Predictors of Physical Activity Maintenance in Colorectal Cancer Survivors

Colorectal cancer survivors report some of the lowest levels of PA of any survivor group, and
increasing physical activity in colorectal cancer survivors presents an enormous opportunity
to improve cancer control and survivorship outcomes. Previous interventions have addressed
the need to increase PA in colorectal cancer survivors, but only one study has targeted
long-term, sustainable PA behavior change in this population. It may take considerable time
for PA to impact physiological, psychological and survival outcomes, and therefore
interventions should find ways to facilitate long-term physical activity once the
intervention ends.

One strategy that has been successful for increasing long-term physical activity adherence in
many other populations is group mediated cognitive-behavioral (GMCB) physical activity
interventions. GMCB PA interventions deliver PA in a group-based format, use behavior change
strategies based on social cognitive theory, and capitalize on group dynamics as a mechanism
of change.Group-dynamics target the group's environment, structure and processes, with the
goal of fostering group cohesion. Group cohesion is associated with physical activity
adherence and long-term maintenance in many populations. In colorectal cancer survivors, this
type of intervention may be particularly effective for increasing physical activity and
quality of life by offering a new network of social support, and the opportunity to be
surrounded by others with a shared experience.

Without supportive social and physical environments, many individuals return to previous low
PA levels after an intervention is complete, and it is theorized that in order to achieve
long-term maintenance of physical activity, a multi-level approach is needed. Built
environment characteristics such as walkability, and access to parks and recreation
facilities are also associated with physical activity, and for colorectal cancer survivors,
the type of built environment support that is important for PA may differ from the general
population due to physical limitations (e.g. multiple co-morbid contentions, ostomy and
stoma) that affect their physical activity abilities.

The objectives of this research project are:

Aim 1: Compare the effects of a 12-week GMCB physical activity intervention to an
individually supervised intervention on PA maintenance in colorectal cancer survivors.

Aim 2: Examine the effects of a 12-week GMCB physical activity intervention and an
individually supervised intervention on physical fitness, QOL, and sleep quality in
colorectal cancer survivors.

Aim 3: Explore individual, social, and environmental factors that are associated with
physical activity maintenance, 12-months after intervention completion.

Inclusion Criteria:

1. Provision to sign and date the consent form

2. Fluent in English

3. Stated willingness to comply with all study procedures and be available for the
duration of the study

4. Be a male or female aged 50-80

5. Histologically confirmed cancer of the colon or rectum (stages II-III)

6. Completed resection or other surgery 3-24 months prior to enrollment

7. Received and completed any chemotherapy and/or radiation within one the previous year

Exclusion Criteria:

1. Evidence of metastatic disease

2. Existing participation in ≥150 minutes per week of at least moderate intensity PA

3. Known contraindications for exercise or not able to safely participate in exercise

4. Pregnant women (no testing required)