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Factors predicting gains in moderate-to-vigorous physical activity in prostate cancer survivors on androgen deprivation therapy



Whether individual, environmental, and psychosocial factors predict changes in moderate-to-vigorous physical activity (MVPA) is poorly addressed in prostate cancer (PC) survivors undergoing androgen deprivation therapy (ADT).


This secondary analysis of a randomized controlled trial examined changes in MVPA following a supervised personal training (PT), supervised group-based (GROUP) program, or a home-based, smartphone-assisted exercise (HOME) intervention in PC survivors on ADT and explored individual, environmental, and psychosocial predictors of MVPA.


PC survivors on ADT underwent aerobic and resistance training for 6 months via PT, GROUP, or HOME. MVPA was captured via accelerometers and the Godin Leisure-Time Exercise Questionnaire. Changes in MVPA between groups were assessed using linear regression. The following predictors of MVPA were examined using Spearman correlations: the Neighborhood Environment Walkability Scale (NEWS); the Planning, Attitudes, and Behaviours (PAB) scale; the Relatedness to Others in Physical Activity Scale (ROPAS); and individual factors at baseline.


Participants (n = 37) were 69.4 ± 6.5 years old and 78.4% were on ADT for ≥ 3 months. Changes in accelerometry-based bouts and MVPA as well as self-reported MVPA did not differ between groups at 6 months. The Aesthetics domain of the NEWS questionnaire at baseline was the strongest predictor of positive MVPA changes (r = .66). Attitude (r = .64), planning (r = .57), and motivation (r = .50) at baseline were also predictive of engaging in higher MVPA throughout the intervention.


Changes in objective MVPA were modest. Additional emphasis on specific psychosocial and individual factors is important to inform theory-based interventions that can foster PA behavior change in PC survivors on ADT.

Registration # NCT02046837.

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De-identified data will be available from the corresponding author upon reasonable request.

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  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 68:394–424

    PubMed  Google Scholar 

  2. Canadian Cancer Society’s Advisory Committee on Cancer Statistics (2021) Canadian Cancer Statistics 2021

  3. Alibhai SM, Gogov S, Allibhai Z (2006) Long-term side effects of androgen deprivation therapy in men with non-metastatic prostate cancer: a systematic literature review. Crit Rev Oncol Hematol 60:201–215

    Article  Google Scholar 

  4. Casey RG, Corcoran NM, Goldenberg SL (2012) Quality of life issues in men undergoing androgen deprivation therapy: a review. Asian J Androl 14:226–231

    CAS  Article  Google Scholar 

  5. Bigaran A, Zopf E, Gardner J, La Gerche A, Murphy DG, Howden EJ, Baker MK, Cormie P (2021) The effect of exercise training on cardiometabolic health in men with prostate cancer receiving androgen deprivation therapy: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 24:35–48

    CAS  Article  Google Scholar 

  6. Yunfeng G, Weiyang H, Xueyang H, Yilong H, Xin G (2017) Exercise overcome adverse effects among prostate cancer patients receiving androgen deprivation therapy: an update meta-analysis. Medicine (Baltimore) 96:e7368

    Article  Google Scholar 

  7. Sattar S, Haase KR, Bradley C, Papadopoulos E, Kuster S, Santa Mina D, Tippe M, Kaur A, Campbell D, Joshua AM, Rediger C, Souied O, Alibhai S (2021) Barriers and facilitators related to undertaking physical activities among men with prostate cancer: a scoping review Prostate Cancer Prostatic Dis

  8. Keogh JWL SD, Krageloh C, Ryan C, Masters J, Shepherd G, MacLeod R. (2014) Predictors of physical activity and quality of life in New Zealand prostate cancer survivors undergoing androgen-deprivation therapy N Z Med J 123

  9. Hunt-Shanks TT, Blanchard CM, Baker F, Hann D, Roberts CS, McDonald J, Livingston M, Witt C, Ruiterman J, Ampela R, Kaw OC (2006) Exercise use as complementary therapy among breast and prostate cancer survivors receiving active treatment: examination of exercise intention. Integr Cancer Ther 5:109–116

    Article  Google Scholar 

  10. Claudel SE, Shiroma EJ, Harris TB, Mode NA, Ahuja C, Zonderman AB, Evans MK, Powell-Wiley TM (2019) Cross-sectional associations of neighborhood perception, physical activity, and sedentary time in community-dwelling, socioeconomically diverse adults. Front Public Health 7:256

    Article  Google Scholar 

  11. Adams MA, Sallis JF, Conway TL, Frank LD, Saelens BE, Kerr J, Cain KL, King AC (2012) Neighborhood environment profiles for physical activity among older adults. Am J Health Behav 36:757–769

    Article  Google Scholar 

  12. McGowan EL, Fuller D, Cutumisu N, North S, Courneya KS (2017) The role of the built environment in a randomized controlled trial to increase physical activity among men with prostate cancer: the PROMOTE trial. Support Care Cancer 25:2993–2996

    Article  Google Scholar 

  13. Alibhai SM, Santa Mina D, Ritvo P, Sabiston C, Krahn M, Tomlinson G, Matthew A, Segal R, Warde P, Durbano S, O’Neill M, Culos-Reed N (2015) A phase II RCT and economic analysis of three exercise delivery methods in men with prostate cancer on androgen deprivation therapy. BMC Cancer 15:312

    Article  Google Scholar 

  14. Alibhai SMH, Santa Mina D, Ritvo P, Tomlinson G, Sabiston C, Krahn M, Durbano S, Matthew A, Warde P, O’Neill M, Timilshina N, Segal R, Culos-Reed N (2019) A phase II randomized controlled trial of three exercise delivery methods in men with prostate cancer on androgen deprivation therapy. BMC Cancer 19:2

    Article  Google Scholar 

  15. Borg E, Kaijser L (2006) A comparison between three rating scales for perceived exertion and two different work tests. Scand J Med Sci Sports 16:57–69

    CAS  Article  Google Scholar 

  16. Godin G, Shephard RJ (1997) Godin Leisure-Time Exercise Questionnaire. Med Sci Sports Exerc 29:S36–S38

    Google Scholar 

  17. Freedson PS, Melanson E, Sirard J (1998) Calibration of the computer science and applications. Inc accelerometer Med Sci Sports Exerc 30:777–781

    CAS  Article  Google Scholar 

  18. James F Sallis NO, E Fisher (2015) Ecological models of health behavior HEALTH BEHAVIOR THEORY, RESEARCH, AND PRACTICE, pp. 43–64.

  19. Cerin E, Saelens BE, Sallis JF, Frank LD (2006) Neighborhood Environment Walkability Scale: validity and development of a short form. Med Sci Sports Exerc 38:1682–1691

    Article  Google Scholar 

  20. Parker NH, Lee RE, O’Connor DP, Ngo-Huang A, Petzel MQB, Schadler K, Wang X, Xiao L, Fogelman D, Simpson R, Fleming JB, Lee JE, Tzeng CD, Sahai SK, Basen-Engquist K, Katz MHG (2019) Supports and barriers to home-based physical activity during preoperative treatment of pancreatic cancer: a mixed-methods study. J Phys Act Health 16:1113–1122

    Article  Google Scholar 

  21. Trinh L, Larsen K, Faulkner GE, Plotnikoff RC, Rhodes RE, North S, Courneya KS (2016) Social-ecological correlates of physical activity in kidney cancer survivors. J Cancer Surviv 10:164–175

    Article  Google Scholar 

  22. Cerin E, Conway TL, Saelens BE, Frank LD, Sallis JF (2009) Cross-validation of the factorial structure of the Neighborhood Environment Walkability Scale (NEWS) and its abbreviated form (NEWS-A). Int J Behav Nutr Phys Act 6:32

    Article  Google Scholar 

  23. Wilson PMBE (2010) The relatedness to others in Physical Activity Scale: evidence for structural and criterion validity. J Appl Biobehav Res 15:61–87

    Article  Google Scholar 

  24. Courneya KS, Friedenreich CM (1999) Utility of the theory of planned behavior for understanding exercise during breast cancer treatment. Psychooncology 8:112–122

    CAS  Article  Google Scholar 

  25. Ungar N, Wiskemann J, Weissmann M, Knoll A, Steindorf K, Sieverding M (2016) Social support and social control in the context of cancer patients’ exercise: a pilot study. Health Psychol Open 3:2055102916680991

    Article  Google Scholar 

  26. Livingston PM, Craike MJ, Salmon J, Courneya KS, Gaskin CJ, Fraser SF, Mohebbi M, Broadbent S, Botti M, Kent B, Group EU-OC (2015) Effects of a clinician referral and exercise program for men who have completed active treatment for prostate cancer: a multicenter cluster randomized controlled trial (ENGAGE). Cancer 121:2646–2654

    Article  Google Scholar 

  27. Smith L, Lee JA, Mun J, Pakpahan R, Imm KR, Izadi S, Kibel AS, Colditz GA, Grubb RL 3rd, Wolin KY, Sutcliffe S, Yang L (2019) Levels and patterns of self-reported and objectively-measured free-living physical activity among prostate cancer survivors: a prospective cohort study. Cancer 125:798–806

    Article  Google Scholar 

  28. Pedisic Z, Bauman A (2015) Accelerometer-based measures in physical activity surveillance: current practices and issues. Br J Sports Med 49:219–223

    Article  Google Scholar 

  29. Purswani JM, Ohri N, Champ C (2018) Tracking steps in oncology: the time is now. Cancer Manag Res 10:2439–2447

    Article  Google Scholar 

  30. Michie S, van Stralen MM, West R (2011) The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci 6:42

    Article  Google Scholar 

  31. Kamphuis CB, van Lenthe FJ, Giskes K, Huisman M, Brug J, Mackenbach JP (2009) Socioeconomic differences in lack of recreational walking among older adults: the role of neighbourhood and individual factors. Int J Behav Nutr Phys Act 6:1

    Article  Google Scholar 

  32. Zandieh R, Martinez J, Flacke J, Jones P, van Maarseveen M (2016) Older adults’ outdoor walking: inequalities in neighbourhood safety, pedestrian infrastructure and aesthetics Int J Environ Res Public Health 13

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This study was funded by Prostate Cancer Canada. Prostate Cancer Canada had no role in the design of the study, collection, analysis, and interpretation of data in writing the manuscript.

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Authors and Affiliations



All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Heather Leach, Sara Durbano, Daniel Santa Mina, Catherine Sabiston, Efthymios Papadopoulos, Nicole Culos-Reed, Shabbir Alibhai, and George Tomlinson. The first draft of the manuscript was written by Efthymios Papadopoulos, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Shabbir M. H. Alibhai.

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Ethics approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the institutional review boards of the University Health Network and the Tom Baker Cancer Centre.

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Informed consent was obtained from all participants included in the study.

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Patients signed informed consent regarding publishing their data.

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The authors declare no competing interests.

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Papadopoulos, E., Leach, H.J., Tomlinson, G. et al. Factors predicting gains in moderate-to-vigorous physical activity in prostate cancer survivors on androgen deprivation therapy. Support Care Cancer (2022).

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  • Physical activity
  • Behavior change
  • Environmental predictors
  • Androgen deprivation
  • Prostate cancer