Limitations
breast cancer
RECRUITMENT, BREAST CANCER
This study occurred during the COVID-19 pandemic. All participants completed baseline measures and about two-thirds of participants completed 3-month measures prior to the start of the pandemic (defined as March 12, 2020). All participants completed 6-month measures during the pandemic. Since measures were administered remotely, we were able to collect all outcome data as planned. However, external factors related to the pandemic may have differentially impacted adherence, engagement, and delivery of the intervention. Some peer mentors experienced changes to their jobs that resulted in more flexibility or availability for peer mentoring, while others had to balance increased familial responsibilities or other life circumstances that limited their capacity. The nationwide participant sample drew from 15 geographically diverse states with different COVID-19 restrictions. There is evidence that the pandemic and associated restrictions had detrimental impacts on self-reported and objectively assessed PA compared to pre-COVID-19 activity levels among the general population (Stockwell et al., A few other methodological limitations should be considered. Although the one-arm, pre-post design was appropriate given the focus on exploring feasibility, acceptability, and satisfaction, the lack of a comparison arm or randomization limits evidence of causality. Further, the measures of strength and flexibility were self-report and only captured frequency, rather than duration and/or intensity. The use of a multicomponent intervention with the current study design limits our ability to quantitatively determine which intervention components were most effective and for whom, and to isolate, describe, and evaluate the impact of specific features (i.e., “active ingredients”) on PA and QOL outcomes. Future research should consider alternative experimental approaches, such as MOST, that enable the evaluation of multiple specific intervention components on study outcomes (Collins et al., Characteristics of study participants and how they were recruited may also impact generalizability and impact of the findings. While social media recruitment was cost and time-efficient, participants in this study were likely more technologically savvy and more motivated to change their PA behavior than the general younger breast cancer survivor population. Additionally, while we expected that online recruitment would yield a diverse sample, based on the racial and ethnic diversity of social media users overall (Pew Research Center, 