Colorectal cancer (CRC) survivors who exercise are at reduced risk of death than their sedentary counterparts. The implementation of efficacious exercise promotion interventions targeting the least active CRC survivors is of paramount importance. Messages that stress the gains (i.e., advantages) of engaging in recommended behaviors or the losses (i.e., disadvantages) of not following recommended behaviors have shown to motivate behavior change. In general, gain frame messages increase intentions to exercise more than loss frame messages. Whether gain-frame messages increase exercise among sedentary CRC survivors has never been tested. Due to their diagnosis and treatment of CRC, serving as a possible """"""""teachable moment"""""""", CRC survivors may be especially sensitive to framing effects. A major aim of this study is to determine among 120 early stage sedentary CRC survivors whether gain-frame messages increase total minutes of moderate to vigorous exercise more than loss-framed messages. We will explore mediation for possible effects of framing on exercise. CRC survivors will complete a baseline survey that assesses prevalently-used theoretical frameworks for exercise promotion, including implementation intentions and processes of change. Participants will be assigned at random to receive a brochure containing either gain- or loss-frame messages associated with exercise, along with tips to increase exercise and a toll free number to receive additional instructive brochures on exercise. All participants will complete a one-month follow-up survey to assess exercise, intentions to exercise as well as several of the baseline measures (e.g., perceived risks and worry, barriers to exercise, attitudes towards exercise). This will be the first study to test how framing affects levels of exercise in sedentary CRC survivors as well as possible mediators and moderators. Effect sizes and variances obtained can be used to develop and refine a larger intervention trial to more powerfully test the mechanisms and outcomes discussed above. Public Health Relevance: Colorectal Cancer (CRC) survivors who exercise are at lower risk to have recurrence of CRC and mortality than their sedentary counterparts. As such, this study tests an intervention to whether discussing the advantages of exercising (gain frame messages) versus the disadvantages of not exercising (loss frame messages) increases exercise among 120 sedentary CRC survivors. The study also explores for whom and why these messages may be effective.
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