https://openworks.mdanderson.org/sumexp22/1129/thumbnail.jp

Mama, Scherezade K

Rinehart, Seth M

English

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Background and Purpose• Rural cancer survivors face many health disparities, including higher mortality rates rates versus survivors residing in urban areas.• Rural adults experience higher pandemic-related disparities with higher COVID-19 mortality rates.Rural cancer survivors already experience increased health barriers including less access to resources such as: transportation, insurance, access to quality care, higher education, financial support, and tend to be older than rural cancer survivors.• During the COVID-19 pandemic, rural cancer survivors reported higher psychosocial distress and lower quality of life, as well as lower levels of adequate physical activity (PA).• Higher psychosocial distress is associated with physical inactivity, both leading to worse health outcomes.• Previous studies have looked at the association of increased COVID-19 distress and physical activity.• However, the association is still unclear in rural cancer survivors, as well as whether psychosocial wellbeing could mediate this association.The purposes of this study were to: 1. To explore associations between distress related to COVID-19 and physical activity in rural cancer survivors.2. To explore associations betweenpsychosocial wellbeing and physical activity in rural cancer survivors.3. To explore potential psychosocial mediators of the association between distress related to COVID-19 and physical activity in rural cancer survivors.HYPOTHESIS: We hypothesized that higher COVID-19 distress and poorer psychosocial wellbeing would be associated with lower physical activity in rural cancer survivors and that psychosocial wellbeing may partially mediate the association between distress and physical inactivity.Acknowledgements: Thank you to the HDPAR Lab for their recruitment and data collection assistance, as well as the PPCC participants for their participation.Funding: This study was funded by grants from the Pennsylvania Department of Health (TRK08-Mama-PSU-2016F, PI: Mama) and Penn State’s Clinical and Translational Science Institute (UL1 TR002014, PI: Sonoway). Seth Rinehart is supported by a training grant from the National Cancer Institute (R25CA056452, PA: Mama)Contact InformationSeth Rinehart, MS | srinehar@cougarnet.uh.eduMethodsParticipants• Rural cancer survivors from central Pennsylvania that participated in a Partnering to Prevent and Control Cancer (PPCC) parent study (n=219) were invited via email in April 2020 to complete an additional questionnaire during the pandemic• Those with working email addresses were sent an invitation and link to the online survey (n=195)• Participants who completed the additional questionnaires during the COVID-19 pandemic were included in analyses (n=104)MeasuresAnalysesLinear regression models were used to explore  associations between COVID-19 distress and physical activity and psychosocial wellbeing and physical activity, controlling for age, gender, BMI and education.Meditation analyses included four single-mediator models to assess the indirect effects of COVID-19 distress on physical activity through:• Anxiety• Depressive symptoms• Perceived stress• Negative affectConstruct MeasureCOVID-19 Distress Modified Impact of Event Scale-6 (IES-6) Anxiety Beck Anxiety Inventory (BAI)Depressive SymptomsCenter of Epidemiological Studies Depression Scale (CES-D) Perceived Stress 10-Item Perceived Stress Scale (PSS-10) Negative Affect Positive and Negative Affect Scales (PANAS)Physical Activity International Physical Activity Questionnaire (IPAQ)Demographics N (%)Age (years) 61.9 ± 13.9BMI (kg/m2) 29.1 ± 7.5GenderMaleFemale36 (34.6)68 (65.4)Education< Bachelors= Bachelors> Bachelors38 (36.5)33 (31.7)33 (31.7)Annual Income< $40,000$40,000-79,000≥ $80,00013 (12.5)33 (31.7)53 (51.5)Cancer TypeBreastColorectalGynecologicalProstateOther27 (26.0)12 (11.5)17 (16.3)21 (20.2)27 (26.0)Table 1. ParticipantCharacteristics (N=104)Psychosocial mediators of the association between distress related to COVID-19 and physical activity among rural cancer survivors Seth M. Rinehart1 & Scherezade K. Mama, DrPH21Department of Health and Human Performance, University of Houston2Department of Health Disparities Research, The University of Texas MD Anderson Cancer CenterResultsGreater COVID-19 distress was associated with greater (walking) physical activity (B=80.8, SE=39.4, p=.043). Anxiety (B=-38.9, SE=17.6, p=.030), depressive symptoms (B=-33.0, SE=14.7, p=.028), and negative affect (B=-139.6, SE=67.9, p=.043) were all negatively associated with (moderate/vigorous) physical activity. Anxiety, depressive symptoms, and negative affect, (but not perceived stress) significantly mediated the effect of COVID-19 distress on physical activity in single-mediator models, when controlling for age, gender, BMI and education.ConclusionsRural cancer survivors who reported greater COVID-19 related distress had poorer associated psychosocial wellbeing. Of those psychosocial wellbeing constructs, higher rates of anxiety, depressive symptoms, and negative affect individually showed significant association with lower rates of physical activity. These three acted as significant mediators for moderate/vigorous physical activity as well. Findings point to the need for psychosocial interventions that address pandemic-related distress to improve physical activity in rural cancer survivors. Additional studies are needed to better understand how to improve psychosocial wellbeing to reduce distress and increase physical activity to reduce cancer health disparities in rural communities. Anxiety Depressive SymptomsNegative AffectTable 2. Indirect Effects of Psychosocial Mediators on Physical Activity in Single-Mediator ModelsMediator Effect SE 95% CI (LL; UL)Anxiety -71.6 20.7 -122.8; -30.5Depressive symptoms -46.6 16.4 -79.2; -14.0Negative affect -187.9 77.3 -341.5; -34.3Note: All figures adjusted for gender, age, BMI, and education

Psychosocial mediators of the association between distress related to COVID-19 and physical activity among rural cancer survivors

https://openworks.mdanderson.org/cgi/viewcontent.cgi?article=1129&context=sumexp22

Psychosocial mediators of the association between distress related to COVID-19 and physical activity among rural cancer survivors

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