Browsing by Author "Friedenreich, Christine M."
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Item Open Access A qualitative study examining newly diagnosed breast cancer patients’ experiences of participating in the Alberta Moving Beyond Breast Cancer (AMBER) prospective cohort study(2023-06-02) Corcoran, Lynn; Friedenreich, Christine M.; McNeely, Margaret L.; Culos-Reed, Nicole S.; Bell, Gordon; Dickau, Leanne; Courneya, Kerry S.; Vallance, Jeff K.Abstract Background Decisions to participate in cancer trials are associated with uncertainty, distress, wanting to help find a cure, the hope for benefit, and altruism. There is a gap in the literature regarding research examining participation in prospective cohort studies. The aim of this study was to examine the experiences of newly diagnosed women with breast cancer participating in the AMBER Study to identify potential strategies to support patients’ recruitment, retention, and motivation. Methods Newly diagnosed breast cancer patients were recruited from the Alberta Moving Beyond Breast Cancer (AMBER) cohort study. Data were collected using semi-structured conversational interviews with 21 participants from February to May 2020. Transcripts were imported into NVivo software for management, organization, and coding. Inductive content analysis was undertaken. Results Five main concepts associated with recruitment, retention, and motivation to participate were identified. These main concepts included: (1) personal interest in exercise and nutrition; (2) investment in individual results; (3) personal and professional interest in research; (4) burden of assessments; (5) importance of research staff. Conclusions Breast cancer survivors participating in this prospective cohort study had numerous reasons for participating and these reasons could be considered in future studies to enhance participant recruitment and retention. Improving recruitment and retention in prospective cancer cohort studies could result in more valid and generalizable study findings that could improve the care of cancer survivors.Item Open Access Association between circadian physical activity patterns and mortality in the UK Biobank(2023-09-01) Stein, Michael J.; Baurecht, Hansjörg; Sedlmeier, Anja M.; Konzok, Julian; Bohmann, Patricia; Fontvieille, Emma; Peruchet-Noray, Laia; Bowden, Jack; Friedenreich, Christine M.; Fervers, Béatrice; Ferrari, Pietro; Gunter, Marc J.; Freisling, Heinz; Leitzmann, Michael F.; Viallon, Vivian; Weber, AndreaAbstract Background The benefit of physical activity (PA) for increasing longevity is well-established, however, the impact of diurnal timing of PA on mortality remains poorly understood. We aimed to derive circadian PA patterns and investigate their associations with all-cause mortality. Methods We used 24 h PA time series from 96,351 UK Biobank participants aged between 42 and 79 years at accelerometry in 2013–2015. Functional principal component analysis (fPCA) was applied to obtain circadian PA patterns. Using multivariable Cox proportional hazard models, we related the loading scores of these fPCs to estimate risk of mortality. Results During 6.9 years of follow-up, 2,850 deaths occurred. Four distinct fPCs accounted for 96% of the variation of the accelerometry data. Using a loading score of zero (i.e., average overall PA during the day) as the reference, a fPC1 score of + 2 (high overall PA) was inversely associated with mortality (Hazard ratio, HR = 0.91; 95% CI: 0.84–0.99), whereas a score of -2 (low overall PA) was associated with higher mortality (1.69; 95% CI: 1.57–1.81; p for non-linearity < 0.001). Significant inverse linear associations with mortality were observed for engaging in midday PA instead of early and late PA (fPC3) (HR for a 1-unit increase 0.88; 95% CI: 0.83–0.93). In contrast, midday and nocturnal PA instead of early and evening PA (fPC4) were positively associated with mortality (HR for a 1-unit increase 1.16; 95% CI: 1.08–1.25). Conclusion Our results suggest that it is less important during which daytime hours one is active but rather, to engage in some level of elevated PA for longevity.Item Open Access Cross-sectional and longitudinal associations between the built environment and walking: effect modification by socioeconomic status(2022-06-21) Christie, Chelsea D.; Friedenreich, Christine M.; Vena, Jennifer E.; Turley, Liam; McCormack, Gavin R.Abstract Background Although socioeconomic status (SES) has been shown to modify associations between the neighborhood built environment and physical activity, contradictory results exist. Objectives of this cross-sectional and longitudinal analysis were to: 1) examine whether overall neighborhood walkability and specific built characteristics were associated with walking among adults at a single point in time and after they relocate neighborhoods, and 2) test for effect modification of these associations by SES. Methods We linked longitudinal data from 703 adults who relocated urban neighborhoods between two waves of Alberta’s Tomorrow Project (2008–2015) to neighborhood built environment data. We created a walkability index from measures of population counts, street connectivity, and destination diversity within 400 m of participants’ homes. In cross-sectional analyses, we used generalized linear models to estimate associations between built characteristics and minutes walked per week at baseline. For the longitudinal analyses, we used fixed-effects linear regression models to estimate associations between changes in built characteristics and minutes walked per week. We also assessed if indicators of SES (individual education or household income) modified both sets of associations. Results Most cross-sectional and longitudinal associations were small and statistically non-significant. Neighborhood population count (b = 0.03, 95% CI: 0.01, 0.07) and street connectivity (b = − 1.75, 95% CI: − 3.26, − 0.24) were cross-sectionally associated with walking duration among the overall sample. None of the longitudinal associations were statistically significant among the overall sample. There was limited evidence of effect modification by SES, however, we found negative cross-sectional associations between street connectivity and walking among adults with lower education and income, and a positive association between percent change in walkability and change in walking among lower educated adults. Conclusions Despite population count and street connectivity being associated with walking at baseline, changes in these built environment variables were not associated with changes in walking following residential relocation. Our findings also provide evidence, albeit weak, that changes in neighborhood walkability, resulting from residential relocation, might more strongly affect walking among low SES adults. Further longitudinal research is needed to examine built environment characteristics with walking for different purposes and to test for inequitable socioeconomic impacts.Item Open Access Diurnal timing of physical activity and risk of colorectal cancer in the UK Biobank(2024-09-18) Stein, Michael J.; Baurecht, Hansjörg; Bohmann, Patricia; Fervers, Béatrice; Fontvieille, Emma; Freisling, Heinz; Friedenreich, Christine M.; Konzok, Julian; Peruchet-Noray, Laia; Sedlmeier, Anja M.; Leitzmann, Michael F.; Weber, AndreaAbstract Background Physical activity reduces colorectal cancer risk, yet the diurnal timing of physical activity in colorectal cancer etiology remains unclear. Methods This study used 24-h accelerometry time series from UK Biobank participants aged 42 to 79 years to derive circadian physical activity patterns using functional principal component analysis. Multivariable Cox proportional hazard models were used to examine associations with colorectal cancer risk. Results Among 86,252 participants (56% women), 529 colorectal cancer cases occurred during a median 5.3-year follow-up. We identified four physical activity patterns that explained almost 100% of the data variability during the day. A pattern of continuous day-long activity was inversely associated with colorectal cancer risk (hazard ratio (HR) = 0.94, 95% confidence interval (CI) = 0.89–0.99). A second pattern of late-day activity was suggestively inversely related to risk (HR = 0.93, 95% CI = 0.85–1.02). A third pattern of early- plus late-day activity was associated with decreased risk (HR = 0.89, 95% CI = 0.80–0.99). A fourth pattern of mid-day plus night-time activity showed no relation (HR = 1.02, 95% CI = 0.88–1.19). Our results were consistent across various sensitivity analyses, including the restriction to never smokers, the exclusion of the first 2 years of follow-up, and the adjustment for shift work. Conclusions A pattern of early- plus late-day activity is related to reduced colorectal cancer risk, beyond the benefits of overall activity. Further research is needed to confirm the role of activity timing in colorectal cancer prevention.Item Open Access Exercise Dose Effects on Body Fat 12 Months after an Exercise Intervention: Follow-up from a Randomized Controlled Trial(2019-01-20) Friedenreich, Christine M.; Ruan, Yibing; Duha, Aalo; Courneya, Kerry S.Background. Exercise interventions can result in weight loss, which is associated with reductions in disease risk. It is unknown how the volume of exercise prescribed in a one-time exercise intervention impacts long-term body fatness. We compared 24-month body fat changes among postmenopausal women previously prescribed 300 versus 150 minutes/week of exercise in a year-long exercise intervention trial. Methods. The Breast Cancer and Exercise Trial in Alberta (BETA) was a two-centred randomized controlled trial in Alberta, Canada. The trial consisted of a 12-month intervention and 12-month observation period. For the intervention, participants were randomized to either a moderate-volume exercise group (150 min/week) or a high-volume exercise group (300 min/week). Participants in this study were 334 inactive postmenopausal women who had been followed-up to 24 months. The primary outcome for this study was 24-month change in total body fat using dual energy X-ray absorptiometry scans. Other measures included weight, waist and hip circumferences, subcutaneous and intra-abdominal fat from computed tomography scans, and lean mass. Researchers were blinded to randomization group when measuring body fat. Results. Both groups self-reported ∼180 minutes/week moderate–vigorous activity at 24 months. No statistically significant difference was found in total body fat at 24 months between the two groups. Statistically significant effects (comparing high versus moderate groups) were found for BMI (least-square mean change (95% CI): −0.66 (−0.97, −0.36) versus −0.25 (−0.55, 0.05) kg/m2, ), waist-to-hip ratio (−0.033 (−0.040, −0.026) versus −0.023 (−0.030, −0.016), ), and subcutaneous abdominal fat area (−32.18 (−39.30, −25.06) versus −22.20 (−29.34, −15.05) cm2, ).Conclusion. Prescribing 300 versus 150 minutes/week of exercise to inactive postmenopausal women resulted in some long-term greater decreases in measures of body composition but no overall differences in total body fat loss. This trail is registered with NCT01435005.Item Open Access Hours spent and energy expended in physical activity domains: Results from The Tomorrow Project cohort in Alberta, Canada(BioMed Central, 2011-10-10) Csizmadi, Ilona; Lo Siou, Geraldine; Friedenreich, Christine M.; Owen, Neville; Robson, Paula J.Item Open Access Impact of Physical Activity on Oxidative Stress Markers in Patients with Metastatic Breast Cancer(2021-07-16) Delrieu, Lidia; Touillaud, Marina; Pérol, Olivia; Morelle, Magali; Martin, Agnès; Friedenreich, Christine M.; Mury, Pauline; Dufresne, Armelle; Bachelot, Thomas; Heudel, Pierre-Etienne; Fervers, Béatrice; Trédan, Olivier; Pialoux, VincentPurpose. Regular physical activity (PA) can affect oxidative stress, known to be involved in carcinogenesis. The objective of this study was to evaluate the associations between a six-month PA intervention and oxidative stress biomarkers, PA, and clinical outcomes in patients with metastatic breast cancer. Methods. Forty-nine newly diagnosed patients with metastatic breast cancer were recruited for a single-arm, unsupervised, and personalized six-month walking intervention with activity tracker. PA level and PA fitness, plasma concentrations of DNA oxidation (8OhdG), lipid peroxidation (MDA), and protein oxidation (AOPP), plasma activities of superoxide dismutase (SOD), glutathione peroxidase (GPX), and catalase, plasma and leucocyte activities of myeloperoxidase (MPO) and NADPH oxidase (NOX), and clinical markers of tumor progression (RECIST criteria) were measured at baseline and after the six-month intervention. Results. GPX activity (+17%) and MDA (+9%) significantly increased between baseline and the end of the intervention. Changes in PA level and fitness were significantly positively correlated with changes in plasma GPX and significantly negatively with changes in NOX in the leucocytes. Plasma MDA was significantly higher (+20%) whereas plasma AOPP was lower (-46%) for patients with tumor progression or that died during the six months as compared to patients without progression. Conclusion. A six-month PA intervention may be potentially beneficial in metastatic breast cancer patients for enhancing antioxidant enzyme activity and decreasing prooxidant enzyme activity. Moreover, AOPP and MDA could also be favorable and unfavorable biomarkers, respectively, since they are associated with disease progression and fitness level in this population. This trial is registered with NCT number: NCT03148886.Item Open Access Influence of Inflammation, Insulin Resistance and Excess Body Size on Breast Cancer Risk: A Nested Case-Control Study(2020-02-06) Haig, Tiffany R.; Brenner, Darren R.; Friedenreich, Christine M.; Li, Haocheng; Robson, PaulaBackground: Breast cancer is the most common malignancy affecting women in Canada. In 2019, breast cancer represented 25% of all new cancers among Canadian women and 13% of all cancer deaths. Excess body size is associated with postmenopausal breast cancer risk. The mechanisms associating adiposity to breast cancer are unclear. Both inflammation and insulin resistance have been implicated in this association; however, literature to date has been inconsistent. Here, we aim to examine the associations between high-sensitivity C-reactive protein (hsCRP) and hemoglobin A1c (HbA1c), common measures of inflammation and insulin resistance, respectively, with breast cancer risk, while adjusting for measures of excess body size. Methods: We conducted a nested case-control study within the Alberta’s Tomorrow Project cohort (Alberta, Canada) including 197 invasive breast cancer cases and 394 matched controls. Serum concentrations of hsCRP and HbA1c were measured from blood samples collected prior to diagnosis, along with anthropometric measurements, general health, and lifestyle data. Conditional logistic regression was used to evaluate the associations between hsCRP, HbA1c, and breast cancer risk adjusted for body fat percentage and other risk factors for breast cancer. Results: Participants included in this study were a mean age of 65.1 years and mostly postmenopausal (147 cases and 293 controls). More than half were categorized as overweight/obese (60.5% for cases; 64.9% for controls), and median values of hsCRP (0.9; interquartile range (IQR) = 1.8) and HbA1c (5.6; IQR = 0.6) were similar between cases and controls. Higher concentrations of hsCRP were associated with elevated breast cancer risk (odds ratio [OR] = 1.27; 95% confidence interval [CI] = 1.03, 1.55). The observed associations were unchanged with adjustment for body fat percentage. Higher HbA1c concentrations were not significantly associated with an increased risk of incident breast cancer relative to controls (OR = 1.22; 95% CI = 0.17, 8.75). Conclusion: These data suggest that hsCRP, a marker of inflammation, may be associated with elevated breast cancer risk, independent of body fat percentage. However, elevated concentrations of HbA1c did not appear to increase breast cancer risk in this group of women in Alberta.Item Open Access Polycystic Ovarian Syndrome: An Investigation of Non-Pharmacologic Management Strategies and Cardiometabolic Consequences(2021-05-12) Benham, Jamie L.; Sigal, Ronald J.; Corenblum, Bernard; Rabi, Doreen M.; Friedenreich, Christine M.Background: Preliminary evidence suggests exercise training may result in improved reproductive, anthropometric, cardiometabolic and psychosocial health in women with polycystic ovary syndrome (PCOS).Objective: To evaluate the effects of exercise training on reproductive, anthropometric, cardiometabolic, and sleep quality health measures in reproductive-aged women with PCOS.Methods: First, we performed a systematic review and meta-analysis of studies assessing the effects of exercise training on reproductive outcomes. Second, we performed a pilot randomized controlled trial evaluating the feasibility of conducting a larger trial evaluating reproductive, anthropometric, cardiometabolic, and sleep quality health measures. Feasibility outcomes included: participant recruitment, attrition, adherence to prescribed exercise and daily ovulation assessment.Results: The systematic review included 14 studies involving 617 women. Semi-quantitative analysis suggested exercise training may increase ovulation rates, menstrual regularity and pregnancy. In the trial, all recruitment methods were important as each recruited participant was not reached by the other methods. 47 participants were randomized: no-exercise control (n=17), high-intensity interval training (HIIT) (n=16), continuous aerobic exercise training (CAET) (n=14). Across all groups, attrition was 15%. Median exercise adherence was 68% (IQR 53%, 86%). Ovulation assessment adherence dropped from 87% (IQR 61%, 97%) in the first 3-months of the intervention to 65% (IQR 0%, 96%) in the final 3-months. 22/33 (66.7%) women ovulated during the intervention period with no between-group differences. Body mass index decreased for CAET compared with HIIT (-0.9 kg/m2, p=0.04) and control (-1.0 kg/m2, p=0.01). Mean waist circumference decreased significantly (-7.3 cm, -6.9 cm, -4.5 cm in HIIT, CAET and control) with no significant between-group differences. In HIIT compared with CAET, LDL-C decreased significantly (-0.33 mmol/L, p=0.03). In HIIT compared with control, HDL-C increased (0.18 mmol/L, p=0.04). 79% of participants reported poor sleep quality.Conclusions: While exercise training may improve anthropometric, reproductive and sleep quality health markers in women with PCOS, the effects of exercise training on reproductive health measures remain unclear. Feasibility challenges with exercise training and daily ovulation assessment adherence limited the ability to analyze the effect of exercise on ovulation. Further studies are needed to determine optimal exercise prescriptions for this population.Item Open Access Predicting Early Discontinuation of Adjuvant Chemotherapy and its Impact on Survival among Individuals with Stage III Colon Cancer(2020-08-05) Boyne, Devon J; Brenner, Darren R.; Friedenreich, Christine M.; Cheung, Winson Y.; Hilsden, Robert J.; Sajobi, Tolulope T.Background: Approximately one in three patients with stage III colon cancer fail to complete the entirety of their adjuvant chemotherapy prescription. Two questions arise from this observation: 1) Can we predict which patients will discontinue adjuvant chemotherapy? and 2) Does a shortened duration of adjuvant chemotherapy impact overall survival? Evidence pertaining to the first question is limited. While question two was recently addressed within a large randomized trial, results from this trial have been controversial. Methods: To address question one, we conducted a systematic review and survey of medical oncologists to identify factors that predict non-completion of adjuvant chemotherapy. Building upon the results of this investigation, we developed an online calculator to predict the risk of discontinuation at the individual-level. For question two, a systematic review and meta-analysis was performed. In addition, we emulated a target trial that examined the effect of a shortened duration of adjuvant chemotherapy on overall survival using real-world data.Results: According to a systematic review of 18 studies and survey of 14 medical oncologists, there was evidence that increased comorbidity, worse performance status, higher T stage, and adjuvant CAPOX chemotherapy or poor oxaliplatin candidacy were associated with an increased risk of discontinuation. Using information from 1,378 patients, an online risk calculator was developed. Internal validation suggested that this calculator accurately predicted and classified patients with respect to their risk of discontinuation (optimism-adjusted C-statistic=0.80; 95% CI:0.79-0.82; calibration plots were within acceptable limits). A meta-analysis of 22 studies suggested that a shortened duration of adjuvant chemotherapy was harmful among patients prescribed a monotherapy (HR: 0.59; 95% CI: 0.52-0.68) but not among among those prescribed FOLFOX or CAPOX (HR: 0.80; 95% CI: 0.58-1.09). In a target trial analysis of 485 colon cancer patients, both the overall and subgroup-specific hazard ratios were consistent with those from a randomized trial. Conclusions: Results from this investigation can help assess and communicate the risk of early discontinuation within this study population. Results from our meta-analysis and target trial emulation suggest that a shortened duration of adjuvant chemotherapy may be appropriate for some patients which supports findings from a recent randomized trial.Item Open Access Prioritizing a research agenda on built environments and physical activity: a twin panel Delphi consensus process with researchers and knowledge users(2023-12-07) Prince, Stephanie A.; Lang, Justin J.; de Groh, Margaret; Badland, Hannah; Barnett, Anthony; Littlejohns, Lori B.; Brandon, Nicholas C.; Butler, Gregory P.; Casu, Géna; Cerin, Ester; Colley, Rachel C.; de Lannoy, Louise; Demchenko, Iryna; Ellingwood, Holly N.; Evenson, Kelly R.; Faulkner, Guy; Fridman, Liraz; Friedenreich, Christine M.; Fuller, Daniel L.; Fuselli, Pamela; Giangregorio, Lora M.; Gupta, Neeru; Hino, Adriano A.; Hume, Clare; Isernhagen, Birgit; Jalaludin, Bin; Lakerveld, Jeroen; Larouche, Richard; Lemon, Stephenie C.; Loucaides, Constantinos A.; Maddock, Jay E.; McCormack, Gavin R.; Mehta, Aman; Milton, Karen; Mota, Jorge; Ngo, Victor D.; Owen, Neville; Oyeyemi, Adewale L.; Palmeira, António L.; Rainham, Daniel G.; Rhodes, Ryan E.; Ridgers, Nicola D.; Roosendaal, Inge; Rosenberg, Dori E.; Schipperijn, Jasper; Slater, Sandra J.; Storey, Kate E.; Tremblay, Mark S.; Tully, Mark A.; Vanderloo, Leigh M.; Veitch, Jenny; Vietinghoff, Christina; Whiting, Stephen; Winters, Meghan; Yang, Linchuan; Geneau, RobertAbstract Background The growth of urban dwelling populations globally has led to rapid increases of research and policy initiatives addressing associations between the built environment and physical activity (PA). Given this rapid proliferation, it is important to identify priority areas and research questions for moving the field forward. The objective of this study was to identify and compare research priorities on the built environment and PA among researchers and knowledge users (e.g., policy makers, practitioners). Methods Between September 2022 and April 2023, a three-round, modified Delphi survey was conducted among two independent panels of international researchers (n = 38) and knowledge users (n = 23) to identify similarities and differences in perceived research priorities on the built environment and PA and generate twin ‘top 10’ lists of the most important research needs. Results From a broad range of self-identified issues, both panels ranked in common the most pressing research priorities including stronger study designs such as natural experiments, research that examines inequalities and inequities, establishing the cost effectiveness of interventions, safety and injuries related to engagement in active transportation (AT), and considerations for climate change and climate adaptation. Additional priorities identified by researchers included: implementation science, research that incorporates Indigenous perspectives, land-use policies, built environments that support active aging, and participatory research. Additional priorities identified by knowledge users included: built environments and PA among people living with disabilities and a need for national data on trip chaining, multi-modal travel, and non-work or school-related AT. Conclusions Five common research priorities between the two groups emerged, including (1) to better understand causality, (2) interactions with the natural environment, (3) economic evaluations, (4) social disparities, and (5) preventable AT-related injuries. The findings may help set directions for future research, interdisciplinary and intersectoral collaborations, and funding opportunities.Item Open Access A Prospective Cohort Study of Metabolic Syndrome and Endometrial Cancer Survival(2020-07-24) Kokts-Porietis, Renee L.; Friedenreich, Christine M.; Nelson, Gregg; Cook, Linda S.; Courneya, Kerry S.Background: Metabolic syndrome has been previously associated with increased endometrial cancer risk, but the relationship with metabolic syndrome and endometrial cancer survival remains unclear. Objectives: To determine the associations between metabolic syndrome using the harmonized criteria with disease-free survival, overall survival, endometrial cancer-specific survival and time to recurrence among endometrial cancer survivors. Second, to determine the association between the number of metabolic syndrome components as well as each individual metabolic syndrome component with these prognostic outcomes. Methods: A prospective cohort of 540 endometrial cancer survivors diagnosed between 2002 and 2006 participated in the Alberta Endometrial Cancer Cohort and were followed until death or March 20, 2019. Baseline in-person interviews, direct anthropometric measurements and fasting blood samples were used to assess metabolic syndrome. Recurrence and survival data were obtained via medical chart abstraction and vital status updates. Results: Compared to endometrial cancer survivors without metabolic syndrome, survivors with metabolic syndrome had worse overall survival when assessed with the harmonized criteria. Of the individual metabolic syndrome components, only waist circumference was associated with recurrence and survival outcomes. Lifetime recreational physical activity prior to diagnosis was observed to modify the associations between metabolic syndrome and its components with overall survival and disease-free survival. Conclusion: The metabolic syndrome, especially waist circumference, was associated with worse overall and disease-free survival among endometrial cancer survivors. Future research should aim to confirm these results and improve our understanding of the role lifestyle factors such as physical activity have in the association between metabolic syndrome and endometrial cancer survivors’ prognosis.Item Open Access Raising awareness about physical activity’s role in reducing cancer risk: qualitative interviews with immigrant women and community agency managers(2024-07-31) Iziduh, Sharon; Dhakal, Smita; Sihota, Riana; Ye, Xinyang; Friedenreich, Christine M.; Khanlou, Nazilla; Sabiston, Catherine M.; Smith-Turchyn, Jenna; Tomasone, Jennifer R.; Gagliardi, Anna R.Abstract Objectives To explore how to reach immigrant women through community agencies to raise awareness of the role of physical activity (PA) in reducing cancer risk. Study design Qualitative description. Methods We conducted semi-structured telephone interviews with immigrant women and community agency managers to discuss the ideal design of an education session on PA and cancer risk, and identified themes using content analysis. Results Participants included 22 women (6 African or Caribbean Black, 4 Chinese, 3 Filipino, 5 Indian, 4 Pakistani) and 16 agency managers from across Canada. Women were not familiar with Canada’s PA guidelines, and few were aware that PA reduces the risk of cancer. All expressed interest in education about PA and cancer. Diverse women and managers expressed similar preferences for education session design including content (e.g. PA amount/type), format (e.g. in person preferred but virtual more practical), personnel (external expert plus agency staff), cultural tailoring (e.g. translated supplemental take home information) and reinforcing (e.g. follow-up with participants) strategies. Women and managers identified few barriers to participating in education sessions, chiefly, that women lacked time due to work and family responsibilities; and noted several enablers of participation (e.g. emphasize social aspect, provide gift cards or recreation centre passes). Conclusions We generated insight on the ideal characteristics of a community-based education session that could raise awareness among immigrant women of the importance of PA in reducing cancer risk. Further research is needed to assess the feasibility and impact of PA education sessions designed based on these findings.