Explaining the potential role of physical activity in employment disparities after breast cancer - PROJECT SUMMARY Breast cancer is the most diagnosed cancer in the world with the largest survivorship group. The rise of breast cancer survivors (BCS) living longer, healthier lives merits attention to important areas of cancer survivorship such as employment and physical activity (PA). Most cancer survivors wish to remain or return to work, and employment is associated with quality of life, health insurance, treatment adherence and recovery, and financial security. Cancer-related fatigue and cognitive impairment are two frequent side effects of cancer and treatment and are common obstacles to working. PA has been shown to reduce cancer-related fatigue and cognitive impairment, but cancer survivors experience barriers such as accessibility to exercise opportunities and different experiences based on education and income. Therefore, we will: (1) identify differences in employment status, (2) determine the relationships between PA and work outcomes, and the role of fatigue, cognition, accessibility to exercise opportunities, and different experiences based on education and income, using structural equation modeling and mediation analysis, and (3) use semi-structured interviews to better understand the PA-work life relationship and identify obstacles and facilitators of desired program elements to apply to multilevel tailored intervention design. The proposed research strategy will build the foundation for tailored, comprehensive intervention design to reduce cancer health and employment differences and help ALL cancer survivors live longer, healthier lives. The proposed training period will allow applied learning and formal training in (1) cancer disparity research, (2) mediation analysis with structural equation modeling, and (3) qualitative research for intervention design. These training opportunities will enhance my research capability, leading to significant contributions in the fight towards eliminating health differences for cancer survivors. I have assembled an exceptional mentoring team, in an outstanding training environment to achieve my training goals, equipping me with the skills to become a leader in cancer differences and behavioral health. Therefore, we will: (1) identify differences in employment status, (2) determine the relationships between PA and work outcomes, and the role of fatigue, cognition, accessibility to exercise opportunities, and different experiences based on race and geography, using structural equation modeling and mediation analysis, and (3) use semi-structured interviews to better understand the PA-work life relationship and identify obstacles and facilitators of desired program elements to apply to multilevel tailored intervention design. The proposed research strategy will build the foundation for tailored, comprehensive intervention design to reduce cancer health and employment differences and help ALL cancer survivors live longer, healthier lives. The proposed training period will allow applied learning and formal training in (1) cancer research, (2) mediation analysis with structural equation modeling, and (3) qualitative research for intervention design. These training opportunities will enhance my research capability to establish independence, leading to significant contributions in the fight towards eliminating health differences for cancer survivors. I have assembled an exceptional mentoring team, in an outstanding training environment to achieve my training goals and career transition. This K01 will equip me with the skills to become a leader in cancer differences and behavioral health.
