Physical activity and exercise self-regulation in cancer survivors: A qualitative study

Objective: Despite the benefits of physical activity, many cancer survivors do not adhere to clinically recommended levels. This qualitative study investigated factors of self-regulation contributing to survivor physical activity patterns. Methods: Participants attended focus groups with prompts on exercise habits and self-regulation on the basis of social cognitive theory, self-determination theory, and self-regulation theory. Content analysis with a priori codes was conducted to identify emergent themes. Results: Participants (n = 35) were predominately older (63.7 y ± 10.8), female (69%), white (71%), and breast cancer (60%) survivors, with 41% not meeting activity guidelines. Emergent themes included exercise goal development, selection, and attainment; exercise planning; and self-reward. Participants tended to develop values-based, general goals rather than action-based, measurable goals. Goal attainment success emerged as a facilitator of future goal performance; completing a current goal facilitated subsequent goal attainment, while failure hindered future goal completion. Rather than having deliberate intentions to schedule exercise, participants exercised if expedient in the context of normal daily activities. Food consumption emerged as a major mechanism for self-reward. Conclusions: Our findings suggest that values-based goals, unplanned activity, influence from previous goal attempts, and self-reward were important factors related to self-regulation. Interventions designed to improve self-regulation may consider facilitating development of autonomous, value-based goals, assisting in development of strategies for future goals if current goals are not met, endorsing exercise as a scheduled activity, and introducing healthy self-reward alternatives.