Introduction Endometrial cancer survivors frequently have multiple long-standing cardiovascular risk factors. Treating these can be challenging but is vital to prevent excess morbidity and mortality. The identification of motivators and barriers to lifestyle modification could allow the development of targeted interventions to optimise cardiovascular health.

Methods A subset of women participating in a prospective cohort study optimising cardiovascular risk factors in endometrial cancer survivors (OPTIMUS) underwent semi-structured interviews (in person or by phone) in 2023. Questions focused on feelings towards and reasons for taking up lifestyle changes, the perceived cost and effort required. All transcripts were double-coded using NVivo and analysed thematically with a leaning towards the Theoretical Framework of Acceptability.

Results Fifteen women were purposively selected to ensure maximal variation in baseline characteristics and engagement with lifestyle modification. Barriers to change included pre-existing health conditions, lack of time and the cost of healthy food and gym membership. This was especially evident for women from lower socioeconomic backgrounds. Lack of individualised support was a common theme, with generic information not appropriate for women with underlying health conditions or non-Western dietary preferences. Perceived benefits to overall health and family were strong motivators for change, with the patient-healthcare provider relationship an important influencer.

Conclusion/Implications There is a desire to improve overall health among endometrial cancer survivors. Behaviour change is difficult and motivation is varied. Consideration needs to be given to ethnicity and socioeconomic status when advising on cardiovascular risk factor optimisation and is a crucial step toward equality in survivorship.