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. Employment is associated quality of life, health insurance, treatment
adherence and recovery, and financial security. Cancer-related fatigue and cognitive impairment are two
frequent barriers to working, but current literature shows they are alleviated by physical activity (PA). Limited
studies have shown disproportionate adverse health outcomes among Black BCS living in the rural South and
much is still unknown. Common drivers behind these adverse outcomes experienced by Black BCS include
discrimination and accessibility to exercise opportunities. Therefore, we will: (1) identify work disparities, (2)
determine the relationships between PA and work outcomes, and the role of fatigue, cognition, discrimination,
and accessibility to exercise opportunities, using structural equation modeling and mediation analysis, and (3)
use semi-structured interviews to better understand the PA-work life relationship and identify barriers 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 disparities 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, (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 inequities 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 disparities and behavioral health.