title: Correlates of physical activity in a population-based sample of kidney cancer survivors: an application of the theory of planned behavior.
abstract: BACKGROUND
  Over half of kidney cancer survivors (KCS) are completely inactive and only a quarter are meeting physical activity (PA) guidelines. This highlights the need to identify and understand the determinants of PA in this understudied population. The purpose of this study is to determine the social cognitive correlates of PA intention and behavior in KCS using the Theory of Planned Behavior (TPB).
  
  
  METHODS
  All 1,985 KCS diagnosed between 1996 and 2010 in Alberta, Canada were mailed a self-report survey that consisted of the Godin Leisure Time Exercise Questionnaire and standard TPB items for intention, planning, perceived behavioral control (PBC), affective and instrumental attitudes, and descriptive and injunctive norms. Standard demographic and medical variables were also collected.
  
  
  RESULTS
  Completed surveys were received from 703 of 1,654 (43%) eligible KCS. The TPB was tested using structural equation modelling and demonstrated an adequate-to-good fit to the data [χ² = 256.88, p < .001; TLI = 0.97; CFI = 0.98; RMSEA = 0.06, 90% CI = 0.05-0.06].There were significant pathways to PA from PBC (ß = 0.18, p = 0.02), planning (ß = 0.22, p < 0.01), and intention (ß = 0.31, p < 0.01); and to planning from intention (ß = 0.81, p < 0.01). In addition, there were significant model pathways to intention from instrumental attitude (ß = 0.28, p = 0.03), descriptive norm (ß = 0.09, p = 0.01), and PBC (ß = 0.52, p < 0.01). Overall, the TPB accounted for 69%, 63%, and 42% of the variance in intention, planning and PA, respectively.
  
  
  CONCLUSIONS
  The TPB appears to be a useful model for explaining PA in KCS. All TPB constructs except injunctive norm and affective attitude were useful for explaining intention with PBC emerging as the largest correlate. Developing PA interventions based on the TPB may be effective in promoting PA in KCS and may lead to important improvements in health.
authors.affiliation: Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Edmonton, Alberta, T6G 2H9, Canada.
authors.forename: Linda
authors.initials: L
authors.lastname: Trinh
authors.forename: Ronald C
authors.initials: RC
authors.lastname: Plotnikoff
authors.forename: Ryan E
authors.initials: RE
authors.lastname: Rhodes
authors.forename: Scott
authors.initials: S
authors.lastname: North
authors.forename: Kerry S
authors.initials: KS
authors.lastname: Courneya
mesh_terms: D000368:Aged; D000416:Alberta; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003710:Demography; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D033182:Intention; D007680:Kidney Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011582:Psychological Theory; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*