JMIR Publications

ABSTRACT

Background:

Cancer survivors who meet physical activity (PA) recommendations experience better health outcomes and with the growing availability of wearable activity trackers (WATs), it may be easier to track PA. However, it is unknown what motivates cancer survivors for wearing these devices.

Objective:

The purpose of this study is to investigate the associations between motivations for exercise, WAT use, and meeting the recommended amount of PA among a cohort of cancer survivors.

Methods:

Data on WAT users who reported having a cancer diagnosis were analyzed from the National Cancer Institute’s Health Information National Trends Survey (HINTS) 5 Cycle 3. Included were all survivors with complete information on demographics, exercise motivations, WAT use, and minutes of moderate to vigorous PA (MVPA) per week (n=608). To assess exercise motivations, participant’s responses to “why you start/continue exercise regularly” with separate questions asking if the reason was “pressure, appearance, guilt, or enjoyment” were used. Multivariable logistic regression models were used to assess motivational predictors of WAT use and the association between WAT use and meeting the U.S. recommended amount of MVPA. A separate cluster analysis was conducted to identify exercise motivational profiles that were associated with using WATs.

Results:

The mean age of the cohort was 66.9 years (± 12.1). The majority were non-Hispanic white (n = 473, 78%), female (n = 322, 54.9%), and skin cancer was the most commonly reported diagnosed cancer (n = 154, 27.8%). Cancer survivors who used WATs were 1.6 times more likely to meet MVPA recommendations compared to those who did not use WATs (OR: 1.65, 95% CI: 1.03, 2.65) (P=.04). When exercise motivations were assessed independently, cancer survivors who reported not feeling any guilt as a motivation for exercise were 73% less likely to use a WAT compared to those that felt any guilt (OR: 0.27, 95% CI: 0.14, 0.54) (P<.001). Three distinct motivational profiles emerged from the cluster analysis that differed significantly across motivation and class membership. WAT users had an increased probability of membership in a motivational profile characterized as being strongly motivated to exercise by guilt, appearance, and enjoyment (OR: 4.06, 95% CI:1.90, 8.65, P<.001).

Conclusions:

Among this cohort of cancer survivors, WAT users were significantly more likely to meet PA recommendations. Cancer survivors who reported guilt as an exercise motivation were significantly more likely to use WATs. However, when examining clusters of motivation, WAT users were more likely to be in a profile motivated to exercise by a mix of intrinsic and extrinsic motivations, guilt, enjoyment, and appearance. Given the health benefits of PA for cancer survivors, technology focused interventions that target increasing exercise motivation may increase WAT use and PA participation among cancer survivors.