Physical Activity Across the Cancer Journey: Experiences and Recommendations From People Living With and Beyond Cancer

Abstract

Background The majority of individuals living with and beyond cancer are not sufficiently active to achieve health benefits. Objective The aim of this study was to explore individuals’ experiences of physical activity (PA) behavior across the cancer journey and to ask individuals living with and beyond cancer to identify strategies to support habitual PA. Design An exploratory, descriptive, qualitative design was used. Methods Purposive sampling methods were used to recruit individuals living with and beyond cancer who had been referred to, and/or participated in, a community-based exercise program or were attending a cancer support center. The focus group discussions were audio recorded, transcribed verbatim, and analyzed using a thematic analysis approach. Results Seven focus groups were conducted with 41 participants. Many individuals reported that regular PA provided a vehicle for recovery that created a sense of “self-power,” defined as taking ownership and control of one’s health to increase well-being. Barriers to PA participation included environmental-, patient-, and treatment-related challenges. Recommendations to support long-term adherence to PA included completion of fitness assessments at regular intervals and provision of a home exercise program. Limitations The benefits and barriers to PA participation for individuals diagnosed with cancers that were not represented may not have been identified. The strategies recommended to support habitual PA may be salient only to individuals whose cancer diagnoses were represented. Conclusions Exercise is seen as a vehicle for recovery from cancer but long-term adherence for individuals is complex. The findings from this study can inform the development of exercise oncology rehabilitation programs and could support a greater likelihood of program success, thereby optimizing the health, well-being, and quality of life of survivors of cancer.

The Development of the MedEx IMPACT Intervention: A Patient-Centered, Evidenced-Based and Theoretically-Informed Physical Activity Behavior Change Intervention for Individuals Living With and Beyond Cancer

“…These findings and the 8 recommendations for strategies to support habitual PA and adherence to community-based exercise programs that were generated from the discussions are described in detail elsewhere. 40 In summary, the 8 recommendations advocated for the inclusion of: (1) individualized exercise prescription, (2) group-based supervised exercise classes with peers (ie, individuals who have also undergone treatment following a cancer diagnosis), (3) goal setting and action planning, (4) quantification and measurement of PA, (5) provision of information regarding additional health behaviors (ie, healthy eating, smoking cessation, alcohol consumption, and stress management), (6) both supervised and home-based PA sessions, (7) assessments of fitness, and (8) face-to-face counselling from exercise specialists regarding PA within a community-based exercise program to support long-term PA adherence. 40…”

“…Given that the ultimate goal of intervention development is to optimize patient care, the need for an understanding of the factors that contribute to intervention success and/or failure is urgently needed in order to facilitate greater likelihood of intervention success and more appropriate resource allocation. 40 As the burden of cancer continues to grow, 2 so too does the need to develop effective interventions that can support individuals living with and beyond cancer to become habitually physically active, optimize their physical and psychosocial well-being, and reduce their risk of cancer morbidity and mortality. 12,20 The potential impact of previous PABC interventions may have been limited due to a poor understanding of the needs and challenges facing survivors of cancer in adopting PA and the poor application/lack of theory within the intervention development process.…”

“…Given that the ultimate goal of intervention development is to optimize patient care, the need for an understanding of the factors that contribute to intervention success and/or failure is urgently needed in order to facilitate greater likelihood of intervention success and more appropriate resource allocation. 40…”

“…39 Further details regarding the methods for recruitment, data collection and analysis have been reported elsewhere. 40 Details of PPI within this study are outlined in the Guidance for Reporting Involvement of Patients and the Public short-form checklist. 35…”

“…39 Further details regarding the methods for recruitment, data collection and analysis have been reported elsewhere. 40 42 were reviewed. The BCW and the TDF were selected to guide the intervention development process.…”