Evaluating implementation and pragmatism of cancer-specific exercise programs: a scoping review

Purdy, Graeme M.; Sobierajski, Frances; Dolgoy, Naomi; McNeely, Margaret L.

doi:10.1007/s11764-021-01032-8

Cited by 13 publications

(11 citation statements)

References 46 publications

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“…PROGRAM DEVELOPMENT AND IMPLEMENTATION (STANDARDS 2, 3, 4, 7, 9, AND 10) The Fit Cancer program was developed based on established clinical guidelines, PA behavior change theory, and a scoping review of existing cancer CSEP (6). Future programs may also consider engaging clinical stakeholders and using formative research to foster buy-in from medical and/or rehabilitation professionals.…”

Section: Program Evaluation (Standard 11)mentioning

confidence: 99%

Novel Application of Recommendation Standards to Evaluate a Cancer-Specific Community-Based Exercise Program

Covington

Leach

Marshall³

et al. 2022

Transl J ACSM

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Physical activity (PA) is an important health behavior associated with improved physical functioning (1), well-being (1), and length of survival (2) for individuals living with and beyond cancer (i.e., survivors). However, after completion of active treatment, it has been reported that a large proportion of survivors do not meet established PA guidelines of ≥150 min of moderate-intensity PA per week (3,4). For many, treatment-related functional limitations persist months to years after treatment completion (5), and become barriers to initiate and maintain PA (1,3).Community-based supervised exercise programs (CSEP) specific to cancer survivors are growing in popularity and, when studied, have demonstrated feasibility and positive impacts on survivors' PA, muscular endurance, and well-being (6, 7). Oncology clinical practice guidelines recommend supervised exercise in the community or other outpatient settings (8), and leading organizations call for improved the integration of CSEP and oncology services (9). However, systematic and scoping reviews of existing CSEP show there is considerable variability in the reach, implementation, effectiveness, and sustainability of these programs (6,7,10). This variability in implementation and evaluation precludes the ability to ensure quality and to determine implementation strategies that may optimize effectiveness, participant satisfaction, and sustainability (10). Implementation and accreditation standards are critical to ensure safety, quality, and consistency of health care services (11). Thus, the field of exercise oncology is at a pivotal moment where the development and adoption of implementation and accreditation standards is necessary to optimize quality and consistency of CSEP.

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Section: Program Evaluation (Standard 11)mentioning

confidence: 99%

Novel Application of Recommendation Standards to Evaluate a Cancer-Specific Community-Based Exercise Program

Covington

Leach

Marshall³

et al. 2022

Transl J ACSM

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“…This was an unanticipated finding that was likely due to context-specific differences in implementation processes. In Edmonton, the research team’s delivery of the community-based program was more consistent with an explanatory research approach [ 23 ]. Research staff were actively involved in the program, including through oversight of data collection, monitoring of participant adherence, and provision of onsite support to the community exercise specialist delivering the intervention, features consistent with prior YMCA implementation approaches [ 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Criticisms of the focus on community-based initiatives include a lack of concordance with patients’ preferences for home-based interventions, as well as poor attendance and high dropout rates reported from community programs [ 18 , 19 , 20 , 21 ]. Thus, further study is needed to provide contextually relevant and timely information on factors that can enhance or impede implementation success [ 22 , 23 ]. Assessing the feasibility of an implementation strategy offers the opportunity to evaluate both the outcomes and processes involved and refine the intervention and its delivery format prior to program spread and scale [ 22 , 24 ].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of Implementing Cancer-Specific Community-Based Exercise Programming: A Multi-Centre Randomized Trial

McNeely

Suderman

Yurick

et al. 2022

Cancers

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Background: There is growing recognition of the importance of reporting preliminary work on the feasibility of a trial. The present study aimed to assess the feasibility of (1) a proposed fitness testing battery, and (2) processes related to the implementation of cancer-specific exercise programming in a community setting. Methods/Design: A randomized controlled implementation feasibility trial was performed in advance of a large-scale implementation study. Eligible participants within 18 months of a cancer diagnosis were randomized to immediate or delayed community-based exercise at YMCA locations in Calgary and Edmonton, Canada for an 8-week period. The primary outcome for the trial was the feasibility of the physical fitness testing battery, defined as a 70% or greater completion rate across the 24-week study period. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was used to evaluate processes related to implementation of the exercise program across the two sites. Results: Eighty participants were recruited, 73 (91%) completed the 8-week trial, and 68 (85%) completed the 16- and 24-week follow-ups. Sixty participants (75%) completed the full physical fitness test battery at each time point, and 59 (74%) completed the patient-reported outcome measures. Statistically significant between-group differences were found in favor of the exercise group for functional aerobic capacity, upper and lower extremity strength, and symptoms. Differences were found between the sites, however, in completion rates and processes related to program implementation. Discussion: Findings suggest the need for minor adaptations to the physical fitness battery and outcome measures to better fit the community context. While findings support feasibility, context-specific challenges related to implementation processes were identified.

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“…Some institutions, such as the Canadian Cancer Society [ 17 ] and the Australian public hospitals [ 18 ] have developed real-world settings. Still, current research is limited to cancer survivors or people diagnosed with cancer [ 19 , 20 ]. The aim of this article was (a) to describe the process behind a free, not-for-profit community-based therapeutic exercise program (TEP) for MBC patients in the clinical setting and (b) to determine the recruitment, compliance and improvement in outcomes after its completion.…”

Section: Introductionmentioning

confidence: 99%

Implementation of a Standard Care Program of Therapeutic Exercise in Metastatic Breast Cancer Patients

Pajares

Roldán-Jiménez

Alba

et al. 2022

IJERPH

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Background: There is little information on the feasibility and benefit of therapeutic exercise (TE) in women with metastatic breast cancer (MBC). The aim of this article is to describe the implementation of a TE intervention in MBC patients, and to determine the recruitment, compliance and improvement in outcomes after its completion. Methods: The “Therapeutic Exercise program in MBC” (TEP-MBC) consists of 1 h of individualized TE supervised by a physiotherapist in a group format, consisting of four groups of seven to eight participants. TEP-MBC was delivered twice a week, lasting 12 weeks (22 sessions), with patients considered to have completed the program when attending at least 17 sessions (>75% attendance). After referral, patients underwent a clinical interview and a physical and functional assessment. This information was complemented with patient-reported outcomes. Data about referral, compliance and assessment were collected. Results: Only 11 of the 30 patients completed the program. Drop-out was mainly related to personal issues and symptoms arising from the disease or treatment. All patients who completed the program improved cancer-related fatigue and increased their functional parameters. Conclusions: The TEP-MBC was safe and feasible in patients with MBC, although with low compliance. The high variability in baseline measures reflects the heterogeneous level of function.

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Evaluating implementation and pragmatism of cancer-specific exercise programs: a scoping review

Cited by 13 publications

References 46 publications

Novel Application of Recommendation Standards to Evaluate a Cancer-Specific Community-Based Exercise Program

Novel Application of Recommendation Standards to Evaluate a Cancer-Specific Community-Based Exercise Program

Feasibility of Implementing Cancer-Specific Community-Based Exercise Programming: A Multi-Centre Randomized Trial

Implementation of a Standard Care Program of Therapeutic Exercise in Metastatic Breast Cancer Patients

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