Medical, demographic and social cognitive correlates of physical activity in a population-based sample of colorectal cancer survivors.

Physical activity (PA) improves quality of life in colorectal cancer survivors (CRC) and may reduce the risk of disease recurrence and early death. Few studies, however, have examined the correlates of PA in CRC survivors. Using the Alberta Cancer Registry, 2000 randomly selected CRC survivors were mailed a self-reported questionnaire assessing medical, demographic, behavioural and social cognitive variables from the theory of planned behaviour (TPB). Of the 600 survivors who responded, 33% were meeting public health PA guidelines and almost half were completely sedentary. Higher PA was reported by survivors who were younger, unmarried, better educated, wealthier, employed, non-smokers, social drinkers, not treated with radiation therapy, disease-free, in better health and less comorbidity. In multivariate path analysis, these variables were not directly associated with PA after controlling for the TPB variables. The TPB explained 34% (P < 0.001) of the variance in PA behaviour with direct associations for intention (ß= 0.22; P= 0.015) and planning (ß= 0.18; P= 0.001). Intention, in turn, had 62% (P < 0.001) of its variance explained by perceived behavioural control (ß= 0.43; P < 0.001), affective attitude (ß= 0.25; P < 0.001) and instrumental attitude (ß= 0.15; P < 0.001). The TPB may be a useful framework for developing population-based interventions to increase PA in CRC survivors.

Social ecological correlates of physical activity in normal weight, overweight, and obese individuals.

OBJECTIVE: Research is limited concerning the moderating influence of weight status (ie normal, over, and obese) on the social ecological correlates of physical activity (PA) in adults. Therefore, the present study attempted to shed light on this issue. DESIGN: In 2001, a national cross-sectional mail out panel survey was conducted over a 3-month period in the United States. SUBJECTS: There were 1867 normal weight (ie body mass index (BMI)=20-24.99 kg/m2), 2145 overweight (ie BMI=25-29.99 kg/m2), and 1902 obese (ie BMI>30 kg/m2) adults. MEASURES: Various demographic measurements were taken in addition to social support (SS), self-efficacy (SE), access to facilities, and PA. RESULTS: Normal weight individuals engaged in significantly more PA than overweight individuals, who in turn engaged in significantly more PA than obese individuals F(2,5991)=55.51, P<0.01. Further regression analyses showed that higher SE, SS, the access to facilities in a neighborhood, and various interactions among these constructs were significantly and positively associated with PA. Interestingly, the strength of these relationships varied depending on weight status. CONCLUSION: Weight status needs to be taken into consideration when examining social ecological correlates of PA.

The stability of utility scores: test-retest reliability and the interpretation of utility scores in elective total hip arthroplasty.

PURPOSES: Are utility scores for hypothetical health states stable over time even when the health of the patient changes dramatically? Can investigators who use scores for hypothetical states be confident about the stability of those scores? The first purpose is to assess the stability of standard gamble utility scores for three hypothetical health states describing mild, moderate, and severe osteoarthritis (OA) (test-retest reliability). How should investigators interpret utility scores? The second purpose is to provide evidence on the marker-state approach to assist in interpreting utility scores. BACKGROUND: SG scores for three hypothetical marker states and the patient's current state were obtained at multiple times in a longitudinal study of elective total hip arthroplasty (THA). SG scores for current health increased from a mean of 0.59 pre-surgery to 0.76 post-surgery. METHODS: Test-retest reliability was assessed using the intra-class correlation coefficient (ICC). The effects of time on scores were analysed using an analysis of covariance. RESULTS: At the group level the marker-state scores were stable. Mean scores for mild, moderate, and severe OA were 0.69, 0.61, and 0.41. With respect to test-retest reliability, ICCs varied from 0.49 to 0.62. In general, time did not affect the scores for the three marker states. CONCLUSIONS: Group-level standard gamble scores are stable. At the individual level scores for hypothetical health states are somewhat stable over time. The marker states assist in interpretation indicating that, on average, THA converted moderate OA to better than mild.

Exercise adherence in breast cancer survivors training for a dragon boat race competition: a preliminary investigation.

Recent research has applied the theory of planned behavior (TPB) to understanding exercise after a cancer diagnosis, but studies are few and have been limited by retrospective designs, self-report measures of exercise and varied results. In the present study, we extended this research by using a prospective design and an objective measure of exercise adherence. Participants were a convenience sample of 24 breast cancer survivors attending a twice weekly, 12-week training program in preparation for a dragon boat race competition. Participants completed a baseline questionnaire that assessed demographic and medical variables, past exercise, and the TPB (i.e. beliefs, subjective norm, attitude, perceived behavioral control and intention). Program attendance was monitored over a 12-week period by the class instructor. Overall, participants attended 66% of the training sessions. Multiple regression analyses indicated that: (a) intention was the sole determinant of program attendance and explained 35% of the variance; (b) the TPB constructs explained 49% of the variance in intention with subjective norm being the most important determinant; and (c) the key underlying beliefs were support from physician, spouse, and friends, and confidence in being able to attend the training class when having limited time, no one to exercise with, fatigue, and other health problems. Based on this preliminary study, it was concluded that the TPB may provide a good framework on which to base interventions designed to promote exercise in breast cancer survivors.

Prediction of obligatory exercise by exercise-related imagery.

Obligatory exercise is a compulsive behavior pattern in which exercise dominates daily life at the expense of other activities and lack of exercise produces withdrawal symptoms. This study examined the hypothesis that obligatory exercise is motivated similarly to eating disorders (cf. S. P. Coen & B. M. Ogles, 1993) and would be predicted by appearance-related imagery. Obligatory exercise (J. K. Thompson & L. Pasman, 1991) and exercise imagery (H. A. Hausenblas, C. R. Hall, W. M. Rodgers, & K. J. Munroe, 1999) were assessed before and after a 10-week exercise program in 243 adult exercisers. Regression analyses revealed that imagery accounted for 20% of the variance in obligatory exercise. Appearance-related imagery did not predict significantly obligatory exercise. Energy-related imagery was the strongest predictor. Obligatory exercise may not be as associated with appearance-related concerns as eating disorders, suggesting different motivational bases for these 2 behavioral patterns.

Feeling state responses to acute exercise of high and low intensity.

The purpose of the present study was to examine the effects of exercise intensity on feeling states following two acute bouts of exercise (i.e., 50% and 80% of age-predicted maximal heart rate reserve: HRR) in highly fit and unfit females. It was hypothesized that highly fit females would have increased positive well-being and/or reduced psychological distress post-exercise (high intensity) compared to unfit females while both groups would experience similar feeling states following moderate intensity exercise. Twelve highly fit and 12 unfit females completed 3 conditions: attention control and fitness test, and two acute bouts of exercise (30 minutes on a bicycle ergometer) at 50% and 80% age-predicted HRR. Pre- and post-exercise feeling states were measured via the Subjective Experiences Exercise Scale (McAuley & Courneya, 1994). Analyses indicated a time x condition x fitness interaction F(2,21)=6.07, p<.01 (eta2 =.37) for psychological distress. Follow-up univariate analyses revealed no change in the 50% or control conditions, however, psychological distress significantly increased for the unfit participants F(1,11)=4.68,p<.05 (eta2 =.29) while there was no change for the highly fit participants F(1,11)=2.14,p>.05 (eta2 =.16) in the 80% intensity condition. No fitness differences emerged with respect to positive well-being or fatigue. Therefore, the present study's results substantiate the need to consider fitness level in dose-response studies, particularly ones which examine negative feeling states.

Effects of acute exercise on state anxiety in breast cancer survivors.

PURPOSE/OBJECTIVES: To examine the effects of an acute bout of exercise on state anxiety in breast cancer survivors. DESIGN: A two-group (high and low state anxiety) by two-time (pre- and postexercise) mixed factorial design. SETTING: Exercise physiology lab at the University of Alberta. SAMPLE: 34 stage I or II breast cancer survivors ranging in age from 39-65 (X = 50.50; SD = 6.62). METHODS: Participants completed the State Anxiety Inventory prior to and five minutes following an acute bout of exercise. MAIN RESEARCH VARIABLES: State anxiety. FINDINGS: A main effect resulted for group (p < 0.01) and time showing that state anxiety significantly decreased from pre- to postexercise (p < 0.03). Group by time interaction showed that state anxiety for the low state anxiety group did not change from pre- to postexercise (p > 0.05); however, state anxiety significantly decreased in the high state anxiety group (p < 0.03). CONCLUSION: Acute exercise may be an effective intervention in reducing state anxiety in breast cancer survivors, especially those with high state anxiety. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses should be aware that in addition to other traditional anxiolytic therapies (e.g., relaxation therapy) commonly prescribed, acute exercise is an effective method for reducing state anxiety in breast cancer survivors.