{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T11:03:37Z","timestamp":1779793417077,"version":"3.53.1"},"reference-count":35,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R01CA207753"],"award-info":[{"award-number":["R01CA207753"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["T32CA250803"],"award-info":[{"award-number":["T32CA250803"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30CA016359"],"award-info":[{"award-number":["P30CA016359"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R25CA203650"],"award-info":[{"award-number":["R25CA203650"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["F31CA268894"],"award-info":[{"award-number":["F31CA268894"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001006","name":"Breast Cancer Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001006","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010900","name":"Yale Cancer Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010900","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009116","name":"Harvard Transdisciplinary Research in Energetics and Cancer Center, Harvard University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009116","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the motivations for participating in a combined nutrition and exercise intervention starting during chemotherapy for breast cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The Lifestyle, Exercise, and Nutrition early after Diagnosis (LEANer) trial randomized 173 women newly diagnosed with stage I\u2010III breast cancer to a yearlong nutrition and exercise intervention (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a087) or usual care (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a086) during chemotherapy to assess the effect on chemotherapy adherence. Upon completion of the trial, using a stratified purposeful sampling method, a subset of women randomized to the intervention arm completed a one\u2010time, individual, semi\u2010structured interview. Interviews were transcribed verbatim and analyzed using thematic analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 29 interviews, we identified four key themes related to women's motivations for participating in a lifestyle intervention during chemotherapy. These included (1) Proactivity \u2013 a pursuit of opportunities to improve and prioritize health; (2) Altruism \u2013 a desire to help others with breast cancer and advance the science around lifestyle factors and treatment outcomes; (3) Lack of perceived harm \u2013 the benefits outweighed risks; and (4) Oncologist recommendation \u2013 an endorsement from their clinical provider played a critical role.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Women with breast cancer were motivated to participate in a nutrition and exercise intervention initiated during chemotherapy because of factors relating to optimizing their own health, altruistic desires, perceived lack of harm, and their oncologist's recommendation. Compared to post\u2010treatment, the opportunity to be proactive and having an oncologist recommendation emerged as unique motivators. Understanding these drivers of motivation can enhance recruitment and promote engagement and adherence in future interventions during active cancer treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pon.70472","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T02:40:26Z","timestamp":1776998426000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Motivation to Participate in a Nutrition and Physical Activity Intervention During Chemotherapy for Breast Cancer: A Qualitative Study"],"prefix":"10.1002","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0848-4866","authenticated-orcid":false,"given":"Leah S.","family":"Puklin","sequence":"first","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maura","family":"Harrigan","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney","family":"McGowan","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah M.","family":"Ferrucci","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"},{"name":"Yale Cancer Center  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brenda","family":"Cartmel","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"},{"name":"Yale Cancer Center  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Zupa","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryann","family":"Deyling","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"Sanft","sequence":"additional","affiliation":[{"name":"Yale Cancer Center  New Haven Connecticut USA"},{"name":"Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1632-7038","authenticated-orcid":false,"given":"Mona","family":"Sharifi","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"},{"name":"Yale University School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melinda L.","family":"Irwin","sequence":"additional","affiliation":[{"name":"Yale School of Public Health  New Haven Connecticut USA"},{"name":"Yale Cancer Center  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201019\u20101318"},{"issue":"9","key":"e_1_2_12_3_1","first-page":"1484","article-title":"Physical Activity Levels Among Breast Cancer Survivors","volume":"36","author":"Irwin M. L.","year":"2004","journal-title":"Medicine and Science in Sports and Exercise"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.11227"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2018.09.002"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph19137579"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34322"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdu042"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097\u20100142(20000201)88:3<674::AID\u2010CNCR26>3.0.CO;2\u2010R"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2005.01.230"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2006.0255"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12966\u2010021\u201001116\u20109"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2023.102255"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2015.61.6375"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/jncics\/pkac072"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12020322"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010014\u20102185\u20104"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.3390\/bs12080271"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010016\u20103542\u20102"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cct.2021.106508"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.23.00871"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35280"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2023.05.015"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0000000000002116"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21719"},{"key":"e_1_2_12_26_1","doi-asserted-by":"crossref","unstructured":"The Diabetes Prevention Program (DPP): Description of Lifestyle Intervention.Diabetes Care25 2165\u20132171(2002) https:\/\/doi.org\/10.2337\/diacare.25.12.2165","DOI":"10.2337\/diacare.25.12.2165"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/1464\u20100597.00092"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.13.4.401"},{"key":"e_1_2_12_29_1","unstructured":"Nutrition Assessment https:\/\/www.fredhutch.org\/en\/research\/divisions\/public\u2010health\u2010sciences\u2010division\/research\/nutrition\u2010assessment.html."},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1006\/jfca.2001.0992"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2018.05.021"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010024\u201008789\u20105"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010017\u20102031\u20108"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1177\/1049732305276687"},{"key":"e_1_2_12_35_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15430421tip3903_2"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/acm.0000000000000388"}],"container-title":["Psycho-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.70472","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pon.70472","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.70472","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T10:20:26Z","timestamp":1779790826000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pon.70472"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["10.1002\/pon.70472"],"URL":"https:\/\/doi.org\/10.1002\/pon.70472","archive":["Portico"],"relation":{},"ISSN":["1057-9249","1099-1611"],"issn-type":[{"value":"1057-9249","type":"print"},{"value":"1099-1611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"assertion":[{"value":"2025-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70472"}}