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Purpose <p>Exercise is recommended for cancer survivors, yet participation remains low and its modifiable correlates in working-age survivors are poorly characterized. We examined cross-sectional associations between exercise participation and 12 health outcomes and estimated cross-sectional indirect associations between psychological resources and exercise operating through commitment to an active lifestyle.</p> Methods <p>We analyzed 3,028 working-age US cancer survivors. Exercise was assessed with a single binary item (any regular weekly activity). Twelve symptom and functional outcomes were regressed on exercise status, adjusting for ten sociodemographic covariates with false discovery rate correction. Hierarchical logistic regression evaluated four predictor blocks: sociodemographics, employment, motivational factors (commitment, risk awareness), and psychological resources (self-efficacy, hope, core self-evaluations). Bootstrapped analyses tested cross-sectional indirect associations involving psychological resources, commitment, and exercise participation.</p> Results <p>Commitment was the strongest correlate of exercise (OR = 2.58, 95% CI [2.25, 2.95]); predicted probability rose from 15 to 88% across commitment levels. All three psychological resources showed significant cross-sectional indirect associations with exercise through commitment (indirect paths accounting for 81% to 97% of the total associations). Exercise was associated with better outcomes across all 12 domains, with larger associations for functional outcomes (mean |<i>d</i>|= 0.35) than symptoms (|<i>d</i>|= 0.25).</p> Conclusions <p>Cross-sectional indirect paths through commitment to an active lifestyle accounted for the majority of the cross-sectional associations between psychological resources and exercise participation. These indirect associations are cross-sectional; prospective and experimental confirmation is required before commitment can be recommended as an intervention target.</p> Implications for cancer survivors <p>If confirmed prospectively, these findings suggest that clinicians may promote exercise by eliciting and reinforcing survivors’ personal commitment to an active lifestyle during routine survivorship visits.</p>

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Commitment to an active lifestyle, psychological resources, and exercise participation among working-age cancer survivors: a cross-sectional study

  • 期刊论文

  • 发表日期：

    2026年8月5日

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  • Ada Chen,
  • Diana Presno,
  • Jing Tao,
  • Lidian Chen

摘要

Purpose

Exercise is recommended for cancer survivors, yet participation remains low and its modifiable correlates in working-age survivors are poorly characterized. We examined cross-sectional associations between exercise participation and 12 health outcomes and estimated cross-sectional indirect associations between psychological resources and exercise operating through commitment to an active lifestyle.

Methods

We analyzed 3,028 working-age US cancer survivors. Exercise was assessed with a single binary item (any regular weekly activity). Twelve symptom and functional outcomes were regressed on exercise status, adjusting for ten sociodemographic covariates with false discovery rate correction. Hierarchical logistic regression evaluated four predictor blocks: sociodemographics, employment, motivational factors (commitment, risk awareness), and psychological resources (self-efficacy, hope, core self-evaluations). Bootstrapped analyses tested cross-sectional indirect associations involving psychological resources, commitment, and exercise participation.

Results

Commitment was the strongest correlate of exercise (OR = 2.58, 95% CI [2.25, 2.95]); predicted probability rose from 15 to 88% across commitment levels. All three psychological resources showed significant cross-sectional indirect associations with exercise through commitment (indirect paths accounting for 81% to 97% of the total associations). Exercise was associated with better outcomes across all 12 domains, with larger associations for functional outcomes (mean |d|= 0.35) than symptoms (|d|= 0.25).

Conclusions

Cross-sectional indirect paths through commitment to an active lifestyle accounted for the majority of the cross-sectional associations between psychological resources and exercise participation. These indirect associations are cross-sectional; prospective and experimental confirmation is required before commitment can be recommended as an intervention target.

Implications for cancer survivors

If confirmed prospectively, these findings suggest that clinicians may promote exercise by eliciting and reinforcing survivors’ personal commitment to an active lifestyle during routine survivorship visits.