Johanna Depenbusch1,2, Alexander Haussmann1,3, Angeliki Tsiouris4,5, Laura Schmidt3, Joachim Wiskemann4, Nadine Ungar3, Monika Sieverding3, Karen Steindorf1. 1. Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany. 2. Medical Faculty, Heidelberg University, Heidelberg, Germany. 3. Institute of Psychology, Heidelberg University, Heidelberg, Germany. 4. Division of Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and Heidelberg University Hospital, Heidelberg, Germany. 5. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Johannes Gutenberg University Mainz, Mainz, Germany.
Abstract
OBJECTIVES: The purpose of this study was to examine the association between physicians' exercise counseling and post-diagnosis physical activity (PA) in patients with cancer by investigating the mediating role of patients' satisfaction with exercise counseling as well as the moderating role of patients' previous PA. METHODS: The study sample consisted of 1002 people with cancer (503 breast, 265 prostate, and 234 colorectal cancer). Participants reported their pre- and post-diagnosis moderate-to-vigorous PA (MVPA) levels, indicated whether their physician had covered different steps of exercise counseling as defined by the 5A framework (Assess, Advise, Agree, Assist, and Arrange) and rated their satisfaction with exercise counseling. A conditional process analysis was used to determine the direct and indirect effects of counseling on post-diagnosis MVPA through satisfaction at different levels of pre-diagnosis MVPA. RESULTS: Physicians' exercise counseling was associated with post-diagnosis MVPA in patients with cancer. However, the association differed by patients' pre-diagnosis MVPA (P = .039). While counseling was directly associated with higher post-diagnosis MVPA for individuals with low pre-diagnosis MVPA (CI: 0.02-0.20, P = .014), the effect was mediated through satisfaction with exercise counseling for previously highly active individuals (Boot CI: 0.01-0.08). CONCLUSIONS: Our findings emphasize the relevance of physicians' exercise counseling for PA in patients with cancer. However, the results indicate that in order to effectively influence patients' PA, it appears important to provide a comprehensive counseling that is adjusted to the patients' exercise experiences.
OBJECTIVES: The purpose of this study was to examine the association between physicians' exercise counseling and post-diagnosis physical activity (PA) in patients with cancer by investigating the mediating role of patients' satisfaction with exercise counseling as well as the moderating role of patients' previous PA. METHODS: The study sample consisted of 1002 people with cancer (503 breast, 265 prostate, and 234 colorectal cancer). Participants reported their pre- and post-diagnosis moderate-to-vigorous PA (MVPA) levels, indicated whether their physician had covered different steps of exercise counseling as defined by the 5A framework (Assess, Advise, Agree, Assist, and Arrange) and rated their satisfaction with exercise counseling. A conditional process analysis was used to determine the direct and indirect effects of counseling on post-diagnosis MVPA through satisfaction at different levels of pre-diagnosis MVPA. RESULTS: Physicians' exercise counseling was associated with post-diagnosis MVPA in patients with cancer. However, the association differed by patients' pre-diagnosis MVPA (P = .039). While counseling was directly associated with higher post-diagnosis MVPA for individuals with low pre-diagnosis MVPA (CI: 0.02-0.20, P = .014), the effect was mediated through satisfaction with exercise counseling for previously highly active individuals (Boot CI: 0.01-0.08). CONCLUSIONS: Our findings emphasize the relevance of physicians' exercise counseling for PA in patients with cancer. However, the results indicate that in order to effectively influence patients' PA, it appears important to provide a comprehensive counseling that is adjusted to the patients' exercise experiences.
Authors: Johanna Depenbusch; Joachim Wiskemann; Alexander Haussmann; Angeliki Tsiouris; Laura Schmidt; Nadine Ungar; Monika Sieverding; Karen Steindorf Journal: Int J Behav Med Date: 2021-09-22