Predictors of Exercise Adherence in Asian Cancer Patients in a Community Based Cancer Rehabilitation Center: An Exploratory Study

Background Physical exercise is a vital component of cancer rehabilitation, with demonstrated improvements in cancer health-related outcomes including anxiety, depression, fatigue, physical function and health-related QoL, yet global participation remains low. In Singapore, uptake of community cancer rehabilitation is limited despite high prevalence of treatment-related impairments. This study aims to establish the knowledge, attitudes and beliefs of Asian cancer patients towards exercise in a community-based community rehabilitation program as well as the clinical characteristics associated with adequate physical exercise levels. Methods A cross-sectional study was conducted among adults (≥ 21 years) enrolled in the Singapore Cancer Society Rehabilitation Centre between December 2021 and March 2023. Clinical data, comorbidity burden, cancer characteristics, and treatment history were collected from medical records. Assessments included the Distress Thermometer (DT), Brief Illness Perception Questionnaire (Brief IPQ), and modified Bandura’s Exercise Self-Efficacy (ESE) scale. Patient-reported personal and societal barriers to exercise were recorded (Yes/No). Adequate exercise was defined as ≥ 150 min/week of moderate aerobic activity and ≥ 2 days/week of resistance training. Logistic regression analyses were performed to identify factors associated with achieving aerobic exercise recommendations. Results Of 132 analysed participants, only 29.5% met recommended aerobic exercise levels and 9.1% met resistance training recommendations. The three most common cancer diagnoses amongst the participants were breast (53.8%), gastrointestinal (11.4%) and gynecological (7.6%) cancers. Clinically significant distress (DT ≥ 5) was present in 41.9%. Univariate analyses showed that moderate comorbidity (OR = 4.299 ; p = 0.034) and genitourinary cancers (OR = 18.667 ; p = 0.010) were positive predictors of adequate exercise. Negative predictors of adequate exercise included female gender (OR = 0.284 ; p = 0.004), prior chemotherapy (OR = 0.429 ; p = 0.046), and lower self-efficacy (OR = 0.840 ; p = < 0.001). Conclusions Exercise adherence among Asian cancer survivors in community rehabilitation is low. Our findings highlight the urgent need for targeted, context-specific interventions within Asian community cancer survivorship programs. Future efforts should focus on gender-specific programming, enhancing exercise self-efficacy and early outreach and screening.