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Journal of Cancer Survivorship

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01-12-2016

Understanding strength exercise intentions and behavior in hematologic cancer survivors: an analysis of the intention-behavior gap

Authors: James R. Vallerand, Ryan E. Rhodes, Gordon J. Walker, Kerry S. Courneya

Published in: Journal of Cancer Survivorship | Issue 6/2016

Abstract

Background

Strength exercise improves many health outcomes in cancer survivors but the prevalence and correlates of strength exercise have not been well-described. Moreover, no study has examined the critical intention-behavior gap for exercise in cancer survivors.

Purpose

The aims of this study are to quantify the intention-behavior gap for strength exercise in hematologic cancer survivors (HCS) and examine correlates of both intention formation and translation using the multi-process action control framework (M-PAC).

Methods

A random sample of 2100 HCS in Alberta, Canada, were mailed a survey assessing strength exercise behavior, the M-PAC, and demographic/medical variables. Separate logistic regressions were used to analyze the relationships between the correlates and intention formation and translation.

Results

Surveys were completed by 606 HCS with 58 % (n = 353) intending to do strength exercise. HCS who were not retired (OR = 1.56, p = 0.001), were highly educated (OR = 1.32, p = 0.001), and had a favorable attitude (OR = 1.56, p < 0.001), descriptive norm (OR = 1.38, p = 0.006), injunctive norm (OR = 1.45, p = 0.004), and perceived control (OR = 1.38, p < 0.001), were more likely to form an exercise intention. Of those with an exercise intention, 51 % (n = 181) reported regular strength exercise. HCS with a detailed plan (OR = 1.86, p < 0.001), favorable attitude (OR = 1.68, p = 0.001), sense of obligation (OR = 1.38, p = 0.010), and self-regulated their affinity for competing activities (OR = 1.35, p = 0.012), were more likely to translate their intention into behavior.

Conclusion

Just over half of HCS intended to do strength exercise and only half of intenders translated that intention into behavior.

Implications for Cancer Survivors

Interventions targeting both intention formation and translation may provide the best approach for increasing strength exercise in HCS.

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Strasser B, Steindorf K, Wiskemann J, Ulrich CM. Impact of resistance training in cancer survivors: a meta-analysis. Med Sci Sports Exerc. 2013;45(11):2080–90. doi:10.1249/MSS.0b013e31829a3b63.CrossRefPubMed

De Backer IC, Schep G, Backx FJ, Vreugdenhil G, Kuipers H. Resistance training in cancer survivors: a systematic review. Int J Sports Med. 2009;30(10):703–12. doi:10.1055/s-0029-1225330.CrossRefPubMed

Cramp F, James A, Lambert J. The effects of resistance training on quality of life in cancer: a systematic literature review and meta-analysis. Support Care Cancer. 2010;18(11):1367–76. doi:10.1007/s00520-010-0904-z.CrossRefPubMed

Hardee JP, Porter RR, Sui X, Archer E, Lee IM, Lavie CJ, et al. The effect of resistance exercise on all-cause mortality in cancer survivors. Mayo Clin Proc. 2014;89(8):1108–15. doi:10.1016/j.mayocp.2014.03.018.CrossRefPubMedPubMedCentral

Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, et al. American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. 2010;42(7):1409–26. doi:10.1249/MSS.0b013e3181e0c112.CrossRefPubMed

Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62(4):243–74. doi:10.3322/caac.21142.CrossRefPubMed

Speed-Andrews AE, McGowan EL, Rhodes RE, Blanchard CM, Culos-Reed SN, Friedenreich CM, et al. Correlates of strength exercise in colorectal cancer survivors. Am J Health Behav. 2013;37(2):162–70. doi:10.5993/AJHB.37.2.3.CrossRefPubMed

Short CE, James EL, Vandelanotte C, Courneya KS, Duncan MJ, Rebar A, et al. Correlates of resistance training in post-treatment breast cancer survivors. Support Care Cancer. 2014;22(10):2757–66. doi:10.1007/s00520-014-2273-5.CrossRefPubMed

Forbes CC, Blanchard CM, Mummery WK, Courneya K. Prevalence and correlates of strength exercise among breast, prostate, and colorectal cancer survivors. Oncol Nurs Forum. 2015;42(2):118–27. doi:10.1188/15.onf.42-02ap.CrossRefPubMed

10.

Oerlemans S, Mols F, Nijziel MR, Lybeert M, van de Poll-Franse LV. The impact of treatment, socio-demographic and clinical characteristics on health-related quality of life among Hodgkin’s and non-Hodgkin’s lymphoma survivors: a systematic review. Ann Hematol. 2011;90(9):993–1004. doi:10.1007/s00277-011-1274-4.CrossRefPubMedPubMedCentral

11.

Courneya KS. Physical activity and cancer survivorship: a simple framework for a complex field. Exerc Sport Sci Rev. 2014;42(3):102–9. doi:10.1249/JES.0000000000000011.CrossRefPubMed

12.

Courneya KS, Stevinson C, McNeely ML, Sellar CM, Peddle CJ, Friedenreich CM, et al. Predictors of adherence to supervised exercise in lymphoma patients participating in a randomized controlled trial. Ann Behav Med. 2010;40(1):30–9. doi:10.1007/s12160-010-9205-5.CrossRefPubMed

13.

Courneya KS, Vallance JKH, Jones LW, Reiman T. Correlates of exercise intentions in non-Hodgkin’s lymphoma survivors: an application of the theory of planned behavior. J Sport Exerc Psychol. 2005;27(3):335.CrossRef

14.

Courneya KS, Stevinson C, McNeely ML, Sellar CM, Friedenreich CM, Peddle-McIntyre CJ, et al. Effects of supervised exercise on motivational outcomes and longer-term behavior. Med Sci Sports Exerc. 2012;44(3):542–9. doi:10.1249/MSS.0b013e3182301e06.CrossRefPubMed

15.

Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50:179–211.CrossRef

16.

Sniehotta FF, Presseau J, Araújo-Soares V. Time to retire the theory of planned behaviour. Health Psychol Rev. 2013;8(1):1–7. doi:10.1080/17437199.2013.869710.CrossRef

17.

Rhodes RE, De Bruijn GJ. How big is the physical activity intention–behaviour gap? A meta-analysis using the action control framework. Br J Health Psychol. 2013;18:296–309. doi:10.1111/bjhp.12032.CrossRefPubMed

18.

Rhodes RE, De Bruijn GJ. What predicts intention-behavior discordance? A review of the action control framework. Exerc Sport Sci Rev. 2013;41:201–7. doi:10.1097/JES.0b013e3182a4e6ed.CrossRefPubMed

19.

Strachan SM, Flora PK, Brawley LR, Spink KS. Varying the cause of a challenge to exercise identity behaviour: reactions of individuals of differing identity strength. J Health Psychol. 2011;16(4):572–83. doi:10.1177/1359105310383602.CrossRefPubMed

20.

Wilson PM, Rodgers WM, Carpenter PJ, Hall C, Hardy J, Fraser SN. The relationship between commitment and exercise behavior. Psychol Sport Exerc. 2004;5:405–21. doi:10.1016/S1469-0292(03)00035-9. CrossRef

21.

Rhodes RE, Yao CA. Models accounting for intention-behavior discordance in the physical activity domain: a user’s guide, content overview, and review of current evidence. Int J Behav Nutr Phys Act. 2015;12(1):9. doi:10.1186/s12966-015-0168-6.CrossRefPubMedPubMedCentral

22.

Dillman DA. Mail and internet surveys: the tailored design method. New York: Wiley-Interscience; 2000.

23.

Cleeland CS, Mendoza TR, Wang XS, Chou C, Harle MT, Morrissey M, et al. Assessing symptom distress in cancer patients: the M.D. Anderson Symptom Inventory. Cancer. 2000;89(7):1634–46.CrossRefPubMed

24.

Godin G, Shephard RJ. A simple method to assess exercise behavior in the community. Can J Sport Sci. 1985;10:141–6.

25.

Cormie P, Newton RU, Spry N, Joseph D, Taaffe DR, Galvao DA. Safety and efficacy of resistance exercise in prostate cancer patients with bone metastases. Prostate Cancer Prostatic Dis. 2013;16(4):328–35. doi:10.1038/pcan.2013.22.CrossRefPubMed

26.

Courneya KS, Jones LW, Rhodes RE, Blanchard CM. Effect of response scales on self-reported exercise frequency. Am J Health Behav. 2003;27(6):613–22.CrossRefPubMed

27.

Ajzen I. Constructing a TPB questionnaire: Conceptual and methodological considerations. 2002. http://www-unix.oit.umass.edu/~aizen/pdf/tpb.measurement.pdf. Accessed June 6 2014.

28.

Courneya KS. Predicting repeated behavior from intention: the issue of scale correspondence. J Appl Soc Psychol. 1994;24(7):580–94. doi:10.1111/j.1559-1816.1994.tb00601.x CrossRef

29.

Luszczynska A, Schwarzer R. Planning and self-efficacy in the adoption and maintenance of breast self-examination: a longitudinal study on self-regulatory cognitions. Psychol Health. 2003;18(1):93–108. doi:10.1080/0887044021000019358.CrossRef

30.

McGowan EL, North S, Courneya KS. Randomized controlled trial of a behavior change intervention to increase physical activity and quality of life in prostate cancer survivors. Ann Behav Med. 2013;46(3):382–93. doi:10.1007/s12160-013-9519-1.CrossRefPubMed

31.

Scanlan TK, Carpenter PJ, Schmift GW, Simons JP, Keeler B. An introduction to the sport commitment model. J Sport Exerc Psychol. 1993;15:1–15.CrossRef

32.

Abraham C, Sheeran P. Deciding to exercise: the role of anticipated regret. Br J Health Psychol. 2004;9(2):269–78.CrossRefPubMed

33.

Abraham C, Sheeran P. Acting on intentions: the role of anticipated regret. Br J Soc Psychol. 2003;42(Pt 4):495–511. doi:10.1348/014466603322595248.CrossRefPubMed

34.

Polit DF. Data analysis and statistics for nursing research. Appleton & Lange: Stamford; 1996.

35.

DiStefano C, Zhu M, Mindrila D. Understanding and using factor scores: considerations for the applied researcher. Pract Assess Res Eval. 2009;14(20):1–11.

36.

Cohen J, Cohen P, West SG, Aiken LS. Applied multiple regression/correlation analysis for the behavioral sciences. 3rd ed. Mahwah: Routledge; 2013.

37.

Kim JO, Mueller CW. Factor analysis: statistical methods and practical issues. Quantitative applications in the social sciences. Beverly Hills: Sage; 1978.CrossRef

38.

McEachan RRC, Conner M, Taylor NJ, Lawton RJ. Prospective prediction of health-related behaviours with the Theory of Planned Behaviour: a meta-analysis. Health Psychol Rev. 2011;5(2):97–144. doi:10.1080/17437199.2010.521684.CrossRef

39.

Chen HN, Cohen P, Chen S. How big is a big odds ratio? Interpreting the magnitudes of odds ratios in epidemiological studies. Commun Stat-Simul C. 2010;39(4):860–4. doi:10.1080/03610911003650383.CrossRef

40.

Vallance JK, Courneya KS, Plotnikoff RC, Yasui Y, Mackey JR. Randomized controlled trial of the effects of print materials and step pedometers on physical activity and quality of life in breast cancer survivors. J Clin Oncol. 2007;25(17):2352–9. doi:10.1200/JCO.2006.07.9988.CrossRefPubMed

41.

Seguin R, Nelson ME. The benefits of strength training for older adults. Am J Prev Med. 2003;25(3 Suppl 2):141–9. doi:10.1016/S0749-3797(03)00177-6.CrossRefPubMed

42.

Kwasnicka D, Presseau J, White M, Sniehotta FF. Does planning how to cope with anticipated barriers facilitate health-related behaviour change? A systematic review. Health Psychol Rev. 2013;7(2):129–45. doi:10.1080/17437199.2013.766832.CrossRef

43.

Trinh L, Plotnikoff RC, Rhodes RE, North S, Courneya KS. Correlates of physical activity in a population-based sample of kidney cancer survivors: an application of the theory of planned behavior. Int J Behav Nutr Phys Act. 2012;9:96. doi:10.1186/1479-5868-9-96.CrossRefPubMedPubMedCentral

44.

Vallance JK, Lavallee C, Culos-Reed NS, Trudeau MG. Predictors of physical activity among rural and small town breast cancer survivors: an application of the theory of planned behaviour. Psychol Health Med. 2012;17(6):685–97. doi:10.1080/13548506.2012.659745.CrossRefPubMed

45.

Stevinson C, Tonkin K, Capstick V, Schepansky A, Ladha AB, Valance JK, et al. A population-based study of the determinants of physical activity in ovarian cancer survivors. J Phys Act Health. 2009;6(3):339–46.CrossRefPubMed

Title: Understanding strength exercise intentions and behavior in hematologic cancer survivors: an analysis of the intention-behavior gap
Authors: James R. Vallerand
Ryan E. Rhodes
Gordon J. Walker
Kerry S. Courneya
Publication date: 01-12-2016
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 6/2016
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-016-0540-9

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