ArticleJournal of cancer survivorship : research and practice2026
Commitment to an active lifestyle, psychological resources, and exercise participation among working-age cancer survivors: a cross-sectional study.
Article in Journal of cancer survivorship : research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeExercise 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.
methodsWe 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.
resultsCommitment 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).
conclusionsCross-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.
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