We determined the barriers to and facilitators of exercise promotion by health care professionals (HCPs) for women with breast cancer (BC). The study was a qualitative descriptive study. Semi-structured interviews were conducted with HCPs who treat individuals with BC in Ontario. The interviews were recorded and transcribed. Two reviewers independently used content analysis to determine codes and themes developed in the interviews. NVivo 10 was used during the coding process. A total of 24 HCPs participated in this study. The data from the interviews were grouped into five main categories: (1) institutional barriers, (2) HCP barriers, (3) perceived patient barriers, (4) facilitators (resource and service needs), and (5) patient characteristics. A graphic depiction of the interaction was created for these categories and how they affect the promotion of exercise for women with BC. Participants in this study identified several barriers to exercise promotion at the institutional, professional, and patient levels and suggested several strategies to facilitate exercise promotion. These findings can inform future exercise interventions to increase exercise adherence and engagement in this population.
Background:
Survivors of cancer who are considered “hard to reach” have less engagement in survivorship programming and lower overall health status, well-being, quality of life, and survival. These include individuals who live in rural areas. There is a need to determine the availability, characteristics, feasibility, and effectiveness of exercise programs for individuals with cancer living in rural settings.
Purpose:
To conduct a scoping review describing the current literature on available exercise programming for survivors of cancer who live in rural or remote settings.
Methods:
Data Sources: Six databases were searched for studies. Study Selection: 105 abstracts were identified through literature searches; 84 studies remained for title and abstract screening after duplicates were removed. Thirty-three articles were included in full-text review. Data Extraction: Data related to participant characteristics, intervention characteristics, study design, and outcomes were extracted from full texts. Data Synthesis: Descriptive quantitative summaries are provided for result variables, and a narrative analysis was performed.
Discussion and Limitations:
Thirteen articles were selected for data extraction. The majority of interventions were phone-based walking programs for survivors of breast cancer. The interventions described were held in only 2 countries. The most common outcomes assessed were physical activity level, quality of life, and anxiety/depression.
Conclusion:
This scoping review highlighted the lack of accessible exercise programs for this subset of hard-to-reach survivors of cancer. This review found that there are few exercise programs accessible for survivors living in rural and remote areas, suggesting one reason for low engagement in physical activity and highlighting the need to devise novel means to implement exercise interventions for this population.
Background
Peer-based exercise interventions that cultivate new opportunities for support with a fellow cancer survivor may result in increased exercise volume. It is not clear whether adding qualified exercise professional (QEP) support to peer-based interventions improves health outcomes. Therefore, the purpose of this study is to determine whether breast cancer survivor (BCS) dyads who receive 10 weekly sessions of virtually delivered QEP support have improved outcomes compared to BCS dyads who do not receive QEP support.
Methods
Participants Adult BCS with medical clearance for exercise, who have an internet-connected device, and currently engage in < 150 min of moderate-intensity exercise per week. Intervention BCS will be matched using evidence-based criteria. The intervention group will receive dyadic exercise information sessions and a program tailored by a QEP for 10 weeks (intervention period) and have access to the QEP for an additional 4 weeks (tapering period). The control will not receive any QEP support. Outcomes The primary outcome is post-intervention self-reported exercise volume. Secondary outcomes include device-assessed exercise volume (i.e., Fitbit), social support, and health-related quality of life. Randomization 108 participants, matched in dyads, will be randomized 1:1 to the MatchQEP or Match groups using a web-based scheme. Statistical analysis Outcomes will be measured at baseline, post-intervention, post-tapering, and at 12 weeks post-intervention follow-up.
Discussion
The findings from this RCT will determine if matched BCS dyads who receive 10 weeks of virtually delivered QEP support have higher levels of self-report and device-measured exercise, social support, and health related quality of life compared to matched dyads without QEP-delivered exercise guidance. To our knowledge this will be the first study to assess the combined effect of peer- and QEP support on exercise volume. Project findings will inform and optimize intervention methods aimed to increase exercise among BCS through accessible exercise supports.
Trial Registration: The study is registered on ClinicalTrials.gov (study identifier: NCT04771975, protocol Version Number: 2, date: July 22, 2021).
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