Advertisement

Supportive Care in Cancer

, Volume 26, Issue 1, pp 231–240 | Cite as

Perceived barriers and preferred components for physical activity interventions in African-American survivors of breast or endometrial cancer with type 2 diabetes: the S.U.C.C.E.S.S. framework

  • Kristin Z. Black
  • La-Shell Johnson
  • Carmen D. Samuel-Hodge
  • Lavanya Gupta
  • Aditi Sundaresan
  • Wanda K. NicholsonEmail author
Original Article

Abstract

Purpose

African-American (AA) female cancer survivors share a disproportionate burden of diabetes compared to their white counterparts. Our objectives were to explore the perspectives of AA survivors with type 2 diabetes on perceived barriers to physical activity (PA) and preferences for a PA intervention and develop a framework for a PA program after cancer treatment.

Methods

Trained interviewers conducted semi-structured interviews with AA survivors of breast or endometrial cancer with diabetes (total n = 20; 16 breast, 4 endometrial). Thirteen open-ended questions were posed to stimulate discussions, which were audio recorded and transcribed verbatim. Two investigators independently reviewed transcriptions and extracted coded quotations to identify major themes.

Results

Median age of participants was 63 years. Nine themes were identified that focused on post-treatment physical symptoms (e.g., lymphedema, bone/joint pain, depression symptoms and self-motivation as barriers to PA, exercise routines tailored to physical limitations and peer partners and program leaders who understand their emotional health needs). The S.U.C.C.E.S.S. framework summarizes the survivors’ preferences for an effective lifestyle intervention: Support efforts to maintain PA, Understand physical and depression symptoms, Collaborate with multi-disciplinary provider, Coordinate in-person intervention activities, Encourage partnerships among survivors for comorbidity risk reduction, develop Sustainable coping strategies for side effects of treatment, and Share local community resources.

Conclusions

Survivors verbalized the need for a multi-disciplinary team to assist with their psychosocial needs and physical limitations to achieve their PA goals, as integrated into the S.U.C.C.E.S.S. framework.

Implications for cancer survivors

The S.U.C.C.E.S.S. framework reflects the perspectives of survivors with type 2 diabetes and may help to inform post-treatment programs.

Keywords

African American women Cancer survivors Type 2 diabetes Physical activity Breast cancer Endometrial cancer 

Notes

Compliance with ethical standards

Funding

Dr. Nicholson was funded in part by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK P30DK093002) and the Agency for Health Care Research and Quality (1P50H502341801).

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in our study involving human participants were in accordance with the ethical standards of the University of North Carolina at Chapel Hill and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The University of North Carolina at Chapel Hill Institutional Review Board (#15-0162) approved the study.

Informed consent

Written or verbal informed consent was obtained from all individual participants included in the study.

Supplementary material

520_2017_3839_MOESM1_ESM.docx (16 kb)
ESM 1 (DOCX 15 kb)

References

  1. 1.
    Ogden CL, Carroll MD, Kit BK, Flegal KM (2013) Prevalence of obesity among adults: United States, 2011–2012. NCHS Data Brief:1–8Google Scholar
  2. 2.
    Tammemagi CM, Nerenz D, Neslund-Dudas C, Feldkamp C, Nathanson D (2005) Comorbidity and survival disparities among black and white patients with breast cancer. JAMA 294:1765–1772CrossRefGoogle Scholar
  3. 3.
    Stava CJ, Beck ML, Feng L, Lopez A, Busaidy N, Vassilopoulou-Sellin R (2007) Diabetes mellitus among cancer survivors. J Cancer Surviv 1:108–115CrossRefGoogle Scholar
  4. 4.
    Beckles GLA, Thompson-Reid PE. Diabetes and women’s health across the life stages: a public health perspective. Atlanta, GA; 2001Google Scholar
  5. 5.
    Giovannucci E, Harlan DM, Archer MC, Bergenstal RM, Gapstur SM, Habel LA et al (2010) Diabetes and cancer: a consensus report. Diabetes Care 33:1674–1685CrossRefGoogle Scholar
  6. 6.
    Centers for Disease Control and Prevention. Data and statistics: physical activity. 2010Google Scholar
  7. 7.
    McTiernan A, Irwin M, Vongruenigen V (2010) Weight, physical activity, diet, and prognosis in breast and gynecologic cancers. J Clin Oncol 28:4074–4080CrossRefGoogle Scholar
  8. 8.
    Chlebowski RT, Aiello E, McTiernan A (2002) Weight loss in breast cancer patient management. J Clin Oncol 20:1128–1143CrossRefGoogle Scholar
  9. 9.
    Kulik NL, Fisher EB, Ward DS, Ennett ST, Bowling JM, Tate DF (2014) Peer support enhanced social support in adolescent females during weight loss. Am J Health Behav 38:789–800CrossRefGoogle Scholar
  10. 10.
    American Cancer Society. Cancer facts & figures 2016. Atlanta, GA; 2016Google Scholar
  11. 11.
    Mohamadi S, Tate DJ, Vakurov A, Nelson A (2014) Electrochemical screening of biomembrane-active compounds in water. Anal Chim Acta 813:83–89CrossRefGoogle Scholar
  12. 12.
    Smits A, Lopes A, Das N, Bekkers R, Galaal K (2014) The impact of BMI on quality of life in obese endometrial cancer survivors: does size matter? Gynecol Oncol 132:137–141CrossRefGoogle Scholar
  13. 13.
    Ward KK, Shah NR, Saenz CC, McHale MT, Alvarez EA, Plaxe SC (2012) Cardiovascular disease is the leading cause of death among endometrial cancer patients. Gynecol Oncol 126:176–179CrossRefGoogle Scholar
  14. 14.
    Ballard-Barbash R, Friedenreich CM, Courneya KS, Siddiqi SM, McTiernan A, Alfano CM (2012) Physical activity, biomarkers, and disease outcomes in cancer survivors: a systematic review. J Natl Cancer Inst 104:815–840CrossRefGoogle Scholar
  15. 15.
    Löf M, Bergström K, Weiderpass E (2012) Physical activity and biomarkers in breast cancer survivors: a systematic review. Maturitas 73:134–142CrossRefGoogle Scholar
  16. 16.
    Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL et al (2012) Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 62:243–274CrossRefGoogle Scholar
  17. 17.
    Clark H, Ko EM, Kernodle A, Harris A, Moore DT, Gehrig PA, Bae-Jump V (2016) Endometrial cancer survivors’ perspectives on obesity counseling: are we seizing the moment? Int J Gynecol Cancer 26:318–324CrossRefGoogle Scholar
  18. 18.
    Joseph RP, Ainsworth BE, Keller C, Dodgson JE (2015) Barriers to physical activity among African American women: an integrative review of the literature. Women Health 55:679–699CrossRefGoogle Scholar
  19. 19.
    McLeroy KR, Bibeau D, Steckler A, Glanz K (1988) An ecological perspective on health promotion programs. Health Educ Q 15:351–377CrossRefGoogle Scholar
  20. 20.
    Carolina Data Warehouse for Health (CDW-H); University of North Carolina Translational and Clinical Sciences Institute. https://tracs.unc.edu/index.php/services/biomedical-informatics/cdw-h. Accessed 28 July 2017
  21. 21.
    The UNC Health registry/cancer survivorship cohort https://tracs.unc.edu/index.php/services/biomedical-informatics/cdw-h (last accessed January 2 2017). No title
  22. 22.
    Miles MBM, Huberman AM, Saldaña J (2014) Qualitative data analysis: a methods sourcebook, 3rd edn. SAGE Publications, Thousand Oaks, CAGoogle Scholar
  23. 23.
    Strauss AL, Corbin JM (2007) Basics of qualitative research: techniques and procedures for developing grounded theory, 3rd edn. SAGE Publications, Thousand Oaks, CAGoogle Scholar
  24. 24.
    Conlon BA, Kahan M, Martinez M, Isaac K, Rossi A, Skyhart R et al (2015) Development and evaluation of the curriculum for BOLD (Bronx oncology living daily) healthy living: a diabetes prevention and control program for underserved cancer survivors. J Cancer Educ 30:535–545CrossRefGoogle Scholar
  25. 25.
    Jernigan AM, Al T, FA SAJ (2013) Obesity management in gynecologic cancer survivors: provider practices and attitudes. Am J Obstet Gynecol 208:e1–e8CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Health Behavior, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillUSA
  3. 3.Center for Health Promotion and Disease PreventionUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Department of Nutrition, Gillings School of Global Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  5. 5.Division of Public Health, Cancer Prevention and Control BranchNorth Carolina Department of Health and Human ServicesChapel HillUSA
  6. 6.Patient-Centered Program on Women’s Endocrine and Reproductive Health (PoWER)University of North Carolina at Chapel HillChapel HillUSA
  7. 7.Department of Obstetrics and Gynecology Center for Women’s Health ResearchUniversity of North Carolina at Chapel HillChapel HillUSA

Personalised recommendations