Purpose: To provide formative data for culturally tailoring an exercise intervention based on social cognitive theory, six focus groups of Mexican-American and Puerto Rican breast cancer survivors were formed to gain insight from breast cancer survivors’ perspectives on the issues surrounding cancer survivorship and exercise.

Methods: Six focus groups with 4-7 breast cancer survivors were conducted; 3 in San Juan Puerto Rico metropolitan area and 3 in different cities in Texas (Houston, San Antonio, and Harlingen in the Lower Rio Grande Valley). A total of 29 breast cancer survivors participated in the sessions. This is the first out of four focus group sessions projected to be held over a year's time. Using a social cognitive theory-based behavioral model as a guide, six questions were consistently presented to each focus group. The focus groups explored the meaning of exercise, previous experience with exercise, relationship between exercise and cancer, safety issues, barriers to exercise, and ideas on a possible exercise intervention. Based on discussion, follow-up questions were added as relevant to the overall six questions. The focus groups met for approximately an hour and a half. Each session was recorded, transcribed verbatim and then the responses were coded with Atlas.ti software using the same social cognitive theory behavioral model as a guide. Frequency and details of coded responses were compared between the six focus groups and compared between the Mexican-American and Puerto Rican groups.

Results: A total of 29 codes were identified and used to catalogue 983 responses. Some responses were catalogued in more than one code. Both groups had similar descriptions of what they considered exercise and similar responses for barriers to exercise. Some of these barriers included time and fatigue. Walking, dancing, and using a gym facility were described throughout as exercise. However, the Mexican-American and the Puerto Rican groups greatly differed in their responses to perceived safety in their community and accessibility to exercise equipment/facilities. For example Puerto Ricans mostly felt secure exercising around their neighborhoods while Mexican-Americans did not; Mexican-Americans had more accessibility to parks or trails while Puerto Ricans did not. Both ethnic groups also expressed the absence of information from health care providers regarding their exercise capabilities and exercise limitations during and after their cancer treatments. In regards to delivering an intervention, the Mexican-American group was open to having a group intervention, while the Puerto Rican group preferred more of an individual intervention.

Conclusions: Using a social cognitive theory-based behavioral model as a guide for coding, we found differences and similarities in factors of exercise behaviors and cancer survivorship exercise adherence between Mexican-American and Puerto Rican breast cancer survivor focus groups. This information can be used to help design culturally competent interventions for these specific ethnic groups.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B5.