Active transportation in adult survivors of childhood cancer and neighborhood controls

Abstract

Purpose Childhood cancer survivors (CCS) are at high risk of treatment-related late effects, including cardiovascular disease and diabetes, which can be exacerbated by inadequate physical activity (PA). Previous PA interventions targeting CCS have focused on the domain of leisure-time/recreational PA. Active transportation, another domain of PA, has not been described in CCS. Therefore, this study aimed to identify active transportation behaviors, barriers, and correlates in adult CCS. Methods We recruited 158 adult CCS and 153 controls matched on age, sex, and neighborhood for a survey regarding active transportation behaviors and perceptions. Linear and logistic regression models accounting for correlation among matched participants were used. Results Adult CCS engaged in similar levels of active transportation as controls (2.72 vs. 2.32 hours/week, P=0.40) despite perceiving greater health-related barriers (1.88 vs. 1.65 (measured on four-point Likert scale), P=0.01). Marital/relationship status (odds ratio (OR)=0.30, 95% confidence interval (CI)=0.11–0.81), planning/psychosocial barriers (OR=0.15, 95% CI=0.04–0.53), and perceived neighborhood walkability (OR=2.55, 95% CI=1.14–5.66) were correlates of active transportation among adult CCS, while objective neighborhood walkability (OR=1.03, 95% CI=1.01–1.05) was a correlate among controls. Conclusions Results suggest adult CCS and controls utilize active transportation at approximately equal levels. Factors other than health, including perceived neighborhood walkability, appear to influence active transportation behaviors to a greater degree in adult CCS. Implications for Cancer Survivors Interventions might consider promoting active transportation as a way to incorporate more PA into the daily lives of adult CCS. Such interventions will not be widely successful, however, without existing or improved neighborhood walkability/bikeability.

The role of social support in physical activity for cancer survivors: A systematic review

“…The most common measure was marital status. Most (n = 17) studies reported that marital status and length of marriage were unrelated to PA. Three studies documented positive associations between being married or partnered and PA, two reported significant associations that became nonsignificant in multivariate models, and three reported associations with some types of, but not total, PA . Number of children and being a member of a community organization were not associated with PA.…”

Factors influencing risk‐based care of the childhood cancer survivor in the 21st century

“…Future work should draw upon previous findings that have shown efficacy in this population, including the use of biochemical verification in tobacco interventions; assisting with decision making related to substance use; and using Web sites, videogames, and other electronic formats to encourage healthy eating. Designing physical activity interventions that use group exercise or increase self‐efficacy as well as promoting ecologic/environmental interventions, such as active transportation and adventure‐based training, are areas to explore. Interventions that target alcohol use, sunscreen behavior, and risky sexual behavior are limited and require further investigation.…”

Neighborhood Characteristics and Cancer Survivorship: An Overview of the Current Literature on Neighborhood Landscapes and Cancer Care

“…Across the scoped articles, survival disparities, primary care, and body size and weight management were the main themes. Neighborhood factors to study these themes were: nSES, exercise opportunities [ 73 , 74 ], access to healthy food options [ 73 ], and access to health care facilities [ 44 ]. One study found that obese survivors of pediatrics cancers were more likely to live in neighborhoods with lower SES [ 73 ].…”