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Background: Physical activity and exercise appear to benefit patients receiving preoperative treatment for cancer. Supports and barriers must be considered to increase compliance with home-based exercise prescriptions in this setting. Such influences have not been previously examined. Methods: The authors used quantitative and qualitative methods to examine potential physical activity influences among patients who were prescribed home-based aerobic and strengthening exercises concurrent with preoperative chemotherapy or chemoradiation for pancreatic cancer. Physical activity was measured using exercise logs and accelerometers. Social support for exercise and perceived neighborhood walkability were measured using validated surveys. Relationships between influences and physical activity were evaluated using linear regression analyses and qualitative interviews. Results: Fifty patients received treatment for a mean of 16 (9) weeks prior to planned surgical resection. Social support from friends and neighborhood esthetics were positively associated with physical activity (P < .05). In interviews, patients confirmed the importance of these influences and cited encouragement from health care providers and desire to complete and recover from treatment as additional motivators. Conclusions: Interpersonal and environmental motivators of exercise and physical activity must be considered in the design of future home-based exercise interventions designed for patients receiving preoperative therapy for cancer.

Parker and Basen-Engquist are with the Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX. R.E. Lee is with the Edson College of Nursing and Health Innovation, Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, AZ. O’Connor is with the Department of Health and Human Performance, University of Houston, Houston, TX. Ngo-Huang is with the Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX. Petzel, J.E. Lee, Tzeng, and Katz are with the Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX. Schadler is with the Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX. Wang and Xiao are with the Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX. Fogelman is with the Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX. Simpson is with the Department of Nutritional Sciences, College of Agriculture & Life Sciences, The University of Arizona, Tucson, AZ; the Department of Pediatrics, College of Medicine, The University of Arizona, Tucson, AZ; and the Department of Immunobiology, College of Medicine, The University of Arizona, Tucson, AZ. Fleming is with the Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL. Sahai is with the Department of General Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX.

Parker (nhparker@mdanderson.org) is corresponding author.
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