Data cleaning resulted in the removal of two records. One participant in a dyad dropped out of the study on day four for personal reasons and was therefore removed from the analysis. Since the study was dependent on being in a dyad, the partner of the individual who dropped out was also removed. Participants’ descriptive demographic information for the final analytical sample (n = 46) is provided in Table 1. Women were on average 42.4 (range = 28–60) years of age. Most women were diagnosed with stage I-III breast cancer (89.2%), had completed active treatment approximately three years prior to the baseline survey, and 63% were currently receiving hormonal therapy.
Without providing any guidance on how often participants should connect or exercise, partners connected (58.1%; range = 4–21 days) and exercised (77.1%; range 9–21 days) on over half of the study days. Partners mainly connected using text messages (57.6%) and emails (31.4%) and felt all their support needs were met on 9 of the 21 days. WBC reported the highest scores for esteem (M = 2.75) and emotional (M = 2.63) exercise support provided by their partners. Mean social support across 21 days for each support type is presented in Figs. 1, 2, 3 and 4. Descriptive information for close-ended daily and follow-up survey responses are presented in Table 2. Results are presented based on the match profiles developed: (a) good (n = 29), (b) neutral (n = 9), and (c) poor (n = 8) match. WBC who identified being in a ‘good match’ reported higher scores on days exercised, days connected, PA, all types of social support, the effectiveness, enjoyment, and similarity of their exercise partner, and higher likelihood of continuing communication with their current partner. Meanwhile, women in a ‘poor match’ had higher scores on the likelihood of future participation with a different exercise partner. The comparisons across groups demonstrated moderate to large effect sizes with the good match group demonstrating much stronger effects of their partnership compared to the poor and neutral match groups.
Responses to open-ended questions were coded into the four types of social support: (1) informational support, (2) tangible support, (3) esteem support, and (4) emotional support. Within these themes, categories were generated based on commonalities in responses. Informational support included women sharing information (i.e., research articles) with one another. Tangible support included (a) sharing exercise videos, (b) sharing workout plans or challenges, and (c) exercising together (i.e., virtually or in-person). Esteem support included (a) active communication (e.g., updating partner on their workout), (b) creating shared goals (e.g., both partners walk in the evening), (c) exercise encouragement (e.g., sharing motivational texts), and (d) general encouragement or support (e.g., reminding partner to drink water). Emotional support included discussions regarding (a) cancer experiences and (b) exercise experiences.
Three profiles of women were created based on their support experience within their dyad and partner similarities. A description of each profile is presented below. Profiles were labeled based on the general pattern of social support experiences described throughout the study: (a) active communication, high support (included 29 women in a ‘good match’); (b) moderate communication, moderate support (included 9 women who were in a ‘neither good nor poor match’, referred to as ‘neutral’ match); and (c) poor communication, low support (included 8 women in a ‘poor match’). The frequency of participant responses in each profile for whether they received or felt they were missing each social support theme and category are shown in Table 3 Across all profiles, esteem support was most frequently documented as received, meanwhile WBC most described tangible and esteem support as lacking. The participants are identified by the dyad pair and partner number (e.g. D1, P1 reflects dyad 1, partner 1).
Women in this profile group provided longer and richer descriptions of their partner experience, which were written in a positive tone. For example, when asked to describe the types of support they received, WBC in this profile shared:
She described her exercise plan (length of exercise and steps). We exchanged information about cancer diagnosis. She was enthusiastic about exercising for both of us, she asked about my exercise goals and total steps I wanted to reach for today and if I had reached them. (D17, P1)
I found checking in with my partner to be supportive. We often checked in around goals for the day and [we] gave each other support if we weren’t very motivated. Usually checking in late in the day would give that final push to get some more activity in (D5, P1)
Women in this profile also documented greater similarities to their partner (e.g., age, stage in life, exercise goals) and described receiving more support than they felt they were missing. In addition, WBC expressed receiving support across all four support categories. They most frequently reported receiving esteem support, followed by tangible, emotional, and informational support, respectively.
WBC commonly described esteem support as having active communication with their partner. This included their partner texting them in the morning to remind them to exercise, sharing a photo of their walk, or sharing they had completed their daily exercise. Esteem support was also received through exercise encouragement or general support. WBC expressed that their partner sent them motivational texts or positive affirmations and discussed additional topics such as eating habits or engaging in casual conversation. For example, one woman noted, “She’s always very encouraging in her messages ‘You’re doing an amazing job’” (D23, P2) and one woman mentioned “[we] discussed nutrition goals, overall health and motivation” (D8, P2). While WBC commonly reported receiving esteem support, some described instances of wanting to receive more esteem support from their partner, in the form of exercise encouragement and active communication. For instance, some WBC desired to have shorter delays between text messages or a message before their walk rather than after: “I didn’t hear back from her about the email updating her on my progress” (D1, P1) and “We didn’t chat very much today” (D5, P1).
Following esteem support, tangible support was occasionally reported by women in this profile. WBC most often described experiencing tangible support through the sharing of workout plans or fitness challenges to participate in as a pair. This included walking plans, push-up challenges, or exercise pamphlets. Meanwhile, women also documented that even though they were receiving resources from their partner, some of the resources were not their preference (e.g., YouTube vs. outdoor activity): “[I would have liked] different types of exercise suggestions” (D6, P1). Overall, as these women were receiving higher levels of support than others in this study, their comments for what would have been helpful shifted from needs to preferences. For example, one woman expressed their desire to be able to exercise with their matched peer: “While it would be great to have my exercise buddy close by to be able to exercise with, our first conversation last night helped motivate me” (D14, P1).
On occasion, women in this profile described receiving emotional and informational support. Emotional support was provided more often regarding the cancer experience rather than experience with exercise. Women noted it was beneficial to talk about their cancer journey and be able to have someone to empathize with about symptoms or treatment side effects that impacted their PA behavior. Further, informational support was documented as being received through the provision of research articles on cancer survivorship and exercise, resistance training and cancer, and survivorship information from external organizations.
Finally, when women were asked to document the types of support, they thought would have been helpful to receive from their partner, some women’s responses provided the study investigators feedback on what would be beneficial beyond this dyad support. Study suggestions included group exercise, in-person exercise, and being provided workout plans from study staff. For instance, one woman detailed the support received from her partner and exercise-related social support she would like to receive moving forward:
I think even though I did not connect with my exercise partner today, she still challenges me to exercise and provides emotional support from our past conversations. I think it would be helpful to me to have an ongoing exercise group or partner going into the future and longer term to keep the challenge of exercising daily in the front of my mind (D17, P1)
Overall, women in a ‘good match’ shared similar characteristics to their partner, had more active communication over the three weeks, and received support across all support types.
Women in a ‘neutral match’ did not respond as often as women in a ‘good match’, gave moderate length and detail in responses, and indicated few similarities with their partner. Women in this profile also listed esteem support as the most frequently received, followed by tangible and emotional support, which were less commonly discussed. The women did not document receiving informational support.
Esteem support in the form of active communication was the most regularly documented, followed by exercise encouragement. WBC articulated that checking in with their partner was useful for accountability and motivational messages encouraged them to exercise: “Just checking in to see if I was active was helpful sometimes, made me feel accountable” (D13, P1). Women also described tangible support received from their partner in the form of exercise videos or challenges was helpful. For instance, one woman described esteem and tangible support received from their partner: “We checked in with each other almost every day, making us accountable to each other. We shared tips, exercises, exercise plan ideas and suggestions and we had a daily planking challenge” (D4, P2). Lastly, only one participant described emotional support in the form of cancer and exercise experiences, wherein they shared conversations about their individual struggles as one way they felt emotionally supported by their peer.
Women mainly expressed wanting more tangible and esteem support. Specifically, WBC stated that their partner provided delayed or minimal communication and described differences in personalities, motivation for the study, and exercise preferences. To illustrate, one woman shared: “She was busy working during the day and wasn’t interested in doing virtual workouts. So, we each did our own thing. Not as motivating for me personally” (D6, P2). Meanwhile, among the women who did receive more communication from their partner, some mentioned the workouts their partner suggested did not interest them, leading them to choose their own workouts. Other women noted that their partner was negative, and this lowered their own motivation to exercise: “[I] receive more complaints than positive messages” (D9, P2). Additionally, due to the perception of a lack of partner support, many women offered suggestions to improve the study with regards to matching participants based on similarities (e.g., schedules), facilitating matched peer introductions and discussions about similar life experiences, and providing opportunities for greater accountability and an exercise partner:
More careful matching of pairs with emphasis on matching of commitments of each person (D9, P2)
Someone to exercise with or to hold accountable for amount of time spent exercising (D13, P1)
Overall, women in a ‘neutral match’ were receiving a moderate amount of support and active communication from their partner, with support received across three categories.
Women who were in a ‘poor match’ were much less likely to respond to questions. Responses that were provided were shorter in length with minimal detail (e.g., “Just checked in with me”; D3, P2). WBC also noted that there were few similarities with their partner, and they experienced little to no contact or responses from their partner. For those who did respond, the most frequent support type received was esteem support, followed by tangible and emotional support. There was no mention of informational support.
Women in this profile wanted to receive greater esteem and tangible support. This was mainly attributed to their partner not responding to their calls or texts on a certain day or during the entire study period or indicating they did not want to exercise. And so, due to the lack of communication, WBC documented a higher need for external motivation outside of their partner. For instance, one woman shared that she needed “extra motivation to get out of bed to do it [exercise]” (D16, P2). Meanwhile, another participant described that “touching base with my exercise partner prior to the day starting” (D20, P1) would have helped to improve their exercise motivation. Finally, because of the low communication and support received from their partner, a few women noted wanting advice from study staff on motivation and resources for weight loss or managing cancer side effects and wanting a partner who is equally committed to the study.
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