title: Pathways between physical activity and quality of life in African-American breast cancer survivors.
abstract: Several studies have indicated that the relationship between physical activity and quality of life is not directed but mediated through various pathways. The purpose of this study was to assess the role of cancer-related fatigue, disability, and functional status as potential mediators in African-American breast cancer survivors.
  
  
  
  African-American breast cancer survivors (N = 135, mean age = 63) aged 55 years and older participated in a web-based survey consisting of measures assessing physical activity, functional status, cancer-related fatigue, disability, quality of life, and sociodemographic and medical characteristics. Structural equation modeling was used to assess the structural relationships among the constructs.
  
  
  
  The initial structural model fit the data and revealed a significant relationship between physical activity and quality of life (β = 0.34, P < 0.01). Subsequent structural models with proposed complementary and mediating paths of fatigue, function, and disability fit the data. The adjusted model indicated that physical activity was no longer associated with quality of life (β = 0.11, P > 0.05) and mediated through pathways of functional status and fatigue (total β = 0.16, P < 0.01). The final adjusted model accounted for 32 % of the variance in quality of life.
  
  
  
  Our data suggest that physical activity may be indirectly related to quality of life through pathways consisting of fatigue and functional status. Further longitudinal studies are needed to test the pathways through which varying levels of physical activity influence cancer-related and quality of life outcomes in minority cancer survivors.
authors.affiliation: Comprehensive Cancer Center, Center for Population Health and Health Disparities and the College of Public Health, The Ohio State University, Columbus, OH, USA. meadows.262@osu.edu.|, 1590 N. High Street, Suite 525, Columbus, OH, 43201, USA. meadows.262@osu.edu.
authors.forename: Rachel
authors.initials: R
authors.lastname: Meadows
authors.affiliation: Transdisciplinary Center for Health Equity Research, Texas A&M University, College Station, TX, USA.
authors.forename: Timethia
authors.initials: T
authors.lastname: Bonner
authors.affiliation: Institute of Healthy Aging Fort Worth, The University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Megha
authors.initials: M
authors.lastname: Dobhal
authors.affiliation: Institute of Healthy Aging Fort Worth, The University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Sujana
authors.initials: S
authors.lastname: Borra
authors.affiliation: Institute of Healthy Aging Fort Worth, The University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Jordan A
authors.initials: JA
authors.lastname: Killion
authors.affiliation: Institute of Healthy Aging Fort Worth, The University of North Texas Health Science Center, Fort Worth, TX, USA.
authors.forename: Raheem
authors.initials: R
authors.lastname: Paxton
mesh_terms: D001741:Black or African American / Q000523:psychology*; D000368:Aged; D001943:Breast Neoplasms / Q000208:ethnology* / Q000503:physiopathology / Q000523:psychology; D015444:Exercise / Q000502:physiology* / Q000523:psychology*; D005221:Fatigue / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011788:Quality of Life; D011795:Surveys and Questionnaires; D017741:Survivors; D014481:United States
keywords: African-American; Breast cancer; Cancer survivors; Physical activity; Quality of life