Associations Among Adherence, Satisfaction, And Intentions In A Canada-wide Exercise Oncology Implementation Study

Promoting adherence and building behavior change skills for continued engagement in exercise behavior is important. Satisfaction, a measure of program acceptability, fosters adherence as well as exercise intentions. PURPOSE: To evaluate the relationship between program adherence, satisfaction, and exercise intentions in the EXercise for Cancer to Enhance Living Well (EXCEL) study. METHODS: Individuals with cancer up to 3 years post treatment with any tumor type were eligible. Delivered in a positive motivational climate to support behavior change, EXCEL’s intervention includes group-based exercise for 10-12 weeks, twice weekly. Exercise behavior change topics to support intentions to exercise are delivered by a qualified exercise professional and include self-monitoring, goal setting, relapse prevention, fatigue management, and social support. Adherence was the number of classes attended over the total number of possible classes (20-24), reported as a percentage. Satisfaction surveys (post-intervention) assessed satisfaction with staff support, the exercise program, level of study burden, degree of reward experienced, as well as intentions to continue to exercise. Unadjusted univariate analyses evaluated relationships between adherence (response variable), each satisfaction measure, and intentions (exposure variables). RESULTS: A total of 343 participants (57.9 years; 83.7% female; 49.6% breast cancer diagnosis) were included, with a mean adherence of 82.9%. Higher adherence rates were associated with higher satisfaction overall (ß = 0.585; p < 0.001), including with study staff support (ß = 0.780; p < 0.001), the exercise program (ß = 1.982; p < 0.001), and the degree of reward felt (ß = 1.929; p < 0.001). Adherence was also associated with intentions for continuing to exercise (ß = 0.753; p = 0.003). Adherence and study burden were not associated (ß = -0.321; p = 0.376). CONCLUSION: These findings highlight the relationship amongst program adherence with program satisfaction and exercise intentions, supporting the use of a positive motivational climate in the implementation of exercise oncology interventions to foster behavior change. Supported by Canadian Institutes of Health Research, Canadian Cancer Society, and Alberta Cancer Foundation grants. Supported by Canadian Institutes of Health Research, Canadian Cancer Society, and Alberta Cancer Foundation grants.