for cancer survivors: Results of this study have implications for the design and implementation of exercise behavior change programs for people LWBC as it provides insights into predictors of sustained exercise behavior during and following cancer treatment.

Purpose Meeting physical activity (PA) guidelines (i.e., ≥ 150 min/week of aerobic PA and/or 2 days/week of resistance training) is beneficial for maintaining cancer survivors’ well-being. The impact of the COVID-19 pandemic on PA participation in cancer survivors and its association on quality of life (QoL) remains unknown. The purpose of this study was to compare PA levels prior to and during the COVID-19 pandemic, and examine the association between changes in PA and QoL in cancer survivors. Methods A global sample of cancer survivors participated in a cross-sectional, online survey. Participants self-reported their PA participation before and during the pandemic using the Godin Leisure Time Exercise Questionnaire and QoL with the Functional Assessment of Cancer Therapy (FACT) scales. Paired t -tests compared PA before and during the pandemic. Analysis of covariance examined differences in QoL between PA categories: non-exercisers, inactive adopters, complete and partial relapsers, single and combined guideline maintainers. Results PA participation of cancer survivors ( N  = 488) significantly decreased during the pandemic ( p ’s < .001). Cancer survivors were classified as non-exercisers (37.7%), inactive adopters (6.6%), complete (13.1%) and partial (6.1%) relapsers, and single (23.8%) or combined (12.7%) guideline maintainers. Partial relapsers had significantly lower QoL and fatigue than inactive adopters, and combined guideline maintainers ( p ’s < .05) that were clinically meaningful. Conclusion PA decreased during the pandemic which has negative implications for QoL and fatigue in cancer survivors. Implications for Cancer Survivors PA is critical for maintaining QoL during the pandemic; therefore, behavioral strategies are needed to help cancer survivors adopt and maintain PA.

Purpose The COVID-19 pandemic has imposed additional barriers to physical activity (PA) in cancer survivors. Adaptations to PA programmes are needed during the pandemic. Therefore, the purpose of this study was to evaluate (1) the PA preferences of cancer survivors prior to and during the pandemic and (2) the available resources to engage in PA during the pandemic. Methods Using a cross-sectional study design, cancer survivors were recruited globally to participate in a self-administered survey assessing their PA preferences and available PA resources during the pandemic. Descriptive statistics were used to determine trends in PA preferences and resources. A sub-group analysis was conducted for age, gender, education, and PA levels. Results Cancer survivors ( N  = 493) were mainly women (70.4%) diagnosed with breast cancer (29.0%), with a mean age of 48.7 ± 15.8 years, and 87.1 ± 81.9 months since diagnosis. Since the start of the pandemic, cancer survivors were primarily walking (82.6%), and performing PA alone (62.7%) and at home (46.6%). Sub-group analysis revealed education level, PA levels, and age to be associated with significant differences in PA preferences. The most common equipment available to survivors in their homes were exercise mats (40.6%) and free weights (39.8%). Few survivors were made aware of at-home PA resources (19.1%), and approximately half indicated wanting to receive these resources (49.6%). Conclusions Understanding cancer survivors’ preferences and resources for PA during the pandemic is critical to designing effective home-based interventions. Interventions and recommendations should be tailored based on the level of education and PA participation, as well as age.

Low participation rates in people living with and beyond cancer (LWBC) are of particular concern given the established health benefits of physical activity (PA). Peer-led behaviour change interventions, grounded in experiential knowledge and mutual relation, can enhance intervention effects on PA, has positive implications for health and well-being, and holds potential for community implementation. Peer-led behavioural PA interventions in people LWBC lack a behavioural skills training approach that can help in adopting PA and sustaining participation long-term. Therefore, the purpose of this dissertation is to develop and evaluate a peer-led behavioural PA intervention for people LWBC emphasizing skills training for PA adoption and maintenance informed by the Multi-process Action Control Framework (M-PAC). Study 1 was a cross-sectional, secondary data analysis (N=347) exploring M-PAC processes as correlates of PA among people LWBC. Affective judgments and perceived capability were correlates of intention formation, and identity was identified as a correlate of PA action control. These results informed the design of the peer-led PA behaviour change intervention. Study 2 evaluated the feasibility and acceptability of an online training program for peer mentors (i.e., physically active people LWBC; N=14) using mixed methods. The peer training program included four self-directed online modules and live workshops to equip mentors with the skills and knowledge needed to deliver PA counselling informed by the M-PAC framework, and assessed peer mentor readiness at training completion. The peer mentor training program exceeded a priori success criteria for feasibility (i.e., enrollment, retention, adherence rates) and acceptability (i.e., satisfaction) and adequately prepared peer mentors for intervention delivery. Study 3 evaluated the feasibility and acceptability of a 6-week, M-PAC-informed peer-led PA intervention in a within-subjects mixed methods study. The intervention met a priori feasibility and acceptability success criteria for both participants (N=15) and peer mentors (N=12), and increased PA participation by 104 minutes/week from pre- to post-intervention. This dissertation provides insights into the design and delivery of peer-led PA interventions aimed at sustained behaviour change. The peer-led intervention shows promise in changing PA behaviour of people LWBC, however, intervention efficacy should be replicated in larger, efficacy trials.

This study aimed to identify distinct profiles of quality of life (QoL) and lifestyle behaviors among cancer survivors and explore their associations with clinical and demographic factors. A cross-sectional survey was conducted globally from July to November 2020 among cancer survivors aged 18 and older. Sedentary behavior and sleep were assessed using a modified Domain-Specific Sitting Time Questionnaire, physical activity with the Godin Leisure-Time Exercise Questionnaire, and QoL via the Functional Assessment of Cancer Therapy scale. Latent profile analysis identified subgroups based on lifestyle behaviors, and multinomial logistic regression examined clinical and demographic associations. Among 477 cancer survivors (Mage = 48.5 ± 15.4 years), predominantly female (69.6%) and diagnosed with breast cancer (29.3%), three latent profiles were identified: Class 1 (\"Limited 24-Hour Movement with Low Well-being\"), Class 2 (\"Partial 24-Hour Movement with Moderate Well-being\"), and Class 3 (\"Complete 24-Hour Movement with High Well-being\"). Class 3 had the highest physical activity, lowest sedentary time, and best QoL, associated with older age, lower body mass index, fewer comorbidities, and less chemotherapy or hormone therapy. Identifying latent profiles of QoL and lifestyle behaviors highlights opportunities for tailored interventions in cancer survivorship care. Survivors in low well-being profiles may benefit from targeted interventions to reduce sedentary behavior, increase physical activity, and address fatigue and comorbidities. Those in high well-being profiles may need support to sustain healthy habits and manage emotional well-being.

Background: The purpose of this study was to test Multi-Process Action Control (M-PAC) processes as correlates of physical activity (PA) intention formation and translation (i.e., action control) in individuals diagnosed with cancer. Methods: This study was a cross-sectional survey, completed from July to November of 2020 during the COVID-19 pandemic. PA and M-PAC processes were self-reported using the Godin Leisure-Time Exercise Questionnaire and questionnaires for reflective (instrumental/affective attitudes, perceived opportunity/capability), regulatory (e.g., goal-setting, planning), and reflexive processes (habit, identity). Separate hierarchical multinomial logistic regression models determined correlates of intention formation and action control. Results: Participants (n = 347; Mage= 48.2 ± 15.6) were primarily diagnosed with breast cancer (27.4%) and at a localized stage (85.0%). Most participants intended to perform PA (70.9%), yet only 50.4% met guidelines. Affective judgements (p < 0.001) and perceived capability (p < 0.01) were significantly associated with intention formation. Preliminary models indicated employment, affective judgements, perceived capability, and self-regulation to be significant (ps < 0.05) correlates of action control, but in the final model, only surgical treatment (p = 0.02) and PA identity (p < 0.001) were significantly associated with action control. Conclusion: Reflective processes were associated with PA intention formation, while reflexive processes were associated with PA action control. Behavior change efforts for individuals diagnosed with cancer should extend beyond social-cognitive approaches to include regulatory and reflexive processes of PA behavior (i.e., PA identity).

High-intensity interval exercise (HIIE) is associated with positive health outcomes for female cancer survivors. However, little is known regarding how female cancer survivors feel while performing this exercise. The purpose of this study was to compare in-task and post-task affective response to a single bout of HIIE and moderate-intensity continuous exercise (MICE) in female cancer survivors. Participants (N=10) attended three laboratory sessions: baseline assessments, HIIE and MICE. Affective valence and arousal were measured before, during and after exercise. Results indicated negligible differences in in-task affective valence (dz=-0.02), but a large effect between conditions for affective arousal (dz=-0.92). Post-task affective response displayed a small effect for all domains (dz=-0.23, dz=-0.17, dz=-0.32) except Calmness, which exhibited a small effect (dz=0.38) of the difference between HIIE and MICE conditions. Preliminary results suggest HIIE and MICE result in similar psychological responses and may be equally likely to be performed by female cancer survivors.

Purpose 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. Methods 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. Results 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). Conclusion 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.