Barriers to and Facilitators of Physical Activity in Black and African American Cancer Survivors

By Dustin Samples - January 31, 2023

Black and African American people are disproportionally affected by cancer and the adverse effects thereof. An important way to ameliorate the physical and psychological effects of cancer and treatment is physical activity. However, most Black and African American cancer survivors do not get enough physical activity.

To understand why these patients are experiencing difficulty achieving physical activity goals, a group of researchers from the University of North Carolina at Chapel Hill designed a qualitative interview study where a community advisory board conducted semi-structured telephone interviews with Black and African American cancer survivors. The researchers asked questions about perceived barriers and facilitators of physical activity during and after treatment.

As expected, barriers to physical activity during treatment largely included symptoms related to the treatment itself, including “fatigue, pain, nausea/vomiting, loss of appetite, anemia, compromised immune system, and vision challenges.” Another cited barrier was decreased psychological well-being.

After treatment, common barriers included long-term effects of cancer treatment, such as neuropathy, fatigue, pain, and incontinence. Environmental factors were another barrier, with participants citing the weather, time of day, and physical safety of their environment as reasons they did not engage in more physical activity. Others felt there were more important things to worry about, such as taking care of loved ones, earning money, and taking care of other responsibilities. Interestingly, some expressed an unsubstantiated concern that excess physical activity would make their cancer return.

There were some facilitators to physical activity, and they remained largely the same for the periods both during and after treatment. One significant facilitator was family. Participants expressed that encouragement from their family was helpful, as was the desire to do whatever necessary to prolong their life with family. Another common facilitator was faith, or more specifically, the idea that an outside influence would provide them strength to do what was necessary. Finally, some were motivated by the positive health effects of physical activity, such as improved mood and the feeling of control.

The researchers concluded that “effective PA interventions for Black/AA cancer survivors are likely those that focus on policies and systems change rather than only traditional individual-level behavior change; disseminate research about the safety and benefits of PA to cancer survivors; and include the importance of family and faith in behavioral decisions,” further commenting that the study’s findings were “immediately relevant to clinicians, who may consider these factors when supporting Black/AA survivors to engage in PA as a way of improving their cancer health outcomes.”


Barriers and facilitators to the engagement of physical activity among Black and African American cancer survivors during and after treatments.