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01.02.2009 | Original Article

A prospective study of the determinants of exercise in bladder cancer survivors using the Theory of Planned Behavior

verfasst von: Kristina H. Karvinen, Kerry S. Courneya, Ronald C. Plotnikoff, John C. Spence, Peter M. Venner, Scott North

Erschienen in: Supportive Care in Cancer | Ausgabe 2/2009

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Abstract

Goals of work

Although exercise has gained recognition as an effective supportive care intervention for cancer survivors, exercise participation rates are low. The present study examined the determinants of exercise in bladder cancer survivors using the Theory of Planned Behavior (TPB).

Patients and methods

Bladder cancer survivors (N = 397) residing in Alberta, Canada completed a mailed questionnaire at baseline that assessed demographic, medical, behavioral, and social cognitive variables and a second questionnaire 3 months later that assessed exercise. Multiple regression was the primary analysis.

Main results

Adjuvant therapy (r = −0.10, p = 0.021), cancer invasiveness (r = −0.10, p = 0.051), and age (r = −0.11, p = 0.037) were all negatively associated with exercise. Intention (β = 0.25, p < 0.001), perceived behavioral control (β = 0.18, p = 0.001), and planning (β = 0.12, p = 0.018) explained 20.9% of the variance in exercise over a 3-month period. Perceived behavioral control (β = 0.32, p < 0.001), affective attitude (β = 0.18, p = 0.002), instrumental attitude (β = 0.15, p = 0.025) and descriptive norm (β = 0.10, p = 0.032) explained 39.1% of the variability in exercise intention. Constructs from the TPB mediated the associations between adjuvant therapy, cancer invasiveness, age, and exercise. Age and adjuvant therapy also moderated some of the associations within the TPB.

Conclusions

Some medical and demographic variables predict exercise behavior in bladder cancer survivors, but these associations are mediated by the TPB. Interventions based on the TPB may be effective for promoting exercise in this cancer survivor population.

Afonso C, Graca P, Kearney J, Gibney M, de Almeida M (2001) Physical activity in European seniors: attitudes, beliefs and levels. J Nutr Health Aging 5:226–229PubMed

Aiken LS, West SG (1991) Multiple regression: testing and interpreting interactions. Sage, Newbury Park, CA

Ajzen I (1991) The theory of planned behavior. Org Behav Human Decis Process 50:179–211CrossRef

Ajzen I (2002) Constructing a TpB Questionnaire: Conceptual and Methodological Considerations. Retrieved May 6, 2004, from http://www.people.umass.edu/aizen/pdf/tpb.measurement.pdf

Baranowski T, Anderson C, Carmack C (1998) Mediating variable framework in physical activity interventions: how are we doing? How might we do better? Am J Prev Med 15:266–297PubMedCrossRef

Botteman M, Pashos C, Hauser R, Laskin B, Redaelli A (2003) Quality of life aspects of bladder cancer: a review of the literature. Qual Life Res 12:675–688PubMedCrossRef

Brassington G, Atienza A, Perczek R, DiLorenzo T, King A (2002) Intervention-related cognitive versus social mediators of exercise adherence in the elderly. Am J Prev Med 23:80–86PubMedCrossRef

American Cancer Society (2008) Cancer facts and figures. American Cancer Society, Atlanta, GA

Conn VS, Tripp-Reimer T, Maas ML (2003) Older women and exercise: theory of planned behavior beliefs. Public Health Nurs 20:153–163PubMedCrossRef

10.

Coups EJ, Ostroff JS (2005) A population-based estimate of the prevalence of behavioral risk factors among adult cancer survivors and noncancer controls. Prev Med 40:702–711PubMedCrossRef

11.

Courneya KS (1995) Understanding readiness for regular physical activity in older individuals: an application of the theory of planned behavior. Health Psychol 14:80–87PubMedCrossRef

12.

Courneya KS, Jones LW, Rhodes RE, Blanchard CM (2004) Effects of different combinations of intensity categories on self-reported exercise. Res Q Exerc Sport 75:429–433PubMed

13.

Courneya KS, Karvinen KH, Campbell KL et al (2005) Associations among exercise, body weight, and quality of life in a population-based sample of endometrial cancer survivors. Gynecol Oncol 97:422–430PubMedCrossRef

14.

Courneya KS, Vallance JKH, Jones LW, Reiman T (2005) Correlates of exercise intentions in non-Hodgkin’s lymphoma survivors: an application of the Theory of Planned Behavior. J Sport Exercise Psy 27:335–349

15.

Courneya KS, Conner M, Rhodes RE (2006) Effects of different measurement scales on the variability and predictive validity of the “two-component” model of the theory of planned behavior in the exercise domain. Psychol Health 21:557–570CrossRef

16.

Courneya KS, Karvinen KH, Vallance JK (2007) Exercise motivation and behavior change in cancer survivorship. In: Feuerstein M (ed) Handbook of cancer survivorship. Springer, Heidelberg, New York, pp 113–132CrossRef

17.

Dishman R (1994) Motivating older adults to exercise. South Med J 87:S79–S82PubMed

18.

Ekkekakis P, Lind E (2005) Exercise does not feel the same when you are overweight: the impact of self-selected and imposed intensity on affect and exertion. Int J Obesity 30:652–660CrossRef

19.

Godin G, Jobin J, Bouillon J (1986) Assessment of leisure time exercise behavior by self-report: a concurrent validity study. Can J Public Health 77:359–362PubMed

20.

Grembowski D, Patrick D, Diehr P et al (1993) Self-efficacy and health behavior among older adults. J Health Soc Behav 34:89–104PubMedCrossRef

21.

Hagger MS, Chatzisarantis NLD, Biddle SJH (2002) A meta-analytic review of the theories of reasoned action and planned behavior in physical activity: predictive validity and the contribution of additional variables. J Sport Exerc Psychol 24:3–32

22.

Haskell WL, Lee IM, Pate RR et al (2007) Physical activity and public health: updated recommendations for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc 39:1423–1434PubMedCrossRef

23.

Hunt-Shanks TT, Blanchard CM, Baker F et al (2006) Exercise use as complementary therapy among breast and prostate cancer survivors receiving active treatment: examination of exercise intention. Integr Cancer Ther 5:109–116PubMedCrossRef

24.

National Cancer Institute (2006) SEER Cancer Statistics Review, 1975–2002. Accessed January 31, 2006. http://seer.cancer.gov/csr/1975_2002/sections.html

25.

Jacobs DR, Ainsworth BE, Hartman TJ, Leon AS (1993) A simultaneous evaluation of 10 commonly used physical activity questionnaires. Med Sci Sports Exerc 25:81–91PubMedCrossRef

26.

Johnston DW, Johnston M, Pollard B, Kinmonth AL, Mant D (2004) Motivation is not enough: prediction of risk behavior following diagnosis of coronary heart disease from the theory of planned behavior. Health Psychol 23:533–538PubMedCrossRef

27.

Jones LW, Courneya KS, Vallance JK et al (2004) Associations between exercise and quality of life in multiple myeloma cancer survivors. Support Care Cancer 12:780–788PubMedCrossRef

28.

Jones LW, Courneya KS, Vallance JK et al (2006) Understanding the determinants of exercise intention in multiple myeloma cancer survivors: an application of the theory of planned behavior. Cancer Nurs 29:167–175PubMedCrossRef

29.

Karvinen KH, Courneya KS, North S, Venner P (2007) Associations among exercise and quality of life in bladder cancer survivors: a population based study. Cancer Epidemiol Biomarkers Prev 16:984–990PubMedCrossRef

30.

Karvinen KH, Courneya KS, Venner P, North S (2007) Exercise programming and counseling preferences of bladder cancer survivors: a population-based study. Journal of Cancer Survivorship 1:27–34PubMedCrossRef

31.

Marshall SJ, Biddle SJH (2001) The transtheoretical model of behavior change: a meta-analysis of applications to physical activity and exercise. Ann Behav Med 23:229–246PubMedCrossRef

32.

Norman P, Conner M (2005) The Theory of Planned Behavior and exercise: evidence for the mediating and moderating roles of planning on intention–behavior relationships. J Sport Exerc Psychol 27:488–504

33.

Pate RR, Heath GW, Dowda M, Trost SG (1996) Associations between physical activity and other health behaviors in a representative sample of US adolescents. Am J Public Health 86:1577–1581PubMedCrossRef

34.

Reid RD, Morrin LI, Pipe AL et al (2006) Determinants of physical activity after hospitalization for coronary artery disease: the Track Exercise After Cardiac Hospitalization (TEACH) Study. Eur J Cardiovasc Prev Rehabil 13:529–537PubMedCrossRef

35.

Rhodes RE, Courneya KS (2003) Investigating multiple components of attitude, subjective norm, and perceived control: an examination of the theory of planned behavior in the exercise domain. Br J Soc Psychol 42:129–146PubMedCrossRef

36.

Rhodes RE, Plotnikoff RC, Spence JC (2004) Creating parsimony at the expense of precision? Conceptual and applied issues of aggregating belief-based constructs in physical activity research. Health Educ Res 19:392–405PubMedCrossRef

37.

Rhodes RE, Blanchard CM (2006) Conceptual categories or operational constructs? Evaluating higher order theory of planned behavior structures in the exercise domain. Behav Med 31:141–150PubMedCrossRef

38.

Schmitz KH, Holtzman J, Courneya KS, Masse LC, Duval S, Kane R (2005) Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 14:1588–1599PubMedCrossRef

39.

Schutzer KA, Graves BS (2004) Barriers and motivations to exercise in older adults. Prev Med 39:1056–1061PubMedCrossRef

40.

Sniehotta FF, Scholz U, Schwarzer R (2005) Bridging the intention–behaviour gap: planning, self-efficacy, and action control in the adoption and maintenance of physical exercise. Psychol Health 20:143–160CrossRef

41.

Trost SG, Owen N, Bauman AE, Sallis JF, Brown W (2002) Correlates of adults’ participation in physical activity: review and update. Med Sci Sports Exerc 34:1996–2001PubMedCrossRef

42.

Vallance JK, Courneya KS, Jones LW, Reiman T (2005) Differences in quality of life between non-Hodgkin’s lymphoma survivors meeting and not meeting public health exercise guidelines. Psychooncology 14:979–991PubMedCrossRef

43.

Vallance JK, Courneya KS, Plotnikoff RC, Mackey JR (2008) Analyzing theoretical mechanisms of physical activity behavior change in breast cancer survivors: results from the activity promotion (ACTION) trial. Ann Behav Med 35:150–158PubMedCrossRef

44.

Wankel LM, Mummery WK (1993) Using national survey data incorporating the theory of planned behavior: implications for social marketing strategies in physical activity. J Appl Sport Psychol 5:158–177CrossRef

45.

Witcher CSG, Holt NL, Spence JC, O’Brien Cousins S (2007) A case study of physical activity among older adults in rural Newfoundland, Canada. J Aging Phys Act 15:166–183PubMed

Titel: A prospective study of the determinants of exercise in bladder cancer survivors using the Theory of Planned Behavior
verfasst von: Kristina H. Karvinen
Kerry S. Courneya
Ronald C. Plotnikoff
John C. Spence
Peter M. Venner
Scott North
Publikationsdatum: 01.02.2009
Verlag: Springer-Verlag
Erschienen in: Supportive Care in Cancer / Ausgabe 2/2009
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-008-0471-8

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A prospective study of the determinants of exercise in bladder cancer survivors using the Theory of Planned Behavior