Although physical activity may modify the late effects of childhood cancer treatment, 20%-52% of adult survivors are sedentary. We sought to identify modifiable factors that influence survivors' participation in physical activity.
Structural equation modeling of data from the Childhood Cancer Survivors Study of adult survivors (current mean age, 30.98 years; mean years since diagnosis, 23.74; mean age at diagnosis, 9.25 years) diagnosed between 1970 and 1986.
Forty percent of the variance in male survivors' recent participation vs. nonparticipation in physical activity was explained directly and/or indirectly by self-reported health fears (P=0.01), perceived primary-care physician (PCP) expertise (P=0.01), baseline exercise frequency (P=<0.001), education level (P=0.01), self-reported stamina (P=0.01), cancer-related pain (P=<0.001), fatigue (P=<0.001), age at diagnosis (P=0.01), cancer-related anxiety (P=<0.001), motivation (P=0.01), affect (P=0.01), and discussion of subsequent cancer risk with the PCP (P=<0.001) (N=256; X2=53.38, df=51, P=0.38, CFI=1.000, TLI=1.000, RMSEA=0.014,WRMR=0.76). Thirty-one percent of the variance in females' recent physical activity participation was explained directly and/or indirectly by self-reported stamina (P=<0.001), fatigue (P=0.01), baseline exercise frequency (P=0.01), cancer-related pain (P=<0.001), cancer-related anxiety (P=0.01), recency of visits with PCP (<0.001), quality of interaction with the PCP (P=0.01), and motivation (P=<0.001) (N=366; X2=67.52 df=55, P=0.12, CFI=0.98, TLI=0.98, RMSEA=0.025, WRMR=0.76).
Gender-tailored intervention strategies in which providers specifically target motivation, fear, and affect may support physical activity in childhood cancer survivors.
Keywords: childhood cancer survivors, sedentary lifestyle