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This study's objective was to develop and evaluate the suitability and appropriateness of a theory-based physical activity (PA) guidebook for breast cancer survivors. Guidebook content was constructed based on the theory of planned behavior (TPB) using salient exercise beliefs identified by breast cancer survivors in previous research. Expert judges completed the Maine Area Health Education Center's 18-item attribute checklist for evaluating written health information. Judges indicated that the PA guidebook achieved desirable attributes for the suitability and appropriateness of the guidebook. A subset of TPB expert judges completed items designed to determine the degree of match between the guidebook content and the respective TPB components. Mean item-content relevance ratings indicated at least a "very good match" between the PA guidebook content and the keyed TPB domains. Theoretically based PA information may be an effective strategy for increasing PA in breast cancer survivors at the population level. (Contains 4 tables.)

Abstract Background Patient preference for group assignment may affect outcomes in unblinded trials but few studies have attempted to understand such preferences. The purpose of the present study was to examine factors associated with breast cancer patients' preference for two types of exercise training during chemotherapy. Methods Breast cancer patients (N = 242) completed a battery of tests including a questionnaire that assessed patient preference and the theory of planned behavior (TPB) prior to being randomized to usual care, resistance exercise training (RET), or aerobic exercise training (AET). Results 99 (40.9%) participants preferred RET, 88 (36.4%) preferred AET, and 55 (22.7%) reported no preference. Past exercisers (p = 0.023), smokers (p = 0.004), and aerobically fitter participants (p = 0.005) were more likely to prefer RET. As hypothesized, participants that preferred AET had more favorable TPB beliefs about AET whereas participants that preferred RET had more favorable TPB beliefs about RET. In multivariate modeling, patient preference for RET versus AET was explained (R2 = .46; p < 0.001) by the difference in motivation for RET versus AET (β = .56; p < 0.001), smoking status (β = .13; p = 0.007), and aerobic fitness (β = .12; p = 0.018). Motivational difference between RET versus AET, in turn, was explained (R2 = .48; p < 0.001) by differences in instrumental attitude (β = .27; p < 0.001), affective attitude (β = .25; p < 0.001), and perceived behavioral control (β = .24; p < 0.001). Conclusion Breast cancer patients' preference for RET versus AET during chemotherapy was predicted largely by a difference in motivation for each type of exercise which, in turn, was based on differences in their beliefs about the anticipated benefits, enjoyment, and difficulty of performing each type of exercise during chemotherapy. These findings may help explain patient preference effects in unblinded behavioral trials. Trial Registration ClinicalTrials.gov Identifier NCT00115713.

This study examined the degree to which male youth ice hockey players' (N = 229, M age = 14.15 years; SD = 1.03) perfectionist orientations were associated with anger vulnerability in competition. Perfectionism and trait anger were measured as domain-specific constructs. Athletes were also asked to speculate on the likely intensity of anger responses if they were to commit mistakes in high- and low-criticality situations in competition. Canonical correlation results indicated that heightened perfectionist orientations were associated with heightened competitive trait anger. Cluster analyses produced three clusters of athletes who possessed either low, moderate, or high levels of perfectionism. Significant between-cluster differences on anger responses to mistakes were obtained, with highly perfectionistic athletes anticipating significantly higher levels of anger following mistakes than low and moderately perfectionistic athletes. A significant situation-criticality main effect was also observed, with athletes anticipating higher levels of anger following personal mistakes in high- as opposed to low-criticality situations. Results are discussed within the context of cognitive motivational theories of emotion. [ABSTRACT FROM AUTHOR]

In the present study we examined the demographic, medical, and social cognitive correlates of exercise intentions in non-Hodgkin's lymphoma (NHL) survivors using the theory of planned behavior (TPB). Participants were 399 NHL survivors who completed a mailed survey that assessed demographics, past exercise, and the TPB (i.e., intention, perceived behavioral control, affective and instrumental attitudes, and subjective norm). Descriptive data indicated that only about 50% of NHL survivors intended to exercise at levels that are consistent with current public health guidelines. In support of the TPB, multiple regression analysis indicated that the model explained 55% of the variance in exercise intentions, with perceived behavioral control (b = .47), affective attitude (b = .23), and subjective norm (b = .15), being the most important correlates. It was concluded that the TPB provides a good framework on which to base interventions designed to increase exercise intentions in NHL survivors. [ABSTRACT FROM AUTHOR]

The primary purpose of this study was to examine differences in quality of life (QoL) between non-Hodgkin's lymphoma (NHL) survivors meeting and not meeting public health exercise guidelines. A secondary purpose was to examine exercise behavior changes across three distinct cancer-related time periods (i.e. prediagnosis, on treatment and off treatment). Using a retrospective survey design, 438 NHL survivors residing in Alberta, Canada completed a mailed questionnaire that assessed self-reported exercise prediagnosis, on treatment and off treatment, and current QoL. Descriptive analyses indicated that 33.8, 6.5 and 23.7% of NHL survivors met public health exercise guidelines during prediagnosis, on treatment, and off treatment time periods, respectively. Multivariate analyses of variance indicated that NHL survivors meeting public health exercise guidelines during postdiagnosis time periods had higher current QoL scores than NHL survivors not meeting guidelines. QoL difference scores between the two groups met proposed standards for clinically important differences. Multivariate analyses also indicated significant differences in exercise behavior across the three cancer-related time periods (all p's<0.01). These analyses were unchanged after statistically controlling for important medical and demographic variables. The results of this study provide evidence that NHL survivors meeting public health exercise guidelines on and off treatment reported higher current QoL than those survivors not meeting guidelines. These findings corroborate research examining exercise behavior in other cancer survivor groups and provide preliminary data to support a randomized controlled trial on exercise and QoL in this population. Copyright © 2005 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Purpose: Breast cancer chemotherapy may cause unfavorable changes in physical functioning, body composition, psychosocial functioning, and quality of life (QOL). We evaluated the relative merits of aerobic and resistance exercise in blunting these effects., Patients and Methods: We conducted a multicenter randomized controlled trial in Canada between 2003 and 2005 that randomly assigned 242 breast cancer patients initiating adjuvant chemotherapy to usual care (n = 82), supervised resistance exercise (n = 82), or supervised aerobic exercise (n = 78) for the duration of their chemotherapy (median, 17 weeks; 95% CI, 9 to 24 weeks). Our primary end point was cancer-specific QOL assessed by the Functional Assessment of Cancer Therapy-Anemia scale. Secondary end points were fatigue, psychosocial functioning, physical fitness, body composition, chemotherapy completion rate, and lymphedema., Results: The follow-up assessment rate for our primary end point was 92.1%, and adherence to the supervised exercise was 70.2%. Unadjusted and adjusted mixed-model analyses indicated that aerobic exercise was superior to usual care for improving self-esteem (P = .015), aerobic fitness (P = .006), and percent body fat (adjusted P = .076). Resistance exercise was superior to usual care for improving self-esteem (P = .018), muscular strength (P < .001), lean body mass (P = .015), and chemotherapy completion rate (P = .033). Changes in cancer-specific QOL, fatigue, depression, and anxiety favored the exercise groups but did not reach statistical significance. Exercise did not cause lymphedema or adverse events., Conclusion: Neither aerobic nor resistance exercise significantly improved cancer-specific QOL in breast cancer patients receiving chemotherapy, but they did improve self-esteem, physical fitness, body composition, and chemotherapy completion rate without causing lymphedema or significant adverse events.

Purpose: To determine the effects of breast cancer-specific print materials and step pedometers on physical activity (PA) and quality of life (QoL) in breast cancer survivors., Patients and Methods: Breast cancer survivors (N = 377) were randomly assigned to receive one of the following: a standard public health recommendation for PA, previously developed breast cancer-specific PA print materials, a step pedometer, or a combination of breast cancer-specific print materials and step pedometers. The primary outcome was self-reported moderate/vigorous PA minutes per week. Secondary outcomes were QoL (Functional Assessment of Cancer Therapy-Breast), fatigue, self-reported brisk walking, and objective step counts. Assessments were conducted at baseline and postintervention (12 weeks)., Results: Attrition was 10.3% (39 of 377). On the basis of linear mixed-model analyses, PA increased by 30 minutes/week in the standard recommendation group compared with 70 minutes/week in the print material group (mean difference, 39 minutes/week; 95% CI = -10 to 89; d = 0.25; P = .117), 89 minutes/week in the pedometer group (mean difference, 59 minutes/week; 95% CI, 11 to 108; d = 0.38; P = .017), and 87 minutes/week in the combined group (mean difference, 57 minutes/week; 95% CI, 8 to 106; d = 0.37; P = .022). For brisk walking minutes/week, all three intervention groups reported significantly greater increases than the standard recommendation group. The combined group also reported significantly improved QoL (mean difference, 5.8; 95% CI, 2.0 to 9.6; d = 0.33; P = .003) and reduced fatigue (mean difference, 2.3; 95% CI, 0.0 to 4.7; d = 0.25; P = .052) compared with the standard recommendation group., Conclusion: Breast cancer-specific PA print materials and pedometers may be effective strategies for increasing PA and QoL in breast cancer survivors. A combined approach appears to be optimal., Clinical Trial Registration: ClinicalTrials.gov Identifier NCT00221221

The purpose of this study was to examine the demographic, medical, and social cognitive determinants of exercise intentions in a population-based sample of multiple myeloma cancer survivors. Using a cross-sectional survey, 70 multiple myeloma cancer survivors completed a questionnaire that assessed their medical and demographic characteristics, past exercise behavior, and social cognitive exercise beliefs using the theory of planned behavior. Seventy participants provided valuable data. Descriptive statistics indicated that participants had quite positive instrumental attitude, intentions, and subjective norms and moderate levels of perceived behavioral control and affective attitudes for exercise. Forced entry multiple regression showed that the theory of planned behavior explained 43% of the variance in exercise intentions. Instrumental attitude and perceived behavioral control were both independent predictors of exercise intentions. No demographic or medical variable moderated the association between the theory of planned behavior constructs and exercise intentions. The results of the present investigation support the growing body of evidence confirming the utility of the theory of planned behavior to understand the salient determinants of exercise in cancer survivors. Knowledge gained from this study provides important information to oncology practitioners who are responsible for delivering supportive care interventions, including exercise, to patients diagnosed with multiple myeloma.

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.