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Research regarding cross-behavioral relationships between the cognitive mechanisms motivating health behavior change is lacking for cancer survivors. This study investigated these relationships to inform the development of multiple health behavior change (MHBC) interventions for this at-risk population. Eligible participants included cancer survivors attending an intake appointment for smoking cessation services. This cross-sectional survey study assessed participants' self-efficacy and motivation (stage of change) for smoking cessation and exercise, as well as self-reported health behaviors. Analyses evaluated cross-behavioral associations between cognitive mechanisms and their relationships with smoking and exercise behaviors. Seventy-six participants completed the survey questionnaire. The correlation between self-efficacy scores for smoking cessation and exercise was statistically significant ( r = .45, 95% CI [.09, .67]), as were correlations between self-efficacy and reported levels of exercise (( r = .44, 95% CI [.20, .65]) strenuous); (( r = .36, 95% CI [.12, .59]) moderate), exercise self-efficacy and smoking behavior ( r = -.27, 95% CI [-.46, -.05]), and smoking self-efficacy and smoking behavior ( r = -0.41, 95% CI [-.61, -.18]). For cancer survivors, associations between exercise self-efficacy and smoking cessation self-efficacy may offer an opportunity to leverage MHBC; specifically, this positive association may facilitate exercise intervention in survivors seeking smoking cessation services..

For cancer survivors, who also often present with co-existing health conditions, exercise testing is often performed using submaximal protocols incorporating linear heart rate response for estimating the cardiorespiratory capacity and assessing exercise tolerance. However, use of beta-blocker medications, during sub-maximal protocols based on linear HR response can be problematic. Rating of perceived exertion (RPE), which takes into account an individual's overall perception of effort, can be used as a complementary tool that does not rely solely on the heart rate response to increased workload. We compared heart rate response (VO 2 HR) and self-rating of perceived exertion (VO 2 RPE) in a graded submaximal exercise test (GXT) in 93 endometrial cancer survivors. The results of the GXT were stratified according to whether participants were taking beta-blocker (BB) medications or not (non-BB). Among non-BB participants, there was no difference between the mean VO 2 HR and the mean VO 2 RPE estimates of cardiorespiratory capacity (mlO 2/ /kg/min) (20.4 and 19.3, respectively; p = 0.166). Among BB participants, the mean VO 2 HR approached significant difference than the mean VO 2 RPE (21.7 mlO 2/ /kg/min and 17.6 mlO 2/ /kg/min, respectively; p = 0.087). Bland-Altman plots for both methods showed a proportional bias for the non-BB group; but not the BB group. Our results suggest that sub-maximal protocols based on Borg's Rating of Perceived exertion (RPE) produce differing results from sub-maximal protocols based on HR response when applied to clinical population taking BB medications. Using RPE instead of HR for participants on BB medications may be a better method for assessing the exercise tolerance for estimating the cardiorespiratory capacity in sub-maximal exercise testing.