Understanding how to reach the hard to reach in cancer rehabilitation

Abstract

Introduction: Regular exercise helps manage side effects of cancer treatment, however, less than 30% of survivors participate in regular exercise. Exercise-related barriers, facilitators, and needs of general populations of cancer survivors are described in the literature. No information exists describing this information for hard to reach populations. Purpose: To determine the barriers, facilitators, and exercise needs of hard to reach cancer survivors. Materials and Methods: Research design: Descriptive qualitative study. Population: Hard to reach cancer survivors, including young adults (18-39 years), those living in rural communities, and those living in areas of low socioeconomic status. Data collection: Semi-structured interviews were conducted with participants. Interviews were audio recorded and transcribed verbatim. Transcripts were coded independently by two researchers. Coded data was aggregated into nodes and grouped into themes. Results: Five themes were identified that influence exercise participation in hard to reach survivors: accessibility of exercise programs, appropriateness of exercise programs, social support, personal factors, and exercise information. Young adults described a lack of appropriate exercise programs for their age group, those in rural settings described availability issues, and those in areas of low SES described cost and social support as barriers to exercise. Conclusion: This project identified unique exercise-related barriers, facilitators, and needs of hard to reach cancer survivors. Results can be used by researchers and clinicians when creating exercise interventions for cancer survivors. Interventions must be tailored to the specific needs of each individual in order to facilitate accessible participation in regular exercise and facilitate sustained behaviour change.

Matched and moving: exploring daily social support among women partnered for exercise after a breast cancer diagnosis

“…Nonetheless, researchers have successfully implemented peer support interventions for people treated for cancer using online protocols, indicating that virtual peer support programs may have appeal to this population [40]. This type of matching and naturally evolving study to help women find peers and benefit from social support and exercise is ideal for remote delivery to increase access for underserved, hard-to-reach people treated for cancer [41].…”

“Your Body Is Not At All Where You Left It”: Adolescent and Young Adult Cancer Survivors’ Experiences Transitioning Back Into Physical Activity After Treatment

“…Since AYAs are in a life-stage where appearance is highly valued and social relationships are developing (Abrams et al, 2007;Epelman, 2013), body image and social support may be two especially important factors that impact this transition. Of particular interest, reported barriers to PA re-engagement after treatment among AYAs include body appearance and function changes and perceptions of low social support for PA (Brunet et al, 2013;Larouche& Chin-Peuckert, 2006;Pugh et al, 2018;Smith-Turchyn et al, 2020;Wu et al, 2015). Meanwhile, high perception of social support is cited as facilitating AYAs' PA participation (Pugh et al, 2018;Rosenberg et al, 2014;Wu et al, 2015).…”

“…Meanwhile, high perception of social support is cited as facilitating AYAs' PA participation (Pugh et al, 2018;Rosenberg et al, 2014;Wu et al, 2015). Previous studies have used a quantitative design (Brunet et al, 2013;Rosenberg et al, 2014), did not have a sole focus on PA (Larouche& Chin-Peuckert, 2006;Pugh et al, 2018;Wu et al, 2015), and did not explore body image and social support in detail (Pugh et al, 2018;Smith-Turchyn et al, 2020), limiting an in-depth understanding of how body image and social support influence PA re-engagement among AYAs. Given the complexity of the decision to re-engage in activity, a qualitative methodology may foster exploration of the nuances of the PA transition and better elucidate the role of body image and social support within AYAs' re-engagement efforts (Pearce, 2009).…”

A Survey-Based Study on Physical Activity Promotion for Individuals with a Current or Past Diagnosis of Cancer in Canada

“…Individual factors include physical challenges, such as pain, fatigue, and other physical side effects; institutional factors include a lack of exercise resources and a lack of funding for exercise programs and professionals; educational factors include an unawareness of exercise benefits and the need to exercise, as well as an unawareness of available exercise programs [ 21 , 24 , 25 ]. Further, patients describe a lack of access to and engagement with exercise programs and qualified exercise professionals (QEP’s), including physiotherapists or exercise physiologists [ 26 ].…”