Motivation to Participate in a Nutrition and Physical Activity Intervention During Chemotherapy for Breast Cancer: A Qualitative Study.

OBJECTIVE

To explore the motivations for participating in a combined nutrition and exercise intervention starting during chemotherapy for breast cancer.

METHODS

The Lifestyle, Exercise, and Nutrition early after Diagnosis (LEANer) trial randomized 173 women newly diagnosed with stage I-III breast cancer to a yearlong nutrition and exercise intervention (N = 87) or usual care (N = 86) during chemotherapy to assess the effect on chemotherapy adherence. Upon completion of the trial, using a stratified purposeful sampling method, a subset of women randomized to the intervention arm completed a one-time, individual, semi-structured interview. Interviews were transcribed verbatim and analyzed using thematic analysis.

RESULTS

Among the 29 interviews, we identified four key themes related to women's motivations for participating in a lifestyle intervention during chemotherapy. These included (1) Proactivity - a pursuit of opportunities to improve and prioritize health; (2) Altruism - a desire to help others with breast cancer and advance the science around lifestyle factors and treatment outcomes; (3) Lack of perceived harm - the benefits outweighed risks; and (4) Oncologist recommendation - an endorsement from their clinical provider played a critical role.

CONCLUSIONS

Women with breast cancer were motivated to participate in a nutrition and exercise intervention initiated during chemotherapy because of factors relating to optimizing their own health, altruistic desires, perceived lack of harm, and their oncologist's recommendation. Compared to post-treatment, the opportunity to be proactive and having an oncologist recommendation emerged as unique motivators. Understanding these drivers of motivation can enhance recruitment and promote engagement and adherence in future interventions during active cancer treatment.