Social ecological determinants of physical activity among adult survivors of childhood cancer
Date
2019
Authors
Dugan, Kati F., author
Leach, Heather J., advisor
Chard, Christine A., committee member
Graham, Daniel J., committee member
Withycombe, Janice S., committee member
Journal Title
Journal ISSN
Volume Title
Abstract
Purpose: Adult survivors of childhood cancer (ASCCs) are at high risk for cardiovascular disease from chemotherapy and radiation therapy-related cardiotoxicity. Physical activity can reduce this risk, but most ASCCs do not engage in sufficient physical activity. The Ecological Model of Physical Activity (EMPA) is a theoretical framework which suggests multiple factors facilitate or hinder PA. These factors exist at the individual (e.g., motivation, genetics), micro- (e.g., parents, neighborhood parks), meso- (e.g., transportation), exo- (e.g., two microsystems working together), and macro- (e.g., societal values) system levels. The purpose of this study was to identify barriers and facilitators of physical activity among ASCCs using the EMPA framework. Methods: A concept elicitation survey was distributed to ASCCs (diagnosed with cancer before the age of 18, and currently 18-39 years old) and parent/legal guardians of an ASCC via Qualtrics. The survey consisted of open-ended questions asking about barriers, facilitators and resources for physical activity. Content analysis of open-ended questions categorized responses into levels of the EMPA, and identified key themes. Results: A total of 17 ASCCs, and 8 parents of ASCCs completed the survey. The majority of barriers were considered microsystem factors, and included proximity/access, social support and equipment. This study also identified financial resources as a macrosystem-level barrier to physical activity among ASCC. Seven themes emerged as factors impacting physical activity among ASCC: proximity/access, social support, equipment, time/schedule, none, finances, and health-related barriers. Conclusion: This is the first study to examine barriers and facilitators of physical activity among ASCC using the EMPA. Results from this study will provide a comprehensive understanding of physical activity determinants among ASCC to enhance future quantitative survey development.