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Understanding who engages and why it matters : predictors and outcomes of exercise adherence in real-world and remote cancer exercise programs Myers, Samantha
Abstract
Exercise is a key component of supportive cancer care, yet most individuals diagnosed with cancer are inactive. Understanding the behavioral, clinical, and contextual factors that influence engagement is critical for designing effective, sustainable interventions. This dissertation examined participation and the impact of adherence through retrospective, prospective, and qualitative designs across two cancer exercise programs: 1) PCSC, a real-world behavior change counseling clinic for men with prostate cancer, and 2) BE-FIT, a supervised live-remote intervention for women with breast cancer receiving endocrine therapy. Across three studies, this research aimed to identify key correlates of adherence, evaluate dose-response effects, and explore participant-reported facilitators and barriers to exercise engagement. Study 1 involved a retrospective chart review of PCSC, identifying clinical and psychosocial predictors of program engagement and exercise adherence over 12 months. Higher baseline task self-efficacy, enjoyment, and readiness for change were associated with greater engagement, while higher fatigue predicted attrition. Study 2 analyzed BE-FIT trial data using a dose-response framework. Greater adherence to supervised sessions significantly improved pain and physical function at 8 weeks, with pain benefits sustained at 12 months. Obesity moderated this relationship, with low adherence particularly detrimental among individuals with obesity. Study 3 comprised qualitative interviews with BE-FIT participants. Themes emphasized the value of tailored instruction, accessibility, and peer connection as motivators for adherence. Across both programs, overlapping qualitative themes included perceived health benefits, the need for structure and accountability, and the importance of cancer-specific knowledge. Participants who adhered tended to be highly educated, physically active at baseline, and had a lower body mass index. While PCSC integrated validated psychosocial constructs aligned with behavior change theory, BE-FIT did not, limiting cross-study comparisons and mechanistic insight. Nonetheless, affective responses and contextual support consistently emerged as influential. Collectively, this dissertation highlights the importance of integrating theory-based measurement, tailored implementation, and psychosocial engagement into exercise oncology models. Findings contribute to a growing evidence base guiding the development of scalable, equitable, and patient-centered approaches to physical activity promotion across cancer populations.
Item Metadata
Title |
Understanding who engages and why it matters : predictors and outcomes of exercise adherence in real-world and remote cancer exercise programs
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Creator | |
Supervisor | |
Publisher |
University of British Columbia
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Date Issued |
2025
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Description |
Exercise is a key component of supportive cancer care, yet most individuals diagnosed with cancer are inactive. Understanding the behavioral, clinical, and contextual factors that influence engagement is critical for designing effective, sustainable interventions. This dissertation examined participation and the impact of adherence through retrospective, prospective, and qualitative designs across two cancer exercise programs: 1) PCSC, a real-world behavior change counseling clinic for men with prostate cancer, and 2) BE-FIT, a supervised live-remote intervention for women with breast cancer receiving endocrine therapy. Across three studies, this research aimed to identify key correlates of adherence, evaluate dose-response effects, and explore participant-reported facilitators and barriers to exercise engagement. Study 1 involved a retrospective chart review of PCSC, identifying clinical and psychosocial predictors of program engagement and exercise adherence over 12 months. Higher baseline task self-efficacy, enjoyment, and readiness for change were associated with greater engagement, while higher fatigue predicted attrition. Study 2 analyzed BE-FIT trial data using a dose-response framework. Greater adherence to supervised sessions significantly improved pain and physical function at 8 weeks, with pain benefits sustained at 12 months. Obesity moderated this relationship, with low adherence particularly detrimental among individuals with obesity. Study 3 comprised qualitative interviews with BE-FIT participants. Themes emphasized the value of tailored instruction, accessibility, and peer connection as motivators for adherence. Across both programs, overlapping qualitative themes included perceived health benefits, the need for structure and accountability, and the importance of cancer-specific knowledge. Participants who adhered tended to be highly educated, physically active at baseline, and had a lower body mass index. While PCSC integrated validated psychosocial constructs aligned with behavior change theory, BE-FIT did not, limiting cross-study comparisons and mechanistic insight. Nonetheless, affective responses and contextual support consistently emerged as influential. Collectively, this dissertation highlights the importance of integrating theory-based measurement, tailored implementation, and psychosocial engagement into exercise oncology models. Findings contribute to a growing evidence base guiding the development of scalable, equitable, and patient-centered approaches to physical activity promotion across cancer populations.
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Genre | |
Type | |
Language |
eng
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Date Available |
2025-08-25
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Provider |
Vancouver : University of British Columbia Library
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Rights |
Attribution-NonCommercial-NoDerivatives 4.0 International
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DOI |
10.14288/1.0449860
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URI | |
Degree (Theses) | |
Program (Theses) | |
Affiliation | |
Degree Grantor |
University of British Columbia
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Graduation Date |
2025-11
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Campus | |
Scholarly Level |
Graduate
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Rights URI | |
Aggregated Source Repository |
DSpace
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Rights
Attribution-NonCommercial-NoDerivatives 4.0 International