Taking control: Health engagement control strategies, physical activity, and the mediating effects of psychological needs among breast cancer survivors

Abstract

Women diagnosed with breast cancer face an abundance of health challenges related to the disease and related treatments. Physical activity can help mitigate those challenges by improving health and well-being, and restoring a sense of control over one's health that is often lost. Survivors are aware of these benefits yet remain inactive. Health engagement control strategies (HECS), or a propensity to address health needs, are associated with increased motivation for health behaviors and may help in the satisfaction of basic psychological needs. Based on theoretical tenets and empirical evidence, basic psychological needs are antecedents of physical activity behavior, yet are rarely tested prospectively in this population. The purpose of this study was to examine satisfaction of basic psychological needs for physical activity as mediators of the relationship between HECS and physical activity in a sample of recently treated breast cancer survivors. Women (N=149; Mage=55, SD=11 years) completed questionnaires immediately post-primary treatment (HECS), three months later (basic psychological needs satisfaction), and wore an accelerometer for a 7-day period 9-months post-treatment to assess moderate-to-vigorous physical activity. Controlling for relevant personal and cancer specific variables, the relationship between HECS and physical activity was mediated by the satisfaction of autonomy (point estimate=1.18(83); 95% CI=.11 to 3.65), but not competence or relatedness. Findings remained consistent when controlling for baseline physical activity. These findings highlight the importance of engaging in one's healthcare and building a sense of autonomy for physical activity to support physical activity levels in the early post-treatment period following a breast cancer diagnosis.

Acknowledgments: Canadian Institutes for Health Research, Canada Research Chairs Program