Experiences and perceptions of referrals to a community-based physical activity program for cancer survivors: a qualitative exploration

Abstract

Background Physical activity rates in cancer survivors continue to be low despite the known benefits and availability of evidence-based programs. LIVESTRONG at the Y is a national community-based physical activity program offered cost-free to cancer survivors, though is underutilized. We explored perceptions and experiences of staff and participating survivors to better understand program awareness, referrals and participation. Methods LIVESTRONG at the Y program staff [directors (n = 16), instructors (n = 4)] and survivors (n = 8) from 8 United States YMCAs took part in 30-min semi-structured phone interviews between March–May 2019. Interviews were digitally recorded, transcribed, and evaluated using a thematic analysis approach. Results Program staff themes included: 1) Program awareness should be further developed for both the general public and medical providers; 2) Strong relationships with medical providers increased program referrals; 3) Electronic referral systems between providers and LIVESTRONG would help to streamline the referral process; and 4) Bi-directional communication between program staff and medical providers is key to providing patient progress updates. Survivor themes included: 1) Survivors trust their medical team and the information they provide about physical activity; 2) Providers need to incorporate an action plan and referrals for survivors to be active once treatments are completed; and 3) Personal experiences of those who participated in LIVESTRONG resonate with survivors and increase participation. Conclusions LIVESTRONG staff reported the need for an integrated electronic referral system and bi-directional communication with providers about participant progress. Survivors want physical activity education, electronic referrals and follow-up from their healthcare team, coupled with peer support from other survivors. Cancer care provider knowledge and electronic referrals during and after treatment may expedite and increase participation in this community-based program.

Health Fitness Professionals’ Perceptions to Offering a Cancer Exercise Program: A Qualitative Study

“…This study adds to the growing body of studies evaluating health and fitness professionals’ perspective on the challenges and opportunities for exercise programming in cancer populations because previous studies have primarily focused on patient and care provider perspectives in understanding barriers and enablers to cancer exercise programming. Based on findings of prior research among cancer survivors (13–15,20), the responses obtained in the present study reinforce that cancer survivors and health and fitness professionals cite many similar perceived barriers such as education/awareness, referral/access, and cost (16,17).…”

“…The study observed multifaceted from health and fitness professionals regarding barriers and/or enablers to community-based cancer programming. The present findings also underscore previously established challenges and opportunities in developing community-based exercise programs for individuals across the cancer-control continuum (15)(16)(17).…”

“…Distinct perspectives from cancer survivors and interventionists, and stakeholders' priorities for exercise interventions among rural women cancer survivors, showed strong evidence for the importance of cancer-specific trainers, low-cost accessibility, and champion assistance for programming (15). National programming, including LIVESTRONG at the Yand Better Exercise Adherence after Treatment for Cancer, provides compelling implementation strategies for nonresearch, community-based staff, establishing efficacious clinic-to-community collaboration (16,17). Although these stakeholder perspectives provide a strong foundation for understanding key aspects of delivery and implementation, more research is warranted in the area of health and fitness professionals' perceptions of the barriers and enablers to offering a variety of programs that can meet the needs of cancer survivors.…”

Motivations and Experiences in a Physical Activity Program for Cancer Survivors: Findings from Key Informant Interviews

“…27,[29][30][31] In another recent study of LIVESTRONG at the YMCA, researchers found that personal experiences of those who participated in the program resonated with survivors and increased participation. 40 Promoting a sense of community among participants appears key to motivating cancer survivors to enroll and adhere to the program.…”