Barriers and Facilitators to Physical Activity Participation Among Colorectal Cancer Survivors: A Mixed-Method Systematic Review

Abstract

Objectives

Physical activity (PA) is essential in cancer rehabilitation. Worryingly, PA compliance among colorectal cancer (CRC) survivors is relatively poor, and the barriers and facilitators of PA participation in this population are poorly understood. This review aimed to identify the barriers and facilitators of PA participation among CRC survivors and apply the Capability-Opportunity-Motivation-Behavior (COM-B) model to analyze and categorize these factors.

Methods

A mixed-method systematic review was conducted using six electronic databases (Embase, Medline, PubMed, Scopus, Web of Science, and Chinese National Knowledge Infrastructure) to conduct literature search. The searches were conducted from the inception of databases till May 2024, and eligible studies were limited to English or Chinese. The mixed methods appraisal tool (MMAT) was utilized to perform quality assessment, and the convergent integrated approach and descriptive analysis were used for data synthesis and analysis.

Results

This review included 32 studies (seven qualitative, 24 quantitative, and one mixed-method), and no studies were eliminated due to quality. According to the COM-B model, cancer-related symptoms, time constraints, and lack of motivation or interest were the main barriers to PA participation among CRC survivors. The main facilitators of PA participation for CRC survivors included improvement in cancer-related symptoms, enough social support from family and friends, and perceived benefits of PA.

Conclusions

This review comprehensively identified the unique barriers and facilitators to PA participation among CRC survivors based on the COM-B model. Future research should consider these barriers and facilitators and develop effective PA interventions to increase PA compliance among CRC survivors.