Abstract
Introduction: Obesity has reached pandemic levels in the highly Hispanic populated South Texas-Mexico Rio Grande Valley (RGV) which also has the highest levels of physical inactivity in the country. Mexican-American women are less active than non-Hispanic white women, moreover many breast cancer survivors who were not previously active will stay inactive; and those who were active often do not return to their previous level of activity. Indeed, up to 80% of breast cancer survivors do not meet the current physical activity guidelines, and for Hispanic women this number is likely higher. Furthermore, breast cancer is still the leading cause of death among cancers within Hispanic women. The benefits of being physically active and leaner for breast cancer survivors include reduced risk for recurrence as well as benefits of weight management, improved physical and emotional well-being, reduced risk for chronic diseases, and second primary cancers. Thus promoting exercise behaviors for Hispanic breast cancer survivors is an important endeavor. Identifying the variables associated with increased exercise adoption is needed to address the negative consequences of an inactive lifestyle on survivorship and stem the alarmingly increasing obesity tide. Here we employed a Social Cognitive Theory-based model to investigate variables affecting beliefs in overcoming barriers to exercise specific to Mexican-American breast cancer survivors living in the South Texas-Mexico RGV community.
Methods: We employed a Social Cognitive Theory-based survey on 38 post-treatment breast cancer survivors who had agreed to participate in a 16-week exercise intervention. After assessment of physical fitness, participants completed a psycho-social questionnaire that included questions of a bi-level acculturation scale (BASH) and SCT-based variables of barriers to exercise self-efficacy (BSE), modeling of exercise (MOD), social support for exercise from friends (SSFR) and family (SSFA) and self-identification as an exerciser (SIE). We conducted a predictive model of BSE as the dependent variable and MOD, SSFR, SSFA and SIE as predictor variables. For any significant predictor variables, we then conducted a mediation analyses on the interaction of BASH on effect to BSE.
Results: Baseline data confirmed that our population was obese (average BMI = 30.7; average body fat = 39.3%) coupled with very poor physical fitness (average cardiorespiratory [VO2] = 18.8 mlO2/kg/min). From a range of scores of 1= “not all confident” to 5 = “extremely confident”, participants reported a low level of BSE (M = 2.61). Participants reported a moderate amount of modeling (M = 3.19, possible range 0-8). For a possible range of 0 = “none” to 5 = “very often”, participants reported some SSFR (M=2.02) and slightly more from SSFA (M=2.43). SIE (M= 3.78) with a possible range of 0 = “do not see myself as an exerciser” to 6 = “very much see myself as an exerciser” was the only predictor of BSE (β = 0.50, p = .002) which was not mediated by acculturation level (% mediation < 0.10%).
Conclusions: As expected, our Mexican-American participants were mostly obese and with poor fitness. Surprisingly only one variable was predictive of BSE for our participants which was a single item instrument that asked the participant how much they saw themselves as an exerciser. Not discounting previous studies that have found modeling of exercise behaviors and social support from significant others as conducive to promoting exercise confidence; our study suggests the importance of self-perception as an exerciser. Our study also suggests the importance of promoting this perception in our Hispanic breast cancer population which may be characterized by obesity and poor physical fitness.
Citation Format: Rose A. Treviño-Whitaker, Sonio D. Garcia, Laura Treviño, Ruth Morris, Gabriela A. Villanueva, Amelie G. Ramirez, Daniel C. Hughes. Promoting exercise in Hispanic cancer survivors. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B30.
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