Health beliefs and engagement in moderate-to-vigorous-intensity physical activity among cancer survivors: a cross-sectional study.

PURPOSE: Moderate-to-vigorous-intensity physical activity (PA) can alleviate many adverse side effects and symptoms caused by cancer treatments; yet, most cancer survivors are insufficiently active. Evidence shows that theory-based PA behavior change interventions are more effective than non-theory-based interventions; thus, it is necessary to ascertain modifiable theoretical factors associated with moderate-to-vigorous-intensity PA among cancer survivors. Drawing on the health belief model (HBM), the associations between moderate-to-vigorous-intensity PA and (1) perceived susceptibility to cancer recurrence and health problems, (2) perceived severity of cancer recurrence and health problems, (3) perceived benefits of PA for reducing risk of cancer recurrence and health problems, (4) perceived barriers to PA, and (5) PA barrier self-efficacy among cancer survivors were examined. METHODS: A total of 123 adult cancer survivors (Mage = 50.1 ± 15.5 years; 82.9% female) completed an online self-report survey assessing sociodemographic and medical characteristics, moderate-to-vigorous-intensity PA, and the HBM constructs. Data were analyzed descriptively and using hierarchical linear regression analysis. RESULTS: After adjusting for age, sex, body mass index, time since cancer diagnosis, and treatments received, the HBM constructs collectively explained 29% of the variance in moderate-to-vigorous-intensity PA. Perceived benefits of PA (ß = .20, 95% CI [1.81, 11.67], p = .007) and PA barrier self-efficacy (ß = .42, 95% CI [0.26, 0.53], p < .001) were significantly associated with moderate-to-vigorous-intensity PA. CONCLUSION: Raising awareness of the benefits of PA for reducing risk of cancer recurrence and health problems and strengthening self-efficacy to overcome PA barriers may help to promote cancer survivors' attainment of moderate-to-vigorous-intensity PA guidelines.

Newly diagnosed lung cancer patients' preferences for and beliefs about physical activity prior to chemotherapy.

Physical activity has been found to have a number of benefits for lung cancer patients yet very little information is available concerning physical activity beliefs and preferences for this population. The purpose of the study was to explore physical activity programming and counseling preferences and beliefs about physical activity in newly diagnosed lung cancer patients scheduled to receive chemotherapy. A total of 43 new diagnosed lung cancer patients completed a researcher-administered survey prior to commencing chemotherapy. Results indicated that only 7 participants (17%) reported meeting public health recommendations for physical activity yet the majority of participants (n = 28) indicated interest or possible interest in physical activity counseling. Many participants also indicated interest or possible interest in an exercise program (n = 29) for lung cancer survivors, preferring it to start during chemotherapy (n = 20), for it to be home based (n = 21), and moderate in intensity (n = 22). The most common behavioral belief (advantage) of physical activity was to build/maintain strength (n = 26) and the most common control belief (barrier) was fatigue (n = 11). These data suggest that physical activity counseling and programming may be well received by newly diagnosed lung cancer patients. Information about physical activity and programming preferences and beliefs from this study may be useful for the design of optimal physical activity interventions for lung cancer patients.

The Effectiveness of an Online Learning Strategy on Changing Physical Activity Counseling Practice in Nurses.

BACKGROUND: Nurses may be well poised for providing physical activity guidance and support to patients. PURPOSE: The purposes of this study were to examine the effectiveness of a concise, evidence based online learning modules strategy (OLMS) for improving nurses' physical activity counselling. METHODS: 68 nurses were randomly assigned to either an OLMS group or control group. The OLMS group completed a series of six online learning modules aimed at improving physical activity counselling practice. RESULTS: The OLMS group, compared to the control group, showed a trend for improvement in Physical Activity Counselling Practice (p = .063) after controlling for baseline values, and significant improvement in (a) Self-efficacy for Physical Activity Counselling (p = .001), (b) Knowledge of Physical Activity Guidelines, (p = .031), and (c) Perceived Benefits of Physical Activity Counselling (p = .014) over the course of the intervention. No significant change was found for Barriers for Providing Physical Activity Counselling (p > .05). CONCLUSIONS: The OLMS tested may be an effective means for improving self-efficacy, knowledge, and perceived benefits of physical activity counselling, suggesting the utility of online learning strategies for improving nurses' physical activity counselling practice. Given barriers to providing physical activity counselling were not affected by the intervention, future interventions and policy change could target these barriers specifically in order to give nurses more tools and time for reaching patients and addressing physical activity counselling in practice.

A randomized controlled trial of continuous activity, short bouts, and a 10,000 step guideline in inactive adults.

OBJECTIVE: Although several studies have examined the effect of accumulated bouts on health outcomes, the impact of recommending short bouts on activity-related behavior in health promotion efforts has received minimal investigation. METHOD: During this 5-week study in 2007-2008, 43 university employees (8 male, 35 female) in the Southeastern United States were randomly assigned to a group recommended to achieve (a) 10,000 steps (10K), (b) 30-minutes (30 min) of continuous physical activity, or (c) 30-minutes of activity in bouts of at least 10 minutes (bouts). RESULTS AND CONCLUSIONS: Repeated measures ANOVA revealed that the 10K group showed the largest increase in step counts whereas the bouts group showed the smallest change over the intervention period, p=0.01. Condition differences were most pronounced on days in which participants met their activity recommendation. Accelerometer results revealed that the 10K (d=1.1) and 30 min groups (d=0.89) showed large increases in minutes of moderate to vigorous activity (MVPA), whereas the bouts group showed minimal change (d=0.11). Although activity recommendations did not differentially affect self-efficacy, participants from all conditions showed decreased self-efficacy across the intervention (p=0.02), highlighting the need to develop strategies to increase self-efficacy in activity promotion efforts.

The Alberta Physical Activity and Breast Cancer Prevention Trial: quality of life outcomes.

OBJECTIVE: Interventions for disease prevention should also be evaluated for quality of life (QoL) effects. Few exercise trials have examined QoL in the context of primary disease prevention. Here, we report the QoL outcomes from the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial. METHODS: The ALPHA trial was a randomized controlled trial in Calgary and Edmonton, Canada between May 2003 and July 2007 that compared an exercise intervention to a sedentary lifestyle among 320 sedentary, postmenopausal women. The exercise group was asked to perform moderate-to-vigorous intensity aerobic exercise 45 min/day, 5 days/week for 1 year. QoL was assessed by the short form-36 health survey. RESULTS: Compared to the control group, the exercise group maintained significantly better physical functioning (p<0.001), general health (p<0.001), vitality (p=0.002), and bodily pain (p=0.020) by 4-5 points which exceeds the 3.0 minimally important difference for these scales. Changes in body composition partially mediated the intervention effects. Antidepressant use and the presence of comorbidities moderated some intervention effects. CONCLUSIONS: A 1-year moderate-to-vigorous aerobic exercise program prevents declines in the physical aspects of QoL in postmenopausal women. Exercise may have a potentially important advantage for breast cancer prevention compared to other lifestyle or biomedical interventions.

Promotion of physical activity among oncologists in the United States.

Promotion of physical activity by health care providers has been found to positively influence the levels of physical activity in patients. The primary purpose of this study was to examine physical activity promotion practices of oncologists in the United States. Secondary purposes were to examine oncologists' perceptions of the benefits of physical activity for cancer survivors and barriers for promotion of physical activity. Of 702 medical and radiation oncologists in the United States invited to participate in the mailed survey, 199 oncologists responded to the survey (response rate, 30%). Approximately 64% of oncologists inquired about their patients' physical activity on some or most visits. Logistic regression indicated that oncologists who had been practicing > or =10 years (OR [odds ratio] = 2.52), were themselves physically active (OR = 1.99), or were medical oncologists (OR = 2.25) were the most likely to recommend physical activity to their patients. "Reducing the risk of recurrence" was rated lowest of all the potential benefits of physical activity for cancer patients. "Insufficient time" was rated the highest as a barrier to promotion of physical activity. Some oncologists are still not discussing physical activity with their patients. A number of barriers and perceptions of the benefits of physical activity may influence such discussions.

Family history of cancer as a cue to action for physical activity behaviour and beliefs.

Objective: Examine if family history of cancer serves as a cue to action prompting adults to assess their personal risk of cancer, consider the consequences, and engage in physical activity (PA) if they believe it will reduce their risk.Design: Cross-sectional survey of adults with and without a close relative with cancer.Main Outcome Measures: Health Belief Model (HBM) constructs of perceived cancer vulnerability, perceived cancer severity, response effectiveness of PA, self-efficacy for PA, and barriers to PA, and moderate-to-vigorous intensity PA (MVPA).Results: Perceived barriers and self-efficacy correlated with MVPA in both groups (p < .05), and perceived vulnerability and response effectiveness correlated with MVPA in participants with a close relative with cancer (p < .05). In multiple regression analyses, HBM constructs accounted for 18.5% and 8.3% of the variability in MVPA among participants with and without a close relative with cancer, respectively. Participants with a close relative with cancer had greater perceived vulnerability to cancer compared to participants without a close relative with cancer (p < .001).Conclusion: Adults with and without a close relative with cancer may be differentially influenced by HBM constructs, and as a result may respond differently to PA interventions and public health messaging.

Associations between exercise and quality of life in bladder cancer survivors: a population-based study.

BACKGROUND: Exercise has been shown to improve quality of life (QoL) in some cancer survivor groups, but it is unknown if the unique QoL issues faced by bladder cancer survivors are also amenable to an exercise intervention. This study provides the first data examining the association between exercise and QoL in bladder cancer survivors. METHODS: Bladder cancer survivors identified through a provincial cancer registry were mailed a survey that included the Godin Leisure Time Exercise Questionnaire, the Functional Assessment of Cancer Therapy-Bladder (FACT-Bl) scale, and the Fatigue Symptom Inventory. RESULTS: Of the 525 bladder cancer survivors (51% response rate) that completed the survey, 22.3% were meeting public health exercise guidelines in the past month, 16.0% were insufficiently active (i.e., some exercise but less than the guidelines), and 61.7% were completely sedentary. ANOVA indicated a general linear association between meeting guidelines and QoL, with those meeting guidelines reporting more favorable scores than completely sedentary survivors on the FACT-Bl (mean difference, 7.6; 95% confidence interval, 3.6-11.7; P < 0.001), the FACT (P = 0.001), the trial outcome index (P < 0.001), functional well-being (P < 0.001), additional concerns (P = 0.001), sexual functioning (P < 0.001), erectile function (P < 0.001), body image (P < 0.001), and various fatigue indicators (P < 0.05). Adjusting for key medical and demographic factors slightly attenuated the magnitude of the associations but did not alter the substantive conclusions. CONCLUSIONS: Exercise is positively associated with QoL in bladder cancer survivors, although few are meeting public health exercise guidelines. Studies testing the causal effects of exercise on QoL issues unique to this population are warranted.

Correlates of exercise motivation and behavior in a population-based sample of endometrial cancer survivors: an application of the Theory of Planned Behavior.

BACKGROUND: Despite evidence of the benefits of exercise in cancer survivors, exercise participation rates tend to decline after treatments. Few studies have examined the determinants of exercise in less common cancer sites. In this study, we examined medical, demographic, and social cognitive correlates of exercise in endometrial cancer survivors using the Theory of Planned Behavior (TPB). METHODS: A mailed survey was completed by 354 endometrial cancer survivors (1 to 10 years postdiagnosis) residing in Alberta, Canada. The study was cross-sectional. Exercise behavior was assessed using the Godin Leisure Time Exercise Questionnaire and the TPB constructs were assessed with standard self-report scales. Multiple regression analyses were used to determine the independent associations of the TPB constructs with intention and behavior. RESULTS: Chi-square analyses indicated that marital status (p = .003), income level (p = .013), and body mass index (BMI) (p = .020) were associated with exercise. The TPB explained 34.1% of the variance in exercise behavior with intention (beta = .38, p < .001) and self-efficacy (beta = .18, p = .029) being independent correlates. For intention, 38.3% of the variance was explained by the TPB with self-efficacy (beta = .34, p < .001) and affective attitude (beta = .30, p < .001) being the independent correlates. The TPB mediated the associations of marital status and BMI with exercise but not income level. Age and BMI moderated the associations of the TPB with intention and behavior. CONCLUSION: The TPB may be a useful framework for understanding exercise in endometrial cancer survivors. Exercise behavior change interventions based on the TPB should be tested in this growing population.

Evaluation of Online Learning Modules for Improving Physical Activity Counseling Skills, Practices, and Knowledge of Oncology Nurses.

PURPOSE/OBJECTIVES: To examine the effectiveness of online learning modules for improving physical activity counseling practices among oncology nurses. 
. DESIGN: Randomized, controlled trial.
. SETTING: Online.
. SAMPLE: 54 oncology nurses.
. METHODS: Oncology nurses were randomly assigned to the learning modules group or control group. The learning modules group completed six online learning modules and quizzes focused on physical activity for cancer survivors, general physical activity principles, and motivational interviewing.
. MAIN RESEARCH VARIABLES: Percentage of cancer survivors counseled, self-efficacy for physical activity counseling, knowledge of physical activity, and perceived barriers and benefits of physical activity counseling.
. FINDINGS: Analyses of covariance revealed no significant difference between the learning modules and control groups in the percentage of cancer survivors that oncology nurses counseled. Significant differences were found in self-efficacy for physical activity counseling and perceived barriers to physical activity counseling at postintervention. 
. CONCLUSIONS: The online learning intervention tested in this study improved some parameters of physical activity counseling but did not increase the percentage of cancer survivors that oncology nurses counseled. Additional pilot work is needed to refine the intervention.
. IMPLICATIONS FOR NURSING: This study suggests the potential utility of an evidence-based online learning strategy for oncology nurses that includes information on physical activity and its benefits in cancer survivorship. The findings offer a framework on how to implement physical activity counseling skills in oncology nursing practice.

Exercise preferences of endometrial cancer survivors: a population-based study.

Exercise has gained recognition as an effective supportive care intervention for cancer survivors, yet participation rates are low. Knowledge of the specific exercise counseling and programming preferences of cancer survivors may be useful for designing effective interventions. In this study, we examined the exercise preferences of 386 endometrial cancer survivors. Participants completed a questionnaire that included measures of past exercise behavior, exercise preferences, and medical and demographic information. Some key findings were as follows: (a) 76.9% of participants said they were interested or might be interested in doing an exercise program and (b) 81.7% felt they were able or likely able to actually do an exercise program. Participants also indicated that walking was their preferred activity (68.6%) and moderate exercise was their preferred intensity (61.1%). Logistic regression analyses showed that meeting public health guidelines for exercise, being overweight or obese, receiving adjuvant treatment, months since diagnosis, income, marital status, and level of education all influenced exercise preferences. These results suggest that endometrial cancer survivors have unique exercise preferences that are moderated by a number of demographic and medical variables. These findings may have implications for the design and implementation of clinical and population-based exercise interventions for endometrial cancer survivors.

Lifestyle Counseling Practices of Oncology Nurses in the United States and Canada.

BACKGROUND: Oncology nurses are well poised to provide lifestyle behavior counseling to cancer survivors. However, very little is known about the current lifestyle behavior counseling practices of oncology nurses. OBJECTIVES: The primary purpose of this study was to examine lifestyle behavior counseling practices of oncology nurses. The secondary purpose was to examine differences in lifestyle behavior counseling based on nurses' health behaviors, additional training received, and country of residence. METHODS: Oncology nurses (N = 314) were primarily recruited through emails from oncology nursing email lists. Participants completed an online survey. FINDINGS: Overall, oncology nurses reported providing lifestyle counseling to most cancer survivors when appropriate. The majority of oncology nurses said they were receptive to receiving additional training about lifestyle counseling. Participants who had received additional training and who lived in the United States were more likely to provide counseling to cancer survivors. Concerning their own health behaviors, no meaningful differences were found regarding lifestyle behavior counseling practices, which contrasts with findings from previous research. Strengthening oncology nurses' lifestyle behavior counseling knowledge and skills may offer opportunities to enhance survivors' optimal health and quality of life and to reduce their risk of recurrence.

Exercise issues in older cancer survivors.

Older cancer survivors experience the combined deleterious effects associated with aging and a cancer diagnosis. The purpose of the present paper is to review the potential role of physical exercise in attenuating the effects of cancer and its treatments in older cancer survivors. Noting the limited direct research on exercise in older cancer survivors, we review the literature on: (a) older adults in general; and (b) cancer survivors in general. We conclude that although there is limited direct evidence on the benefits of exercise in older cancer survivors, there is compelling evidence of the benefits of exercise in cancer survivors in general and other older populations. We also conclude that exercise adherence will be a significant challenge in this population. Based on this evidence, we tentatively recommend exercise to older cancer survivors using the American College of Sports Medicine's [Med Sci Sports Exerc 30 (6) (1998) 992] guidelines for older adults in general. Finally, we offer future research directions that will provide important evidence needed to guide clinical decisions about exercise in older cancer survivors.

Does the perception that God controls health outcomes matter for health behaviors?

The purpose of this study was to examine the associations between God Locus of Health Control, health behaviors, and beliefs utilizing a cross-sectional online survey (N = 549). Results indicated that God Locus of Health Control was correlated with alcohol use, physical activity, perceived risk of chronic disease, and beliefs that poor health behaviors contribute to chronic disease (all p values < .05). Multiple regression analyses including covariates and other locus of control variables revealed that God Locus of Health Control was only an independent correlate of the belief that physical inactivity contributed to chronic disease. Insights from this study may be important for future faith-based health behavior change interventions.

Effect of an exercise training intervention with resistance bands on blood cell counts during chemotherapy for lung cancer: a pilot randomized controlled trial.

PURPOSE: Chemotherapy for lung cancer can have a detrimental effect on white blood cell (WBC) and red blood cell (RBC) counts. Physical exercise may have a role in improving WBCs and RBCs, although few studies have examined cancer patients receiving adjuvant therapies. The purpose of this pilot trial was to examine the effects of an exercise intervention utilizing resistance bands on WBCs and RBCs in lung cancer patients receiving curative intent chemotherapy. METHODS: A sample of lung cancer patients scheduled for curative intent chemotherapy was randomly assigned to the exercise intervention (EX) condition or usual care (UC) condition. The EX condition participated in a three times weekly exercise program using resistance bands for the duration of chemotherapy. RESULTS: A total of 14 lung cancer patients completed the trial. EX condition participants completed 79% of planned exercise sessions. The EX condition was able to maintain WBCs over the course of the intervention compared to declines in the UC condition (p = .008; d = 1.68). There were no significant differences in change scores in RBCs. CONCLUSIONS: Exercise with resistance bands may help attenuate declines in WBCs in lung cancer patients receiving curative intent chemotherapy. Larger trials are warranted to validate these findings. Ultimately these findings could be informative for the development of supportive care strategies for lung cancer patients receiving chemotherapy. TRIAL REGISTRATION: Clinical Trials Registration #: NCT01130714.

Resources for physical activity in cancer centers in the United States.

Physical activity (PA) has many benefits for cancer survivors. However, the available PA resources for survivors at cancer centers throughout the United States are undocumented. The current study surveyed major cancer centers concerning the availability and types (e.g., facilities, programs, counseling, information resources) of PA resources available. Of supportive care services, PA resources were the least commonly reported. Significant correlations were found among availability of PA resources and other supportive care services. Although many cancer centers reported offering PA programming, formal and informal PA guidance and support seem to fall on oncology nurses and other clinicians. Oncology nurses should be reminded that they may be one of the only sources of PA guidance available to survivors at cancer centers.

Stress reactivity, health behaviors, and compliance to medical care in breast cancer survivors.

PURPOSE/OBJECTIVES: To explore relationships among quality of life (QOL), stress reactivity, health behaviors, and compliance to medical care in breast cancer survivors. DESIGN: One-time descriptive laboratory study. SETTING: A visual motor laboratory at a rural university in the southeastern United States. SAMPLE: 25 breast cancer survivors. METHODS: Participants were subjected to the Trier Social Stress Test (TSST) in a laboratory setting and completed questionnaires at home prior to and after the laboratory session. main research variables: Changes in heart rate variability (HRV), salivary cortisol, and state anxiety from the State-Trait Anxiety Inventory (STAI) estimated stress reactivity. Health behaviors, QOL, and trait anxiety were determined by questionnaires. Compliance to medical care was determined from medical records. FINDINGS: Analyses of variance (ANOVAs) indicated that QOL scores were higher for participants with lower compared to higher stress reactivity (p < 0.05). In addition, ANOVAs revealed that participants high in compliance to medical care indicated a lower stress response as determined by HRV (p < 0.01) and the STAI (p < 0.05) compared to those low in compliance. No significant differences were noted in any of the health behaviors based on stress reactivity. CONCLUSIONS: The data suggest that breast cancer survivors who indicate the greatest stress reactivity tend to have the poorest compliance to medical care and lowest QOL. IMPLICATIONS FOR NURSING: Nurses may wish to provide additional support to breast cancer survivors who indicate high stress reactivity in the hopes of improving compliance to medical care and QOL. KNOWLEDGE TRANSLATION: The data suggest that supportive care strategies that reduce stress could potentially improve compliance to medical care in breast cancer survivors. In addition, strategies for managing stress may result in improvements in QOL. Health behaviors, according to the data, do not seem to be influenced by stress reactivity.

Physical activity promotion among oncology nurses.

BACKGROUND: Oncology nurses may be influential for providing physical activity guidance to cancer patients. OBJECTIVE: The purposes of this study were to examine physical activity promotion practices of oncology nurses and to explore nurses' perceived benefits of physical activity for cancer patients and barriers to physical activity promotion. METHODS: Two thousand e-mails were sent by a data service company to a random selection of oncology nurses throughout the United States with a link to a Web-based survey. To be eligible, nurses had to be currently seeing patients. RESULTS: Completed surveys were received from 274 oncology nurses. Most participants inquired about physical activity on at least some office visits (74.9%) and gave physical activity recommendations to 65.7% and 66.9% of on-treatment and posttreatment patients. "Lack of time" and that "patients are not interested" were the most prominent barriers identified by nurses, whereas perceived benefits for patients were rated favorably, with the exception of "reducing risk of recurrence." Almost all perceived benefits and barriers were correlated with physical activity promotion, with the strongest correlates being "unsure what to recommend" and "unsure that physical activity is safe." CONCLUSIONS: Although most oncology nurses frequently inquire about patient physical activity, they may be less apt to provide recommendations. A number of barriers and perceived benefits may influence physical activity promotion, especially concerning what to recommend and patient safety. IMPLICATIONS FOR PRACTICE: Oncology nurses would benefit from education opportunities about the benefits of physical activity for survival outcomes and types of physical activity to recommend.

Predictors of adherence to supervised and unsupervised exercise in the Alberta Physical Activity and Breast Cancer Prevention Trial.

BACKGROUND: Few studies have examined the predictors of adherence separately for supervised and unsupervised exercise or in postmenopausal women over an extended time period. Here, we report the predictors of exercise adherence in the Alberta Physical Activity and Breast Cancer Prevention (ALPHA) Trial. METHODS: The ALPHA trial randomized 160 postmenopausal women in Calgary and Edmonton, Canada to an exercise intervention that consisted of an average of 200 min/wk of supervised (123 minutes) and unsupervised (77 minutes) exercise over a 1-year period. Baseline data were collected on demographic, health-related fitness, quality of life, and motivational variables from the theory of planned behavior. RESULTS: Participants completed an average of 95% of their supervised exercise and 79% of their unsupervised exercise. In multivariate analyses, 8.1% (P=.001) of the variance was explained for supervised exercise by being from Edmonton (ß=0.22; P=.004) and older (ß=0.15; P=.050). For unsupervised exercise, 21.1% (P<.001) of the variance was explained by being from Calgary (ß=-0.39; P<.001), having a family history of breast cancer (ß=0.21; P=.003), and having higher vitality (ß=0.19; P=.011). CONCLUSIONS: Predictors of adherence may differ for supervised and unsupervised exercise, moreover, predicting adherence to supervised exercise may be particularly difficult in well-controlled efficacy trials.

Exercise programming and counseling preferences of breast cancer survivors during or after radiation therapy.

PURPOSE/OBJECTIVES: To explore exercise programming and counseling preferences and exercise-related beliefs in breast cancer survivors during and after radiation therapy, and to compare differences based on treatment and insurance status. DESIGN: Cross-sectional survey. SETTING: Ambulatory cancer center in a rural community in eastern North Carolina. SAMPLE: 91 breast cancer survivors during or after radiation therapy. METHODS: The researchers administered the questionnaire to participants. MAIN RESEARCH VARIABLES: Exercise programming and counseling preferences and exercise beliefs moderated by treatment status (on-treatment, early, and late survivors) and insurance status (Medicaid, non-Medicaid). FINDINGS: Chi-square analyses indicated that fewer Medicaid users were physically active and reported health benefits as an advantage of exercise compared to non-Medicaid users (p < 0.05). In addition, more Medicaid users preferred exercise programming at their cancer center compared to non-Medicaid users (p < 0.05). More on-treatment and early survivors listed health benefits as advantages to exercise, but fewer indicated weight control as an advantage compared to late survivors (p < 0.05). Early survivors were more likely than on-treatment survivors to indicate that accessible facilities would make exercising easier for them (p < 0.05). CONCLUSIONS: Medicaid users are less active, less likely to identify health benefits as an advantage for exercising, and more likely to prefer cancer center-based exercise programming compared to non-Medicaid users. In addition, on-treatment and early survivors are more likely to list health benefits and less likely to indicate weight control as advantages of exercising compared to late survivors. IMPLICATIONS FOR NURSING: The low activity levels of Medicaid users may be best targeted by providing cancer center-based exercise programming. Exercise interventions may be most effective if tailored to the unique needs of treatment status.