J Gynecol Oncol.  2015 Apr;26(2):141-147. 10.3802/jgo.2015.26.2.141.

Physical activity for an ethnically diverse sample of endometrial cancer survivors: a needs assessment and pilot intervention

• Rossi A
• Moadel-Robblee A
• Garber CE
• Kuo D
• Goldberg G
• Einstein M
• Nevadunsky N

• KMID: 2160797
• DOI: http://doi.org/10.3802/jgo.2015.26.2.141

Abstract

OBJECTIVE
To determine the physical activity (PA) behavior, needs and preferences for underserved, ethnically diverse women with a history of endometrial cancer (EC).
METHODS
Women with a history of EC (41 non-Hispanic black, 40 non-Hispanic white, and 18 Hispanic) completed a needs assessment during their regular follow-up appointments at Montefiore Medical Center in Bronx, NY, USA. An 8-week pilot PA intervention based on the results of the needs assessment was conducted with 5 EC survivors.
RESULTS
Mean body mass index (BMI) among the 99 respondents was 34.1+/-7.6 kg/m2, and 66% did not exercise regularly. Self-described weight status was significantly lower than actual BMI category (p<0.001). Of the 86% who were interested in joining an exercise program, 95% were willing to attend at least once weekly. The primary motivations were improving health, losing weight, and feeling better physically. Despite the high interest in participation, volunteer rate was very low (8%). However, adherence to the 8-week pilot PA intervention was high (83%), and there were no adverse events. Body weight decreased in all pilot participants.
CONCLUSION
These data show that ethnically diverse EC survivors have a great need for, and are highly interested in, PA interventions. However, greater care needs to be taken to assess and identify barriers to increase participation in such programs.

Keyword

Endometrial Neoplasms; Exercise; Health Behavior; Obesity; Needs Assessment; Survivors

MeSH Terms

Aged
Body Mass Index
Endometrial Neoplasms/epidemiology/*ethnology/*rehabilitation
Ethnic Groups
Exercise/physiology
Female
Health Behavior/ethnology
Humans
Middle Aged
*Motor Activity
*Needs Assessment/statistics & numerical data
Obesity/complications/therapy
Pilot Projects
Surveys and Questionnaires
*Survivors/statistics & numerical data

Reference

1. Lee I, Oguma Y. Physical activity. In : Schottenfeld D, Fraumeni JF, editors. Cancer epidemiology and prevention. 3rd ed. New York: Oxford University Press;2006.

2. Garber CE, Blissmer B, Deschenes MR, Franklin BA, Lamonte MJ, Lee IM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc. 2011; 43:1334–1359.

3. Basen-Engquist K, Scruggs S, Jhingran A, Bodurka DC, Lu K, Ramondetta L, et al. Physical activity and obesity in endometrial cancer survivors: associations with pain, fatigue, and physical functioning. Am J Obstet Gynecol. 2009; 200:288.e1–288.e8.

4. Mayer DK, Terrin NC, Menon U, Kreps GL, McCance K, Parsons SK, et al. Health behaviors in cancer survivors. Oncol Nurs Forum. 2007; 34:643–651.

5. von Gruenigen VE, Waggoner SE, Frasure HE, Kavanagh MB, Janata JW, Rose PG, et al. Lifestyle challenges in endometrial cancer survivorship. Obstet Gynecol. 2011; 117:93–100.

6. Courneya KS, Karvinen KH, Campbell KL, Pearcey RG, Dundas G, Capstick V, et al. Associations among exercise, body weight, and quality of life in a population-based sample of endometrial cancer survivors. Gynecol Oncol. 2005; 97:422–430.

7. Fader AN, Frasure HE, Gil KM, Berger NA, von Gruenigen VE. Quality of life in endometrial cancer survivors: what does obesity have to do with it? Obstet Gynecol Int. 2011; 2011:308609.

8. Arem H, Irwin ML. Obesity and endometrial cancer survival: a systematic review. Int J Obes (Lond). 2013; 37:634–639.

9. Setiawan VW, Pike MC, Kolonel LN, Nomura AM, Goodman MT, Henderson BE. Racial/ethnic differences in endometrial cancer risk: the multiethnic cohort study. Am J Epidemiol. 2007; 165:262–270.

10. Rosato V, Zucchetto A, Bosetti C, Dal Maso L, Montella M, Pelucchi C, et al. Metabolic syndrome and endometrial cancer risk. Ann Oncol. 2011; 22:884–889.

11. Voskuil DW, Monninkhof EM, Elias SG, Vlems FA, van Leeuwen FE. Physical activity and endometrial cancer risk, a systematic review of current evidence. Cancer Epidemiol Biomarkers Prev. 2007; 16:639–648.

12. Kwon S, Hou N, Wang M. Comparison of physical activity levels between cancer survivors and non-cancer participants in the 2009 BRFSS. J Cancer Surviv. 2012; 6:54–62.

13. Marcus BH, Selby VC, Niaura RS, Rossi JS. Self-efficacy and the stages of exercise behavior change. Res Q Exerc Sport. 1992; 63:60–66.

14. Marcus BH, Simkin LR. The stages of exercise behavior. J Sports Med Phys Fitness. 1993; 33:83–88.

15. Blaney CL, Robbins ML, Paiva AL, Redding CA, Rossi JS, Blissmer B, et al. Validation of the measures of the transtheoretical model for exercise in an adult African-American sample. Am J Health Promot. 2012; 26:317–326.

16. Berscheid E, Walster E, Bohrnstedt G. The happy American body: a survey report. Psychol Today. 1973; 7:119–131.

17. Petrie TA, Tripp MM, Harvey P. Factorial and construct validity of the body parts satisfaction scale-revised: an examination of minority and nonminority women. Psychol Women Q. 2002; 26:213–221.

18. Smith SL. Physical exercise as an oncology nursing intervention to enhance quality of life. Oncol Nurs Forum. 1996; 23:771–778.

19. Arem H, Irwin ML, Zhou Y, Lu L, Risch H, Yu H. Physical activity and endometrial cancer in a population-based case-control study. Cancer Causes Control. 2011; 22:219–226.

20. US Census Bureau. American Community Survey selected population tables, 2007-2011. Suitland: US Census Bureau;2011.

21. Karvinen KH, Courneya KS, Campbell KL, Pearcey RG, Dundas G, Capstick V, et al. Exercise preferences of endometrial cancer survivors: a population-based study. Cancer Nurs. 2006; 29:259–265.

22. Beesley VL, Eakin EG, Janda M, Battistutta D. Gynecological cancer survivors' health behaviors and their associations with quality of life. Cancer Causes Control. 2008; 19:775–782.

23. Giardina EG, Sciacca RR, Flink LE, Bier ML, Paul TK, Moise N. Cardiovascular disease knowledge and weight perception among Hispanic and non-Hispanic white women. J Womens Health (Larchmt). 2013; 22:1009–1015.

24. Dorsey RR, Eberhardt MS, Ogden CL. Racial/ethnic differences in weight perception. Obesity (Silver Spring). 2009; 17:790–795.

25. Kuchler F, Variyam JN. Mistakes were made: misperception as a barrier to reducing overweight. Int J Obes Relat Metab Disord. 2003; 27:856–861.

26. Duncan DT, Wolin KY, Scharoun-Lee M, Ding EL, Warner ET, Bennett GG. Does perception equal reality? Weight misperception in relation to weight-related attitudes and behaviors among overweight and obese US adults. Int J Behav Nutr Phys Act. 2011; 8:20.

27. von Gruenigen VE, Courneya KS, Gibbons HE, Kavanagh MB, Waggoner SE, Lerner E. Feasibility and effectiveness of a lifestyle intervention program in obese endometrial cancer patients: a randomized trial. Gynecol Oncol. 2008; 109:19–26.

28. Kolden GG, Strauman TJ, Ward A, Kuta J, Woods TE, Schneider KL, et al. A pilot study of group exercise training (GET) for women with primary breast cancer: feasibility and health benefits. Psychooncology. 2002; 11:447–456.