Abstract
Background: Exercise reduces cancer-related fatigue and improves functional capacity in cancer survivors; however, who responds most to training remains unclear. We aimed to identify predictors and moderators of cancer survivors' response to a 30-week community-based exercise program. Methods: Participants were 229 adults (Mage=54.9 years, 82.1% female, 44% undergoing treatment) diagnosed with cancer who participated in the Wellspring Cancer Exercise Program. Self-report and objective data were collected at pre- (week 0), mid- (weeks 10 and 20), and post-intervention (week 30), and at follow-up (week 46). Separate generalized estimating equation regression models were tested for each putative predictor/moderator (i.e., age, sex, marital status, ethnicity, body mass index [BMI], vocational status, comorbidity index, treatment status, cancer stage, exercise self-efficacy beliefs, extracurricular exercise). Results: In models with cancer-related fatigue as the outcome, sex, vocational status, and self-efficacy beliefs had significant main effects (Wald ?2?4.62, p<.05), and interaction effects were significant between time and age, ethnicity, and extracurricular exercise (Wald ?2=4.03, p<.05). In models with functional capacity as the outcome, age, marital status, and self-efficacy beliefs had significant main effects (Wald ?2?3.97, p<.05), and interaction effects were significant between time and BMI and cancer stage (Wald ?2?11.61, p<.05). Conclusions: Although cancer survivors responded favourably to a community-based exercise program, some responded better, namely those who were younger, women, Caucasian, married/cohabiting, more active, had lower BMIs, diagnosed with earlier stage cancer, working/transitioning to work, and had higher self-efficacy beliefs. Research that addresses how to optimize effects among those who are predicted to benefit less is needed.
