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Determining patient needs to enhance exercise program implementation and uptake in rural settings for women after a cancer diagnosis

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Abstract

Purpose

To qualitatively explore exercise barriers and facilitators experienced by rural female cancer survivors from the program interventionist and recipient perspective for the purpose of enhancing exercise program implementation and uptake in rural settings.

Methods

A descriptive qualitative study design was utilized. Focus groups were conducted prior to implementation of an evidence-based exercise program by a rural non-research cancer clinical site. Nineteen rural female cancer survivors (mean age = 61.7 ± 10.9 years) and 11 potential interventionists (mean age = 42.3 ± 15.3 years) completed focus groups (stratified by participant role). Focus groups were audio recorded, transcribed, coded, and analyzed using inductive thematic analysis with NVivo 11.

Results

Cancer survivors identified 12 barrier themes (cancer specific adverse effects, lack of support, lack of knowledge, perceived negative aspects of exercise, cost, lack of resources, motivation, inconvenience, lack of program flexibility, time, weather, safety) and eight facilitator themes (knowledge, ease of access, resources, awareness, cost, options, organized, fun) related to exercise. Interventionists identified seven barrier themes (cost, transportation, lack of cancer survivor and interventionist knowledge, fear, motivation, lack of support, lack of resources) and four facilitator themes (resources, support, knowledge, motivation). Narratives revealed differing role-specific perspectives on shared themes between survivors and interventionists as well as potential implementation strategies for enhancing exercise participation and exercise program uptake among rural female cancer survivors.

Conclusion

Exploring multi-level stakeholder perspectives on cancer survivors’ exercise needs and related strategies yields important information for organizations to consider when implementing exercise programs in rural contexts.

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Data availability

Data and materials available upon request from the corresponding author.

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Funding

This work was supported by the National Institutes of Health (R21CA182601, R25CA76023, 5R25MH080916, 3U01 HL133994-02S1, UL1 TR002345, and R01HG009351).

Author information

Authors and Affiliations

  1. University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294, USA

    Jessica L. Adams, Maria Pisu, Robert A. Oster, Haiyan Qu, Richard M. Shewchuk & Laura Q. Rogers

  2. University of Tennessee Health Science Center, Memphis, TN, USA

    Michelle Y. Martin

  3. Russell Medical Center, Alexander City, AL, USA

    Mary E. Sheffield & Alex Minter

  4. Washington University in Saint Louis, Saint Louis, MO, USA

    Ana A. Baumann

Authors
  1. Jessica L. Adams
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  2. Michelle Y. Martin
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  3. Maria Pisu
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  4. Robert A. Oster
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  5. Haiyan Qu
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  6. Richard M. Shewchuk
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  7. Mary E. Sheffield
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  8. Alex Minter
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  9. Ana A. Baumann
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  10. Laura Q. Rogers
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Contributions

All authors, excluding Mary E. Sheffield and Alex Minter, contributed to the study conception and design. All authors, excluding Ana A. Baumann, contributed to material preparation, data collection, or analysis. The first draft of the manuscript was written by Jessica L. Adams, and all authors commented on subsequent versions of the manuscript. All authors approved the final manuscript.

Corresponding author

Correspondence to Laura Q. Rogers.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethics approval

All study procedures involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its amendments or comparable ethical standards. The proposal was approved by the UAB Institutional Review Boards for Human Use.

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Informed consent was obtained from all participants included in the study.

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Informed consent was obtained from all participants included in the study.

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Code available upon request from the corresponding author.

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Adams, J.L., Martin, M.Y., Pisu, M. et al. Determining patient needs to enhance exercise program implementation and uptake in rural settings for women after a cancer diagnosis. Support Care Cancer 29, 4641–4649 (2021). https://doi.org/10.1007/s00520-021-05990-8

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  • DOI: https://doi.org/10.1007/s00520-021-05990-8

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