Iris Kanera

156 Chapter 7 is essentially different compared to dealing with difficult situations concerning exercising. These results emphasize that lifestyle change support should be tailored to individual lifestyle risks, to relevant personal characteristics, and particularly to relevant social cognitive factors. Prevalence of PA Prevalence on cancer survivors’ adherence to PA recommendations vary strongly in the literature from about 18% - 50% in primarily American and British studies up to 91% in Dutch studies (Blanchard et al., 2008; Bours et al., 2015; Buffart et al., 2012; Inoue-Choi et al., 2013; Kuijpers et al., 2016; Stevinson et al., 2014; van Putten et al., 2016; Winkels et al., 2016). Differences in general are related to variations in cancer populations with regard to age and type of cancer (Fassier et al., 2016; Kang, 2015; Kuijpers et al., 2016; Winkels et al., 2016), and measurement of PA (various self-report questionnaires measuring duration and/or intensity, and accelerometers; Blanchard et al., 2008; Bours et al., 2015; Boyle, Lynch, Courneya, & Vallance, 2015b; Buffart et al., 2012; Inoue-Choi et al., 2013; Shi et al., 2017; Stevinson et al., 2014; van Putten et al., 2016). Within the Netherlands, adults aged 55-75 years report about 77% PA adherence, which is lower than among similar aged Dutch cancer survivors (Statistics Netherlands, 2015). Why Dutch cancer survivors report high levels of PA adherence requires further exploration. Both IPAQ and SQUASH ask respondents to estimate duration ánd intensity of their behavior. It might be that cancer survivors experience PA as being more heavy (higher metabolic equivalent of task [MET]) compared to peers without a history of cancer, resulting in reporting higher PA intensities and consequently a higher PA score. Social cognitive correlates of PA In our study and prior research among Dutch cancer survivors, associations between PA and higher self-efficacy were found (Kampshoff et al., 2016). Self-efficacy included beliefs concerning overcoming PA-related barriers such as residual problems due to cancer treatment (Kampshoff et al., 2016). A study among Canadian breast and prostate cancer survivors, employing similar theoretical foundation to our study, identified more correlates of PA, i.e., attitude, subjective norm, perceived behavior control, and intention (Blanchard, Courneya, Rodgers, & Murnaghan, 2002). In our study, cancer survivors’ attitude and intention toward PA were high and consequently, for our study population there was little need to change these beliefs. It might be concluded that Dutch cancer survivors are mainly in need of advice concerning how to make chance happen; e.g., increasing self-efficacy and overcoming barriers.