Factors associated with adherence to physical activity guidelines in patients with prostate cancer Kelly Chipperfield 1 *, Jane Fletcher 1,2 , Jeremy Millar 3,5 , Joanne Brooker 1,2 , Robin Smith 3 , Mark Frydenberg 4 , Tracy Oh 3 and Sue Burney 1,2 1 School of Psychology and Psychiatry, Monash University, Melbourne, Australia 2 Cabrini Monash Psycho-oncology, Cabrini Institute, Cabrini, Melbourne, Australia 3 William Buckland Radiotherapy Centre, The Alfred Hospital, Melbourne, Australia 4 Department of Surgery, Monash University, Department of Urology, Monash Medical Centre, Southern Health, Melbourne, Australia 5 Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia *Correspondence to: School of Psychology and Psychiatry, Monash University, Clayton, VIC, 3168. E-mail: Kelly. chipperfield@monash.edu Received: 21 November 2012 Revised: 22 April 2013 Accepted: 24 April 2013 Abstract Objective: This study aimed to estimate the proportion of patients with prostate cancer (PCa) meeting the National Physical Activity Guidelines of Australia (NPAGA) and determine sociodemographic and medical factors associated with meeting these guidelines. Secondary aims included examining physical activity (PA) levels by treatment type and domain (leisure, work, transport and domestic) and establishing a predictive model of the likelihood that men with PCa would meet NPAGA. Methods: A questionnaire was mailed to 638 men with PCa attending for treatment at the Alfred, Cabrini or Latrobe Regional Hospitals during 2010 and 2011, with a response rate of 59%. Measures included International Physical Activity Questionnaire, Hospital Anxiety and Depression Scale, Functional Assessment of Cancer Therapy – Prostate and sociodemographic items. Inclusion criteria were English speaking men aged 40 to 80 years, who had undergone radiotherapy (RT) between 9 and 30 months prior to the survey. Results: Of 356 men with PCa, less than half were meeting NPAGA (41.9%). Lower education and quality of life (QoL), a higher number of comorbid conditions and symptoms of depression and anxiety were associated with decreased leisure-time PA. Patients treated with androgen deprivation therapy were significantly less active than patients treated with RT only. Logistic regression analyses indicated that the likelihood of meeting NPAGA was significantly lower with higher levels of depressive symptoms and lower levels of education. Conclusions: Meeting NPAGA is associated with higher QoL and psychosocial well-being in men with PCa. These findings contribute important information for targeting PA interventions to PCa survivors. Copyright © 2013 John Wiley & Sons, Ltd. Introduction Prostate cancer (PCa) represents a significant global public health burden and is the most commonly diagnosed internal cancer in Australia, with approximately 20 000 cases identified per year [1]. Primary treatment alterna- tives for PCa include active surveillance, radical prostatec- tomy, external beam radiotherapy, brachytherapy and androgen deprivation therapy (ADT) [2]. Although the effectiveness of these treatments in increasing survival and delaying disease progression has been established [2–4], the negative impact of treatment for PCa on physi- cal function, psychosocial well-being and quality of life (QoL) is widely recognised [5,6]. Given the increasing prevalence of PCa [2] and the impact of treatment on both physical and psychological aspects of QoL, it is important to identify clinically beneficial and cost-effective interven- tions to improve well-being in this patient group. Physical activity (PA) has been proposed as a behav- ioural intervention to improve health and well-being outcomes for patients with cancer [7]. There is evidence, albeit tenuous, that engagement in regular PA after cancer diagnosis may reduce the risk of death from disease [8,9]. Furthermore, PA has been associated with an improve- ment in overall QoL and health status in patients with cancer and cancer survivors [10–14]. The results of numerous studies highlight the importance of PA in counteracting the negative side effects associated with treatment for PCa and demonstrate improvements in QoL and psychosocial well-being with regular PA partic- ipation [13–19]. Importantly, findings by Galvao et al. [20] established that PA can be safely tolerated in this pa- tient group, with no reported effect on prostate-specific antigen levels, testosterone production or disease activity. Previous research indicates that patients with cancer recognise the benefits of PA and are interested in PA Copyright © 2013 John Wiley & Sons, Ltd. Psycho-Oncology Psycho-Oncology (2013) Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/pon.3310