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Multicenter Study
. 2009 Feb;18(2):656-63.
doi: 10.1158/1055-9965.EPI-08-0352. Epub 2009 Feb 3.

Race/ethnicity, physical activity, and quality of life in breast cancer survivors

Ashley Wilder Smith  1 , Catherine M Alfano, Bryce B Reeve, Melinda L Irwin, Leslie Bernstein, Kathy Baumgartner, Deborah Bowen, Anne McTiernan, Rachel Ballard-Barbash
Affiliations
Multicenter Study

Race/ethnicity, physical activity, and quality of life in breast cancer survivors

Ashley Wilder Smith et al. Cancer Epidemiol Biomarkers Prev. 2009 Feb.

Abstract

Purpose: To examine associations between recreational physical activity and quality of life (QOL) in a multiethnic cohort of breast cancer survivors, specifically testing whether associations are consistent across racial/ethnic groups after accounting for relevant medical and demographic factors that might explain disparities in QOL outcomes.

Methods: Data were collected from a population-based cohort of non-Hispanic White (n = 448), Black (n = 197), and Hispanic (n = 84) breast cancer survivors (stage 0-IIIa) in the Health, Eating, Activity, and Lifestyle Study. Physical activity was assessed approximately 2.5 years after breast cancer diagnosis, with QOL assessed on average 6 to 12 months later. We used structural equation modeling to examine relationships between meeting recommended levels of physical activity and QOL, stratifying by race/ethnicity and adjusting for other demographic, comorbidity, and treatment effects.

Results: Structural equation modeling indicated that meeting recommended levels of physical activity had significant positive associations with QOL for Black and non-Hispanic White women (P < 0.05). Fewer Black women reported meeting recommended physical activity levels (P < 0.001), but meeting recommendations was associated with better QOL. Post hoc tests showed that meeting physical activity recommendations was specifically associated with better vitality, social functioning, emotional roles, and global QOL (P < 0.05 for all).

Conclusions: These results suggest that meeting recommended levels of physical activity is associated with better QOL in non-Hispanic White and Black breast cancer survivors. Findings may help support future interventions among breast cancer survivors and promote supportive care that includes physical activity, although more research is needed to determine these relationships among Hispanic and other ethnic minority women.

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Figures

Figure 1
Figure 1
A multi-group multiple-indicator/multiple-cause structural equation model testing the association between physical activity and quality of life. Chi-square (χ2) =388.36; df =185; p<.001; comparative fit index =0.91; Tucker-Lewis index =0.89; root mean square error of approximation=0.06; standardized root mean square residual=0.05; Solid lines represent significant paths, B=Black, W=non-Hispanic White, H=Hispanic, **p<.01; *p<.05.M Paths (γ coefficients) between observed measures (in rectangles) on the left side and the latent outcome variable (in the oval) show the influence of PA and the covariates on QOL. The paths (λ coefficients) from the latent variable to the observed measures on the right side indicate that QOL is measured by six scales or subscales. When the relationship between PA (or a covariate) and QOL varied by race/ethnicity, path coefficients are provided for each racial/ethnic group.
Figure 2
Figure 2
Least squares mean values of SF-36 subscales within physical activity and Race/Ethnicity categories
Figure 3
Figure 3
Least squares mean values of A) Ladder of Life and B) Impact on social/emotional life scales within physical activity and race/ethnicity categories
See this image and copyright information in PMC

References

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