br adherence to national physical activity guidelines modera
adherence to national physical activity guidelines (moderate level) [26,28]. Physical activity interventions should include FCGs, due to their vital role in providing physical and emotional support for older adults with cancer.
Social support and goal setting were prominent themes that served as a facilitator and motivator for physical activity adherence in this Puromycin study. Enjoyment of the social aspects of physical activity, and encour-agement and companionship from others were factors that facilitated adherence to the physical activity intervention for both patients and FCGs [1,14,27]. Guidance from PT/OT, setting realistic physical activity goals, and ability to self-monitor activity progress, can help foster self-efficacy and the belief in one's ability to stay active, despite poor health conditions [29,30].
Study limitations include a primarily Caucasian and well-educated participants, and may limit the generalizability of our study. Physical activity levels in racial/ethnic minorities, and underserved/under-resourced communities are estimated to be lower, and those with higher education levels have higher physical engagement. A further lim-itation is the relatively high level of self-reported physical activity en-gagement of our participants. Finally, we did not capture detailed information on the level of physical activity; therefore, we were unable to determine potential differences in barriers and facilitators by those who are already active and those who are sedentary.
Patient and FCG adherence to a perioperative physical activity inter-vention is influenced by multiple intrapersonal, interpersonal, and envi-ronmental barriers and facilitators. In older adults with cancer and their FCGs, overall health conditions, motivation, goal setting, and social sup-port are important in the process of physical activity engagement. Inter-ventions to enhance optimal postoperative functional recovery for older adults with cancer should include strategies to reduce barriers and op-timize facilitators of physical activity.
Research reported in this publication was supported by the City of Hope Center for Cancer and Aging. It was also supported by the National Cancer Institute of the National Institutes of Health under award num-ber P30CA33572. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Center for Cancer and Aging or the National Institutes of Health.
Conflict of Interest Disclosure
The authors have no conflicts of interest to disclose.
Conception and Design: Virginia Sun, Dan Raz, Sherry Hite, Gouri
Varatkar, Yuman Fong.
Data Collection: All Authors.
Analysis and Interpretation of Data: All Authors.
Manuscript Writing: Virginia Sun.
Approval of Final Article: All Authors.
The lead author is anther grateful for Dr. Hurria's mentorship, support, and guidance over the last six years. This paper is a tribute to Dr. Hurria's contributions and legacy, particularly in advancing geriatric oncology nursing research and geriatric surgical oncology care.
 Husebo AM, Dyrstad SM, Soreide JA, Bru E. Predicting exercise adherence in cancer patients and survivors: a systematic review and meta-analysis of motivational and behavioural factors. J Clin Nurs Jan 2013;22(1–2):4–21.
 Ormel HL, van der Schoot GGF, Sluiter WJ, Jalving M, Gietema JA, Walenkamp AME. Predictors of adherence to exercise interventions during and after cancer treatment: a systematic review. Psycho-Oncology Mar 2018;27(3):713–24.
 Granger CL, Connolly B, Denehy L, et al. Understanding factors influencing physical activity and exercise in lung cancer: a systematic review. Support Care Cancer Mar 2017;25(3):983–99.
 Barber FD. Effects of social support on physical activity, self-efficacy, and quality of life in adult cancer survivors and their caregivers. Oncol Nurs Forum Sep 2013;40
 National Alliance for Caregiving. Cancer caregiving in the U.S; 2016.
 Biegel D, Sales E, Schulz R. Family caregiving in chronic illness: Alzheimer's disease,
 Pergolotti M, Deal AM, Lavery J, Reeve BB, Muss HB. The prevalence of potentially modifiable functional deficits and the subsequent use of occupational and physical therapy by older adults with cancer. J Geriatr Oncol May 2015;6(3):194–201.  Guell C, Panter J, Griffin S, Ogilvie D. Towards co-designing active ageing strategies: a qualitative study to develop a meaningful physical activity typology for later life. Health Expect Oct 2018;21(5):919–26.