Design of the steps to health study of physical activity in survivors of endometrial cancer: Testing a social cognitive theory model

Abstract

Physical activity has been shown to benefit cancer survivors' physical functioning, emotional wellbeing, and symptoms. Physical activity may be of particular benefit to survivors of endometrial cancer because they are more likely to be obese and sedentary than the general population, as these are risk factors for the disease, and thus experience a number of related co-morbid health problems. However, there is little research systematically studying mechanisms of physical activity adherence in cancer survivor populations. This paper describes the design of the Steps to Health study, which applies a Social Cognitive Theory-based model of endometrial cancer survivors' adoption and maintenance of exercise in the context of an intervention to increase walking or other moderate intensity cardiovascular activity. In Steps to Health we will test the influence of self-efficacy and outcome expectations on adherence to exercise recommendations, as well as studying the determinants of self-efficacy. Endometrial cancer survivors who are at least 6 months post-treatment are provided with an intervention involving print materials and telephone counseling, and complete assessments of fitness, activity, self-efficacy and outcome expectations, and determinants of self-efficacy every two months for a six month period. In addition to testing an innovative model, the Steps to Health study employs multiple assessment methods, including ecological momentary assessment, implicit tests of cognitive variables, and ambulatory monitoring of physical activity. The study results can be used to develop more effective interventions for increasing physical activity in sedentary cancer survivors by taking into account the full complement of sources of self-efficacy information and outcome expectations. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptPsychol Sport Exerc. Author manuscript; available in PMC 2012 January 1. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptPhysical activity benefits cancer survivors' physical and psychological functioning, as evidenced by the growing body of research on this topic (Ahmed, Thomas, Yee, & Schmitz, 2006;Basen-Engquist et al., 2006;Courneya, 2001Courneya, , 2003 Courneya & Christine M. Friedenreich, 1999;Courneya, Keats, & Turner, 2000;Courneya et al., 2007;Daley et al., 2007;Fairey, Courneya, Field, & Mackey, 2002;Friedenreich & Courneya, 1996;Galvao & Newton, 2005;Knols, Aaronson, Uebelhart, Fransen, & Aufdemkampe, 2005;Ohira, Schmitz, Ahmed, & Yee, 2006;Pinto & Maruyama, 1999;Schmitz et al., ...

Traditional and Rasch psychometric analyses of the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire in shorter-term cancer survivors 15months post-diagnosis

“…One of the newest cancer survivor-specific HRQoL measures is the Quality of Life in Adult Cancer Survivors (QLACS) questionnaire developed by Avis et al [11] in 2005, and which is now being used in an increasing number of research studies (e.g. [12][13][14][15][16][17][18]). QLACS assesses seven generic and five cancer-specific HRQoL domains (Table 1), and Generic and Cancer-Specific summary scores are calculated by summing the relevant domains (excluding benefits of cancer, which is scored as a distinct domain only).…”

“…[15][16][17][18]). There is a need for HRQoL measures suitable for shorter-term survivors [10], and a need for longitudinal HRQoL assessment in order to determine the natural history of survivorship, identify early predictors of late effects and difficulties and assess the sustained impact of HRQoL interventions (e.g.…”

“…Unidimensionality is essential in order to validly summate multiple responses from any group of items into a single summary score, and linear measurement is a prerequisite for parametric analyses and meaningful calculation and interpretation of change scores. Researchers are computing and using the QLACS higher-order Generic and Cancer-Specific summary scores [12,15,17], and analysing changes in QLACS scores in observational and interventional studies [16][17][18]. Therefore, we aimed to use Rasch analysis to explore the extent to which the QLACS summary scales are unidimensional, such that it is appropriate to combine multiple HRQoL domains to form these higher-order scores (e.g.…”

Are personal characteristics of massage therapists associated with their clinical, educational, and interpersonal behaviors?

“…(15) Applications include designing interventions to increase outcome expectations related to physical activity (16)(17) and home exercise adherence. (18) Other studies have applied outcome expectation and expectancy constructs to improve participation in longitudinal studies (19) and exercise adoption among an at-risk population.…”

“…[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22]. Nearly half of the massage therapists practiced alone (45.7%), while 15.9% practiced with a chiropractor, 14.6% practiced in a salon or spa, 12.6% practiced with other massage therapists, and 12% worked in other practice settings.…”