BMC Women's Health · 4 authors, 3 centres
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This study examined how newly matched pairs of breast cancer survivors naturally support each other to be physically active. Women who felt they were in a 'good match' with their partner reported receiving more esteem, emotional, tangible, and informational support, and were more physically active. The findings suggest that active communication and shared characteristics between partners are key to making peer-based physical activity programs effective for breast cancer survivors.
**Background:** Physical activity (PA) can mitigate physical, emotional, and social challenges in women living beyond breast cancer treatment (WBC), but PA levels remain low. Social support from a peer may increase PA, yet the specific types of support that are most valuable are not well understood. This study aimed to contextualize the natural social support environment and PA behavior in newly formed peer WBC dyads.
**Methods:** This is a secondary analysis of a three-week daily diary study. Women living in Canada, diagnosed with primary breast cancer, aged ≥18 years, and participating in <150 min/week of purposeful exercise were recruited (N=48; final analytic sample n=46 after removing one dyad due to dropout). Participants were matched into dyads by a research assistant based on age (within 10 years), geographical location/time zone, and cancer severity. Dyads received a Fitbit Inspire HR and an 'exercise partner support guide' but were not instructed on how or how often to connect. Daily end-of-day surveys for 21 days assessed exercise participation (yes/no), method of connection with partner, perceived social support (four items from the Social Support in Sport Survey adapted for exercise, rated 1–7), and an open-ended question on what the partner did or said to support exercise. A follow-up survey on day 22 assessed match quality (1=very poor to 5=very good), effectiveness, enjoyment, and similarity. PA was measured via Fitbit (lightly active minutes; fairly+very active minutes summed as MVPA). Descriptive statistics, effect sizes (Hedge's g), and conventional deductive content analysis were used.
**Key Results:** Women (mean age 42.4±7.6 years; 89.2% stage I-III; 63% on hormonal therapy; mean 2.9 years post-treatment) connected with their partner on 58.1% of days (mean 12.20±5.00 days) and exercised on 77.1% of days (mean 16.20±3.28 days). Text messaging was the most common connection method (57.6%). Based on follow-up match quality scores, 29 women (63%) were classified as good match, 9 (20%) as neutral, and 8 (17%) as poor match. The most frequently received support type overall was esteem support (mean 2.75±1.46 out of 7), followed by emotional (2.63±1.29), informational (1.58±0.81), and tangible (1.46±0.77). Good match participants reported higher scores on all social support types, days exercised (17.48±2.81 vs. 14.00±3.54 for neutral and 14.00±2.14 for poor), days connected (13.83±4.73 vs. 10.78±4.89 vs. 7.88±3.00), MVPA minutes/week (287.75±175.41 vs. 206.26±89.10 vs. 194.21±88.41), and light PA minutes/week (1728.29±491.04 vs. 1537.60±314.27 vs. 1555.79±588.41). Effect sizes comparing good vs. poor match were large for most variables (e.g., Hedge's g=1.54 for esteem support, 1.53 for emotional support, 1.29 for days exercised, 1.34 for days connected). Qualitative analysis revealed three profiles: (1) active communication, high support (good match) — women reported receiving all four support types, with esteem support most frequent; (2) moderate communication, moderate support (neutral match) — received esteem, tangible, and emotional support but no informational support; (3) poor communication, low support (poor match) — minimal contact, received mainly esteem support, wanted more tangible and esteem support. Across all profiles, esteem support was most frequently documented as received, while tangible and esteem support were most frequently described as lacking.
**Clinical Implications:** Matching WBC in peer dyads can improve perceptions of support for PA. A good match characterized by active communication, shared characteristics (age, life stage), and receipt of all support types was associated with higher PA. Future interventions should consider more systematic matching criteria, facilitated introductions, and the addition of a qualified exercise professional to provide informational and tangible support (e.g., workout plans) that peers may lack the expertise to offer. The study was limited by a small, homogeneous sample (younger, higher education, English-speaking), data collection during the COVID-19 pandemic (which may have increased motivation for outdoor exercise and social connection), and reliance on open-ended survey responses rather than interviews.