Associations between perceived neighborhood environment and physical activity among breast cancer patients engaged in a physical activity program concomitant to cancer treatment: cross-sectional and longitudinal analyses in the DISCO trial (DiscoSpace)

Background Despite the proven benefits of physical activity during breast cancer treatment, many women reduce their practice after diagnosis. A better understanding of how the neighborhood environment influences physical activity behavior could help optimize strategies for physical activity in breast cancer patients undergoing cancer treatment. Objective This study examined associations between perceived neighborhood environment and physical activity among breast cancer patients undergoing treatment and engaged in a physical activity program. Methods Participants were 313 breast cancer patients enrolled in the DISCO physical activity intervention trial (NCT03529383). In the present observational analysis (DiscoSpace), cross-sectional (at baseline) and longitudinal (during intervention) associations between perceived neighborhood environment and physical activity were investigated. The perceived neighborhood environment was assessed using the ALPHA questionnaire, physical activity and physical functioning were evaluated through the Recent Physical Activity Questionnaire (self-reported physical activity) and the 6-Minute Walk Test (to measure the 6-Minute Walk Distance (6MWD)). Associations were estimated through mixed linear regression models. Results Better perceived cycling and walking infrastructures and network were associated with higher self-reported physical activity at baseline (total infrastructures: β = 0.226, 95% CI (0.063;0.388); network: β = 0.161, 95% CI (0.008;0.314)). Perceived distance to local facilities was inversely associated with 6MWD at baseline (β=-11.363, 95% CI (-20.607;-2.118)). A perception of densely populated neighborhoods (β=-0.306, 95% CI (-0.494;-0.117)) was associated with a lesser increase in self-reported physical activity during the intervention, after adjustment for trial arm. These associations varied according to women’s socioeconomic status and municipality class. Conclusion The perceived neighborhood environment and socioeconomic characteristics of women with breast cancer should be given greater consideration for developing effective programs to promote physical activity in this population.