Factors influencing non-participation in an exercise program
and attitudes towards physical activity amongst cancer survivors
Sarah J. Hardcastle
Paul A. Cohen
Received: 4 July 2017 /Accepted: 25 October 2017 /Published online: 31 October 2017
Springer-Verlag GmbH Germany 2017
Purpose The purposes of this study are to investigate factors
influencing non-participation in a structured exercise program
for cancer survivors and to explore survivors’ experiences and
attitudes in relation to physical activity participation.
Methods Face-to-face or telephone interviews were conduct-
ed with individuals who had registered for, or engaged in, the
‘Life Now’ exercise program run by Cancer Council Western
Australia. Participants were 20 cancer survivors (mean age
63.90 years, SD 15.29) who had either cancelled their regis-
tration or withdrawn from the exercise program during the
preceding 2 years. Interview transcripts were analysed using
Results Seven main themes emerged: availability of the
program; access, time and cost; lack of motivation or
confidence; unwell or fatigued; physical activity preferences;
knowledge of physical activity guidelines; and lack of referral
or advice. The main barriers were contextual and included
availability of, and access to, the program. Participants
expressed a preference for home-based physical activity.
Conclusions Interventions aimed at promoting physical activ-
ity in cancer survivors should offer home-based programs and
include referral and advice from oncologists.
Implications for cancer survivors Increasing cancer survi-
vors’ participation in, and compliance with, exercise programs
may require home-based strategies and referrals from oncolo-
gists to allied health professionals to individualise care.
Keywords Cancer survivors
Physical activity (PA) attenuates many of the adverse effects
of cancer and its treatment, including fatigue and psycholog-
ical distress [1, 2]. Recent evidence suggests that physical
activity during or following treatment reduces the risks of
cancer recurrence and cardiovascular disease (CVD) [3, 4].
Compared to the general population, survivors are at increased
risk of secondary cancers, CVD and functional decline 
which share common risk factors .
Insufficient PA, low fruit and vegetable intake, smoking
and alcohol consumption increase susceptibility to cancer,
CVD and other chronic diseases . Increased PA may pro-
mote cancer survivors’ health, well-being and longevity .
Accordingly, there has been an increase in the development of
exercise programs for cancer survivors . The guidelines for
PA are to accumulate at least 150 min of moderate-intensity
PA per week .
However, between 50 and 70% of cancer
survivors fail to meet these recommendations [8, 9].
Despite an increase in exercise programs specifically tai-
lored to cancer survivors, little is known about how such
Electronic supplementary material The online version of this article
(https://doi.org/10.1007/s00520-017-3952-9) contains supplementary
material, which is available to authorized users.
* Sarah J. Hardcastle
Health Psychology and Behavioural Medicine Research Group,
School of Psychology, Curtin University, Perth, Australia
Cancer Council Western Australia, Bagot Road, Subiaco,
Bendat Family Comprehensive Cancer Centre, St John of God
Hospital, Subiaco, Perth, Australia
Division of Women’s and Infants’ Health, School of Medicine,
University of Western Australia, Crawley, Western Australia,
Institute for Health Research, University of Notre Dame Australia,
Fremantle, Western Australia, Australia
Support Care Cancer (2018) 26:1289–1295