title: Great expectations: racial differences in outcome expectations for a weight lifting intervention among black and white breast cancer survivors with or without lymphedema.
abstract: Black breast cancer survivors are less likely to engage in physical activity than are White survivors. This is unfortunate because physical activity may be especially beneficial given Black breast cancer survivors' higher rates of obesity and adverse treatment effects related to obesity, such as breast cancer-related lymphedema (BCRL). The analysis explored outcome expectations for a weight lifting intervention by sedentary Black or White female breast cancer survivors and assessed the role of BCRL on outcome expectations for exercise.
  
  
  
  Chi-squared tests compared mean outcome expectation values for Black and White breast cancer survivors who completed baseline surveys for the Physical Activity and Lymphedema trial (n = 281). With race as the independent variable, multivariable analysis compared results for women without BCRL with those with BCRL, separately.
  
  
  
  Across the entire sample, Black survivors (n = 90) had significantly higher (p < 0.05) outcome expectations than White survivors (n = 191) for improvements in sleep, appearance, mental health, affect, energy, and eating habits, with small to moderate effect sizes. When stratified by BCRL status, differences by race were robust only among those with BCRL.
  
  
  
  Black cancer survivors had greater expectations than White cancer survivors for how a weight lifting intervention would improve their physical and mental states; these differences were most apparent among women with BCRL. Improving outcomes in Black breast cancer survivors rests on the development of interventions that are appropriately tailored to address the expectations of this population and account for differences in persistent adverse effects of cancer such as BCRL. Copyright © 2016 John Wiley & Sons, Ltd.
authors.forename: Lorraine T
authors.initials: LT
authors.lastname: Dean
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Justin
authors.initials: J
authors.lastname: Brown
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Morgan
authors.initials: M
authors.lastname: Coursey
authors.affiliation: Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Schmitz
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology*; D000368:Aged; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D015444:Exercise; D005260:Female; D006801:Humans; D008209:Lymphedema / Q000209:etiology*; D008875:Middle Aged; D017060:Patient Satisfaction; D011788:Quality of Life; D055070:Resistance Training; D011795:Surveys and Questionnaires; D015996:Survival Rate; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014891:Weight Lifting; D044465:White People / Q000523:psychology*
keywords: breast cancer survivorship disparities; lymphedema; oncology; outcome expectations; physical activity; social cognitive theory