Physical Activity and Cancer among Native American Cancer Survivors: A Pilot Study-Preliminary focus group and interview findings

Pilot Team 1

 Project Co-Leaders


Hendrik de Heer, Ph.D. Associate Professor, Department of Physical Therapy & Athletic Training, College of Health & Human Services

Anna L. Schwartz, Ph.D., FNP-BC, FAAN Associate Professor, School of Nursing, College of Health & Human Services

Details about Anna L. Schwartz research and publications are at


Jennifer Bea, Ph.D. Assistant Professor/Research Scholar, Department of Medicine

Program Coordinator

Etta Yazzie, R. N. Arizona Oncology

Student Researchers

Shauntey Cleveland (NAU), Shelby Dalgai (NAU), Kaitlyn Haskie (NAU), Pearl Nez (NAU), Mark Lee (UACC), Luis Valdez (UACC)


Studies have shown that physical activity in cancer survivorship can lead to improved quality of life and disease free survival,particularly for colorectal and breast cancer. Relatively moderate amounts of physical activity may be needed, such as walking 30 minutes daily at 2.5 miles per hour.None of these studies, however, were focused on Native American cancer survivors.


To conduct focus groups and interviews with Navajo cancer survivors to learn about their exercise beliefs, preferences, barriers and interest in a cancer survivor physical activity program.


Focus groups and individual interviews with Navajo cancer survivors in an urban and rural setting were conducted, led by an experienced bilingual (Navajo & English) focus group leader. Audio recordings of conversations were translated and transcribed in full. Software for qualitative data analysis (NVIVO) was used to summarize major themes.

Preliminary Findings

Overall, participants believed that physical activity was important for improving health during and following cancer treatment. Several factors that may adversely influence engaging in physical activity included: 

  1. a feeling of separation from their social network, in part due to lack of knowledge about cancer among family members and others; 
  2. fatigue and temporary activity limitations related to treatment; 
  3. lack of communication between healthcare personnel and cancer patients about post-treatment appropriateness of timing, duration and intensity of activity; and 
  4. resource limitations. Patients expressed a strong desire to improve health, and activity preferences expressed favored outdoor activity and walking interventions.


In order to increase and maintain an active lifestyle, a community-based program tailored to meet the needs for Navajo cancer patients is essential. A setting which combines easily accessible and affordable ways to engage in moderate physical activity with social support appears preferable. In addition, education for caregivers about cancer and its treatment may be needed.