title: Environments Associated with Moderate-to-Vigorous Physical Activity and Sedentary Behavior of Colorectal Cancer Survivors.
abstract: Physical activity (PA) is an effective intervention for improving the quality of life of colorectal cancer survivors (CRC) and may reduce the risk of cancer recurrence and cancer specific and all-cause mortality. However, most CRC survivors are not sufficiently active to receive these benefits. Sedentary behavior (SB) has also been linked to morbidity and mortality risk independent of activity level, thereby presenting an additional opportunity to improve health outcomes of CRC survivors. The built environment is known to influence PA and SB; however, little is known about where CRC survivors engage in PA and SB. The objective of this exploratory study was to objectively identify locations where CRC survivors engage in PA and SB in order to inform health promoting interventions.
  
  
  
  Activity and location of CRC survivors (n = 31) was monitored for 1 week between January 2014 and April 2015 in Nova Scotia, Canada. Bouts of PA and SB were time-matched with GPS data to attribute bouts to specific geographic locations.
  
  
  
  Participants' home environment was the main location for both time spent in PA bouts (73.7 %) and time spent in SB bouts (90.5 %).
  
  
  
  This study is the first to objectively identify environments where CRC survivors are active and sedentary. These findings highlight the importance of considering the home environment when developing intervention strategies to increase PA and reduce SB in CRC survivors.
authors.affiliation: School of Health and Human Performance, Dalhousie University, PO Box 15000, B3H 4R2, Halifax, NS, Canada. Logan.lawrence@dal.ca.
authors.forename: Logan M
authors.initials: LM
authors.lastname: Lawrence
authors.affiliation: School of Health and Human Performance, Dalhousie University, PO Box 15000, B3H 4R2, Halifax, NS, Canada.
authors.forename: Michelle R
authors.initials: MR
authors.lastname: Stone
authors.affiliation: Environmental Science, Dalhousie University, Halifax, NS, Canada.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Rainham
authors.affiliation: School of Health and Human Performance, Dalhousie University, PO Box 15000, B3H 4R2, Halifax, NS, Canada.
authors.forename: Melanie R
authors.initials: MR
authors.lastname: Keats
mesh_terms: D000368:Aged; D015179:Colorectal Neoplasms; D004777:Environment; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia; D011788:Quality of Life; D057185:Sedentary Behavior; D017741:Survivors
keywords: Behavioral medicine; Built environment; Cancer survivorship; Colorectal cancer; GPS; Physical activity; Sedentary behavior