Perceived barriers and benefits to physical activity in colorectal cancer patients.
OBJECTIVE
There is emerging evidence for the benefits of physical activity (PA) post-diagnosis for colorectal cancer (CRC) survivors. However, population studies suggest activity levels in these patients are very low. Understanding perceived barriers and benefits to activity is a crucial step in designing effective interventions.


METHODS
Patients who were between 6 months and 5 years post-diagnosis with non-metastasised disease were identified from five London (UK) hospitals. Four hundred and ninety five completed a lifestyle survey that included open-ended questions on their perceived barriers (what things would stop you from doing more physical activity?) and benefits (what do you think you would gain from doing more physical activity?). Patients also recorded their activity levels using the Godin Leisure Time Exercise Questionnaire, along with sociodemographic and treatment variables.


RESULTS
The most commonly reported barriers related to cancer and its treatments (e.g. fatigue). Age and mobility-related comorbidities (e.g. impaired mobility) were also frequently cited. Those who reported age and mobility as barriers, or reported any barrier, were significantly less active even after adjustment for multiple confounders. The most frequently reported benefits were physiological (e.g. improving health and fitness). Cancer-related benefits (such as prevention of recurrence) were rarely reported. Those perceiving physiological benefits or perceiving any benefits were more active in unadjusted models, but associations were not significant in adjusted models.


CONCLUSIONS
We have identified important barriers and facilitators in CRC survivors that will aid in the design of theory-based PA interventions.
Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK. abigail.fisher@ucl.ac.uk.|Faculty of Health Sciences, University of Southampton, Southampton, S017 1BJ, UK. abigail.fisher@ucl.ac.uk.
Abigail
A
Fisher
Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK.
J
J
Wardle
Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK.
R J
RJ
Beeken
Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK.
H
H
Croker
Department of Epidemiology and Public Health, University College London, Gower Street, London, WC1E 6BT, UK.
K
K
Williams
Faculty of Health Sciences, University of Southampton, Southampton, S017 1BJ, UK.
C
C
Grimmett
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000523:psychology*; D015444:Exercise / Q000502:physiology*; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology*; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D010465:Perception; D011795:Surveys and Questionnaires; D017741:Survivors / Q000706:statistics & numerical data
Barriers; Colorectal cancer; Facilitators; Physical activity; Qualitative; Survivorship