Exploring the perspectives and experiences of men living with prostate cancer from minority ethnic backgrounds in undertaking physical activity: A qualitative analysis

Objective: Men from minority ethnic backgrounds experience disproportionate burdens of prostate cancer yet remain significantly underrepresented in clinical and exercise-based research. This qualitative study explored how men from diverse ethnic backgrounds understand and experience exercise following prostate cancer, and how psychological, cultural, and structural factors shape their willingness to engage in research. The aim was to generate insight that can support more integrated, culturally attuned approaches within psycho-oncology and cancer services.

Methods: Semi-structured interviews were conducted with ten men from African, Caribbean, Asian, and Middle Eastern backgrounds living with prostate cancer. Data were analysed using Braun and Clarke’s reflexive thematic analysis. A patient-informed topic guide and culturally reflexive approach were used to ensure psychological safety and contextual sensitivity. NHS ethical approval (IRAS: 345,005) was granted by the London-Camberwell St. Giles REC. Institutional ethical approval by Coventry University’s Research Ethics Committee [P178645].

Results: Six interconnected themes were identified: (1) Exercise as Mental Renewal, Identity, and Connection; (2) Cancer-Related Disruption and Fragmented Exercise Support; (3) Barriers to Participation in Exercise and Research; (4) Trust, Representation, and Inclusive Research Practices; (5) Cultural Stigma, Silence, and Shifting Perspectives; and (6) Altruism, Legacy, and Motivation to Engage. Across themes, participants emphasised the psychological significance of exercise for coping and identity reconstruction; the emotional consequences of inconsistent guidance; and the central role of trust, cultural understanding, and relational communication in research engagement. Findings informed a Culturally Sensitive Recruitment Framework designed to support integrated psycho-oncology care and improve equitable participation.

Conclusions: Psychological, cultural, and structural factors jointly shape exercise engagement and research participation among minority ethnic men with prostate cancer. Implementing culturally sensitive, relationship-centred, and psychologically informed recruitment and support strategies may strengthen integrated care and improve equity in psycho-oncology research and practice.