Factors associated with changes in exercise behaviors during the COVID-19 pandemic

Abstract

Purpose There is limited information on how the COVID-19 pandemic has changed health behaviors among cancer patients. We examined changes in exercise behaviors since the pandemic and identified characteristics associated with these changes among cancer patients. Methods Cancer patients ( n = 1,210) completed a survey from August to September 2020 to assess COVID-19 pandemic-related changes in health behaviors and psychosocial factors. Patients were categorized into three groups: exercising less, exercising did not change, and exercising more. Patient characteristics were compared by exercise groups. Results One-third of the patients reported a decreased amount of regular exercise, while 10% reported exercising more during the pandemic. Patients who exercised less were more likely to be unemployed/retired and have poor health status and psychosocial stressors such as disruptions in daily life while less likely to be former smokers (all p < 0.05). In contrast, patients who exercised more were younger, had stage IV diagnosis, and also reported disruptions in daily life (all p < 0.05). Patients who were living in rural areas were also more likely not to experience changes in exercise habits (all p < 0.05), although rural–urban status was not identified as a strong predictor. Conclusion A significant proportion of cancer patients experienced changes in exercise habits, especially exercising less, during the first 6 months of the COVID-19 pandemic. Age, employment status, tumor stage, health status, smoking status, and psychosocial factors were associated with changes in exercise behaviors. Our results highlight the importance of promoting physical activity guidelines for cancer survivorship during the COVID-19 pandemic and may help improve the identification of cancer patients susceptible to exercising less.

A Rapid Systematic Review on the Experiences of Cancer Survivors Residing in Rural Areas during the COVID-19 Pandemic

“…A total of fourteen studies were included in the review [ 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ]. The studies were conducted in a range of different geographies in mostly high income countries and to a lesser extent low-middle income countries: Australia n = 3 [ 47 , 54 , 59 ]; Canada n = 3 [ 48 , 50 , 51 ]; France n = 1 [ 46 ]; India n = 2 [ 55 , 57 ]; United Kingdom n = 1 [ 58 ]; United States of America n = 3 [ 49 , 53 , 56 ]; Mixed geographies n = 1 [ 52 ]. In studies with both rural and non-rural participants the rural/remote/regional n ranged from seventeen to seventy-three per cent of the total sample [ 48 , 49 , 50 , 51 , 52 , 53 , 55 , 57 , 58 , 59 ].…”

“…Most studies collected data with cancer survivors with a range of different diagnoses [ 46 , 47 , 48 , 49 , 50 , 51 , 53 , 55 , 56 , 57 ]. Only one study (Krok-Schoen et al) looked explicitly at healthcare providers as opposed to cancer survivors [ 52 ].…”

“…Most of the studies ( n = 8) reported using a solely quantitative design [ 46 , 49 , 51 , 53 , 55 , 57 , 58 , 59 ]. Two studies reported collecting both quantitative and qualitative data [ 47 , 50 ] but only one study explicitly reported adhering to a mixed methods design [ 48 ].…”

“…Finally, three studies used only qualitative methods to collect their data [ 52 , 54 , 56 ]. Across all the studies data were collected between April 2020–May 2021 [ 46 , 47 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 ] with the exception of research by Galica et al [ 48 ] which did not report the data collection period but did report that this took place during the COVID-19 pandemic. The characteristics of the included studies is reported on in Table 2 .…”

“…There was a perception that living in a rural area with a lower population density provided some degree of ‘insulation’ from the negative effects of COVID-19 [ 48 ] and some rural cancer survivors in Australia reported that there were now more opportunities to engage in physical activity practices compared to before the pandemic [ 47 ]. In the USA, patients living in rural areas appeared to not change their exercise habits as much when compared to their urban counterparts [ 49 , 53 ].…”