Moderating Role of Perceived Neighborhood Environment on Physical Activity and BMI Outcomes of a Diet and Physical Activity Intervention Among Latina Breast Cancer Survivors

AIM: The neighborhood influences lifestyle interventions for cancer survivors. We evaluated the moderating role of perceived neighborhood environment on physical activity outcomes of a diet and physical activity intervention tailored to urban Latina breast cancer survivors. METHODS: This secondary data analysis included a subset of Latina breast cancer survivors (n = 86) who participated in ¡Mi Vida Saludable! (n = 167), a randomized trial evaluating eHealth and in-person diet and physical activity interventions. The eHealth component included motivational and informational messaging, and the in-person component included nutrition and physical activity education. We assessed neighborhood aesthetics and walkability perceptions at baseline. Moderate to vigorous physical activity (MVPA) and body mass index were assessed at baseline and 6 and 12 months. Generalized estimating equations estimated intervention effects on MVPA and body mass index. Interaction terms tested whether perceived neighborhood aesthetics and walkability moderated intervention effects. RESULTS: Latinas with lower incomes and less education more commonly reported low perceived neighborhood aesthetics and walkability. Lower perceptions negatively moderated the effects of the eHealth intervention on change in MVPA between baseline and 6 months: 6-month MVPA change from the eHealth intervention was 501 minutes per week lower (95% CI, -837 to -165) comparing low versus high perceived neighborhood aesthetics and 454 minutes per week lower (95% CI, -799 to -109) comparing low versus high perceived neighborhood walkability. Neighborhood perceptions did not moderate effects of the in-person intervention on MVPA or body mass index at any time point. CONCLUSIONS: Among urban Latina breast cancer survivors, poorer neighborhood perceptions were associated with smaller physical activity improvements following an eHealth intervention. Future interventions should account for neighborhood perceptions.