Usability, acceptability, and implementation strategies for the Exercise in Cancer Evaluation and Decision Support (EXCEEDS) algorithm: a Delphi study

Covington, Kelley R.; Pergolotti, Mackenzi; Marshall, Tim; Leach, Heather J.; Sharp, Julia L.; Campbell, Grace; Williams, Grant R.; Fu, Jack B.; Kendig, Tiffany; Howe, Nancy Litterman; Bundy, Anita

doi:10.1007/s00520-022-07164-6

Cited by 6 publications

(6 citation statements)

References 46 publications

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Section: Discussionmentioning

confidence: 99%

“…Future research should investigate how to create a stepped certification program to reflect the skill sets required for delivering exercise programming to people at different stages of the cancer continuum. 27,28 In conclusion, widespread agreement about the required competencies for exercise oncology professionals will allow for the creation of new training models and propel parallel initiatives required to achieve integration into standard oncology care. 9 For example, in the US, while physical therapists can receive third-party reimbursement for their services, other exercise professionals cannot.…”

Section: Discussionmentioning

confidence: 99%

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Identification of core competencies for exercise oncology professionals: A Delphi study of United States and Australian participants

Kennedy,

Wood,

Campbell

et al. 2024

Cancer Medicine

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IntroductionIntegration of exercise into standard oncology care requires a highly skilled workforce of exercise professionals; however, competency requirements have not kept pace with advancements in the field. Therefore, the aim of this study was to obtain consensus on core competencies required for an exercise professional to be qualified to work with adults undergoing active cancer treatment.Materials and MethodsA three‐round modified electronic Delphi process was used. In Round 1, an international group of 64 exercise oncology stakeholders (i.e., exercise oncology professionals (n = 29), clinical referrers (n = 21), and people with lived experience (n = 14)) responded to open‐ended prompts eliciting perspectives regarding competencies needed for an exercise oncology professional to work with adults receiving active cancer treatment. Subsequently, only exercise oncology professionals participated, ranking the importance of competencies. In Round 2, professionals received summary feedback, ranked new competencies generated from open‐ended responses, and reranked competencies not reaching consensus. In the final round, professionals finalized consensus ranking and rated frequency and mastery level for each.ResultsConsensus was reached on 103 core competencies required for exercise professionals to be qualified to deliver care to adults undergoing active cancer treatment. The core competencies represent 10 content areas and reflect the needs of clinical referrers and people with lived experience of receiving cancer treatment.ConclusionsThe core competencies identified reflect significant advancements in the field of exercise oncology. Results will underpin the development of education, certification, and employment requirements for exercise oncology professionals, providing a critical step toward achieving routine integration of exercise into standard oncology care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Identification of core competencies for exercise oncology professionals: A Delphi study of United States and Australian participants

Kennedy,

Wood,

Campbell

et al. 2024

Cancer Medicine

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“…In our study, we proposed three levels of intervention depending on the degree of symptomatic affectation presented by the patient when prescribing the different exercises in the rehabilitation program, with the possibility, obviously, of making modifications depending on the evolution of the individual (increasing or decreasing the degree of complexity). We believe that greater precision in the prescription of the rehabilitation program can bring us even closer to better clinical practice, as mentioned by Pergolotti and his collaborators in the EXCEEDS study, in which they proposed an algorithm, “Exercise in Cancer Evaluation and Decision Support (EXCEEDS)” [ 45 ]. They developed this to improve clinical decision making in oncological rehabilitation and to facilitate access to these multimodal physical exercise programs in cancer patients.…”

Section: Discussionmentioning

confidence: 99%

Multimodal Physical Exercise and Functional Rehabilitation Program in Oncological Patients with Cancer-Related Fatigue—A Randomized Clinical Trial

Rodríguez

Gómez

Méndez-Sánchez

et al. 2023

IJERPH

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The increase in life expectancy and survival time implies an increase in the possible side-effects of pharmacological treatments in patients. Cancer-related fatigue is one of these side-effects. The main objective of this study was to evaluate the effects of a multimodal program of physical exercise and functional rehabilitation on asthenia, pain, functional capacity, and quality of life in cancer patients with cancer-related fatigue. Methods: This was a randomized, parallel-controlled clinical trial, with two arms (experimental and control group), and it was conducted over the course of a year in the Oncology Hospitalization Unit at the University Hospital of Salamanca, Spain. Participants (n = 48) were assessed at three points during the study. The first assessment was prior to hospital discharge, the second assessment was after 15 days, and the final assessment was at one month post-hospital follow-up. The intervention lasted one month. The main variables studied were the dependency levels (Barthel), cancer-related fatigue (FACT-An), health-related quality of life (EuroQoL-5D), functional capacity (SPPB), and kinesiophobia (TSK-F). Results: Sample size (n = 44). Mean age 63.46 ± 12.36 years. Significant differences between control and experimental group participants in Barthel, FACT-An, TSK-F, and SPPB scores at follow-up and final assessment. Conclusions: There are beneficial effects of a multimodal physical exercise and functional rehabilitation program in improving the autonomy of cancer-related fatigue patients.

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Section: Methodsmentioning

confidence: 99%

“…A validated cutoff for these measures has not been established; therefore, a score of 16 or higher was defined as a cutoff for establishing feasibility, acceptability, and appropriateness based on a prior study among oncology professionals (a score of 16 denotes an average response of agree or strongly agree for each item within the measure). 40 All staff who assisted with PRSA implementation or support (e.g., clinical informatics staff) received an email inviting them to participate in an interview. We did not include informatics staff in the survey given they may not be able to answer key questions (e.g., how appropriate the intervention is for this patient population).…”

Section: Data Collectionmentioning

confidence: 99%

Suicide Risk Screening for Head and Neck Cancer Patients: An Implementation Study

Kansara,

Basta,

Mikhael

et al. 2024

Appl Clin Inform

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Objectives There is limited research on suicide risk screening (SRS) among head and neck cancer (HNC) patients, a population at increased risk for suicide. To address this gap, this single-site mixed methods study assessed oncology professionals' perspectives about the feasibility, acceptability, and appropriateness of an electronic SRS program that was implemented as a part of routine care for HNC patients. Methods Staff who assisted with SRS implementation completed (e.g., nurses, medical assistants, advanced practice providers, physicians, social workers) a one-time survey (N = 29) and interview (N = 25). Quantitative outcomes were assessed using previously validated feasibility, acceptability, and appropriateness measures. Additional qualitative data were collected to provide context for interpreting the scores. Results Nurses and medical assistants, who were directly responsible for implementing SRS, reported low feasibility, acceptability, and appropriateness, compared with other team members (e.g., physicians, social workers, advanced practice providers). Team members identified potential improvements needed to optimize SRS, such as hiring additional staff, improving staff training, providing different modalities for screening completion among individuals with disabilities, and revising the patient-reported outcomes to improve suicide risk prediction. Conclusion Staff perspectives about implementing SRS as a part of routine cancer care for HNC patients varied widely. Before screening can be implemented on a larger scale for HNC and other cancer patients, additional implementation strategies may be needed that optimize workflow and reduce staff burden, such as staff training, multiple modalities for completion, and refined tools for identifying which patients are at greatest risk for suicide.

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Usability, acceptability, and implementation strategies for the Exercise in Cancer Evaluation and Decision Support (EXCEEDS) algorithm: a Delphi study

Cited by 6 publications

References 46 publications

Identification of core competencies for exercise oncology professionals: A Delphi study of United States and Australian participants

Identification of core competencies for exercise oncology professionals: A Delphi study of United States and Australian participants

Multimodal Physical Exercise and Functional Rehabilitation Program in Oncological Patients with Cancer-Related Fatigue—A Randomized Clinical Trial

Suicide Risk Screening for Head and Neck Cancer Patients: An Implementation Study

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