Strength Training after Breast Cancer: Understanding Survivor Defined Barriers and Facilitators

Introduction: The health benefits of weight lifting across the life span have been well documented, however, clinical guidelines, for breast cancer (BRCA) survivors, have long advised against upper body strength training (ST). Recent studies have established that strength training is safe and beneficial, to women throughout the BRCA treatment/ recovery continuum. Methods: This report will focus on the qualitative arm of a randomized control trial accessing the impact of a year-long ST intervention. Participants in the trial were post-treatment BRCA survivors with and without lymphedema (N=295). 50% of the participants were randomized to the intervention group (N=148) and invited to participate in a series of focus groups designed to explore the barriers and facilitators of strength training (11 focus groups / N=68) ). Two independent researchers analyzed and coded focus group transcripts using Nvivo9 software. Results: Analysis of qualitative data revealed several barriers and facilitators to effective and consistent intervention participation. Social Cognitive Theory was used as a framework for understanding these elements. Major factors included social support, emotional and psychological influences, and environmental and personal factors. Conclusion: BRCA survivors have been discouraged from ST however, recent data has shown that it can be safe and BRCA survivors stand to benefit as much from appropriate weight lifting as do other women. Effective promotion of proven interventions should be informed, not only by the data, but by the perspectives of the target audience. This is particularly important when, as in this case, new data represent a paradigm shift.