Exercise preferences and barriers in minority cancer patients undergoing chemotherapy

Background: Physical inactivity and comorbid disease burden are disproportionately high among Black and Latinx cancer patients receiving chemotherapy, yet participation in exercise oncology trials remains low in these groups, despite known benefits. The T esting H ome-based Exe R cise Strategies to I mprove Exercise Participation and Cardio V ascular Health in Unders E rved Minority Patients with Cancer Undergoing Chemotherapy (THRIVE) trial tests the feasibility and acceptability of supervised and unsupervised home-based exercise during chemotherapy in these underrepresented groups. This analysis describes exercise preferences collected through a structured questionnaire administered prior to randomization. Methods: Participants enrolled in the THRIVE trial completed baseline questionnaires assessing exercise interest, preferred modalities, timing, perceived benefits, and anticipated barriers. Eligible patients were sedentary, self-identified as Black or Hispanic/Latinx, and diagnosed with breast, colorectal, or prostate cancer. Descriptive statistics were used to summarize patient characteristics and survey responses. The Benefit Anticipation Questionnaire was scored using a 7-point Likert scale ranging from −3 (very much harmful) to +3 (very much beneficial). The Exercise Barrier Questionnaire was scored using a 7-point Likert scale, ranging from 1 (not at all) to 7 (very much). Data are reported as mean ± standard deviation. Results: Nineteen Black or Latinx participants enrolled in the study to date, and 13 participants returned the questionnaire (mean age 55 ± 12 years), including 12 female breast cancer patients and 1 male prostate cancer patient. Most participants expressed interest in participating in an exercise program (84.6%) and felt capable of doing so (76.9%). Walking (69.2%) and strength training (53.8%) were the most preferred modes. Light- or Moderate-intensity exercise (38.5%) performed 30-60 minutes per session (84.6%) three times per week (69.2%) was most common. Surprisingly, the most preferred time to start an exercise program was during cancer treatment (61.5%), followed by before cancer treatment (30.8%). Participants reported high anticipated benefits for the proposed program, with 91.7% rating the impact as “very much beneficial” for both overall quality of life (M = 2.9 ± 0.3) and physical functioning (M = 2.8 ± 0.9). The most frequently cited barriers were feeling sick/not feeling well (M = 4.3 ± 2.1) and feeling tired or fatigued (M = 4.1 ± 2.0), followed by cost (M = 3.8 ± 2.5) and traveling to the fitness center (M = 3.8 ± 2.1). Conclusion: Black and Latinx cancer patients expressed strong interest and confidence in home-based, supervised exercise programs during cancer treatment. Tailoring exercise schedules and addressing symptoms such as sickness and fatigue may enhance participation. Addressing barriers such as cost and travel may further support adherence.