Physical activity among cancer survivors: do neighborhood walkability and metropolitan size play a role?

Marie-Rachelle Narcisse; Monica L Wang; Mario Schootman; Peter DelNero; Aviva G Schwarz; Pearl A McElfish

doi:10.1007/s11764-024-01584-5

Physical activity among cancer survivors: do neighborhood walkability and metropolitan size play a role?

J Cancer Surviv. 2024 May 22. doi: 10.1007/s11764-024-01584-5. Online ahead of print.

Authors

Marie-Rachelle Narcisse¹, Monica L Wang^{2

3

4}, Mario Schootman⁵, Peter DelNero⁵, Aviva G Schwarz², Pearl A McElfish⁵

Affiliations

¹ Department of Psychiatry and Human Behavior, Brown University, 222 Richmond St., Providence, RI, 02903, USA. marie-rachelle_narcisse@brown.edu.
² Department of Community Health Sciences, School of Public Health, Boston University, 715 Albany St., Boston, MA, 02118, USA.
³ Boston University, Boston University Center for Antiracist Research, 1 Silber Way, Boston, MA, 02215, USA.
⁴ Department of Health Policy and Management, Harvard University, Harvard T.H. Chan School of Public Health, 677 Huntington Ave., Boston, MA, 02115, USA.
⁵ College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA.

PMID: 38775900
DOI: 10.1007/s11764-024-01584-5

Abstract

Purpose: To examine associations between walkability, metropolitan size, and physical activity (PA) among cancer survivors and explore if the association between walkability and PA would vary across United States metropolitan sizes.

Methods: This study used data from the 2020 National Health Interview Survey to examine independent associations of walkability and metropolitan size with engaging in moderate-to-vigorous PA (MVPA) and to explore the effect modification of metropolitan size using log-binomial regression. The dependent variable was dichotomized as < vs. ≥ 150 min/week of MVPA. The predictors were perceived walkability, a total score comprising eight neighborhood attributes, and metropolitan size. Covariates included sociodemographic and health characteristics, geographic region, cancer type, and time since cancer diagnosis.

Results: Engaging in 150 + min/wk of MVPA significantly increased among cancer survivors (n = 3,405) who perceived their neighborhoods as more walkable (prevalence ratio:1.04; p = 0.004). Engaging in 150 + min/wk of MVPA significantly increased among cancer survivors living in medium and small metropolitan areas vs. those living in large central metropolitan areas (prevalence ratio:1.12; p = 0.044). Perceived walkability levels were similar among cancer survivors in nonmetropolitan areas vs. those living in large central metropolitan areas. Association between walkability and PA did not significantly vary across metropolitan sizes.

Conclusions: Perceived neighborhood walkability is positively associated with MVPA among cancer survivors, regardless of metropolitan size.

Implications for cancer survivors: Findings highlight the importance of investing in the built environment to increase walkability among this population and translating lessons from medium and small metropolitan areas to other metropolitan areas to address the rural-urban disparity in PA among cancer survivors.

Keywords: Cancer survivors; Metropolitan size; Neighborhood walkability; Physical activity.