title: Physical activity is associated with clinically important differences in health-related quality of life among rural and small-town breast cancer survivors.
abstract: OBJECTIVE
  The primary purpose of this study was to examine differences in health-related quality of life and fatigue between rural and small-town (RST) breast cancer survivors meeting and not meeting public health physical activity (PA) recommendations.
  
  
  METHODS
  Using a retrospective survey design, RST breast cancer survivors (N = 524) residing in Southern Alberta, Canada completed a mailed questionnaire assessing self-reported prediagnosis, on treatment, and current PA behavior, and current health-related quality of life and fatigue.
  
  
  RESULTS
  Analyses indicated 44.1%, 13.7%, and 34.7% of RST breast cancer survivors met public health PA recommendations during prediagnosis, on treatment, and post-treatment (i.e., current) time periods, respectively. Multivariate analyses of variance suggested indicated survivors currently meeting PA recommendations reported clinically advantageous differences in health-related quality of life and fatigue symptoms than survivors not currently meeting PA recommendations. Repeated measures analyses also indicated significant differences in PA behavior across the three cancer-related time periods (all p < 0.01).
  
  
  CONCLUSIONS
  The results of this study provide evidence that RST breast cancer survivors have similar PA behavior estimates across the cancer trajectory to urban survivors. Being physically active was associated with clinically important advantages with respect to health-related quality of life and fatigue. Strategies designed to facilitate PA behavior in the RST breast cancer survivor population are warranted.
authors.affiliation: Faculty of Health Disciplines, Athabasca University, 1 University Drive, Athabasca, AB, T9S-3A3, Canada. jeffv@athabascau.ca
authors.forename: Jeff K
authors.initials: JK
authors.lastname: Vallance
authors.forename: Celeste M
authors.initials: CM
authors.lastname: Lavallee
authors.forename: Nicole S
authors.initials: NS
authors.lastname: Culos-Reed
authors.forename: Marc G
authors.initials: MG
authors.lastname: Trudeau
mesh_terms: D000368:Aged; D000416:Alberta; D000704:Analysis of Variance; D001943:Breast Neoplasms / Q000523:psychology*; D005221:Fatigue / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity; D015999:Multivariate Analysis; D011788:Quality of Life; D012189:Retrospective Studies; D012424:Rural Population; D011795:Surveys and Questionnaires; D017741:Survivors; D013997:Time Factors