Physical activity behaviour change in black prostate cancer survivors: a qualitative study using the Behaviour Change Wheel

Purpose: Black individuals have a higher cancer burden and face greater obstacles to access cancer care resources when compared to White individuals. Radical prostatectomy is the standard surgical treatment and a common treatment option for prostate cancer; however, when compared to their White counterparts, Black individuals treated for prostate cancer often experience higher treatment-related side effects, resulting in a difficult recovery period. Physical activity is effective in alleviating treatment-related side effects; however, little is known about the barriers and facilitators to physical activity experienced by Black individuals after surgical management of prostate cancer to inform the design of physical activity interventions. Methods: Twelve Black individuals underwent radical prostatectomy for prostate cancer participated in a focus group study. We used the Behaviour Change Wheel, which incorporates Capability, Opportunity, Behaviour (COM-B) model and the complementary Theoretical Domains Framework (TDF), as our guiding theoretical framework. Data was analyzed using deductive qualitative analysis. Results: Facilitators and barriers were identified for all components of the Behaviour Change Wheel. Capability appeared to be a central factor to how participants described their physical activity engagement. Opportunity and motivation were described as both barriers and facilitators for behaviour change when occurring in isolation; however, when co-occurring with the presence of capability, they were described as facilitators that influence participants’ physical activity engagement. Conclusions: Our results demonstrate barriers and facilitators that are recognized among Black individuals who have undergone radical prostatectomy for prostate cancer. The design of a physical activity intervention needs to consider the physical and psychological capabilities as the fundamental basis with the additional support of physical activity opportunity and motivation. Implications for cancer survivors: Intersectionality across capability, opportunity, and motivation is essential to intervention design and development to increase physical activity in Black individuals surgically treated for prostate cancer.