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Experiences participating in a telehealth exercise program among older adults with cancer: a qualitative study

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Abstract

Purpose

Telehealth delivery of exercise programs has rapidly increased in recent years; yet, little is known regarding older cancer survivors’ (OCS) experiences participating in telehealth exercise. The purpose of this study was to determine OCS barriers and facilitators to participation in telehealth-delivered exercise.

Methods

OCS who participated in a 12-week, one-on-one telehealth exercise program were recruited to participate in one of three focus groups. Focus groups were conducted virtually using a semi-structured interview guide. Focus groups were audio recorded, transcribed verbatim, and analyzed utilizing thematic analysis with Atlas.ti.

Results

Fourteen OCS (age range 65–79 years) participated in the focus groups, five (35.7%) of which had not completed a telehealth follow-up assessment. The most common cancer type was breast (n = 6, 42.9%), and all cancer stages were represented. Three overall themes were identified: having adequate space to exercise, meeting OCS physical and psychosocial needs, and OCS learning throughout the exercise program. Within these themes, five facilitators and two barriers were identified. Facilitators included the individualization of the exercise program, no travel, accountability, learning to exercise, and support from staff and family. The barriers identified were having limited space to exercise and a learning curve with technology.

Conclusion

OCS viewed telehealth exercise positively. Identified barriers aligned with those in younger cancer survivors (≥18 years), indicating that OCS are able to engage with telehealth exercise programs alongside their younger counterparts.

Implications for Cancer Survivors

Telehealth exercise mitigates exercise barriers in OCS and should be used as a strategy to support exercise participation among cancer survivors, regardless of age.

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References

  1. Cespedes Feliciano EM, Vasan S, Luo J, Binder AM, Chlebowski RT, Quesenberry C, et al. Long-term trajectories of physical function decline in women with and without cancer. JAMA Oncol. 2023;9(3):395–403. https://doi.org/10.1001/jamaoncol.2022.6881.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Pandya C, Magnuson A, Flannery M, Zittel J, Duberstein P, Loh KP, et al. Association between symptom burden and physical function in older patients with cancer. J Am Geriatr Soc. 2019;67(5):998–1004. https://doi.org/10.1111/jgs.15864.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Sehl M, Lu X, Silliman R, Ganz PA. Decline in physical functioning in first 2 years after breast cancer diagnosis predicts 10-year survival in older women. J Cancer Surviv. 2013;7(1):20–31. https://doi.org/10.1007/s11764-012-0239-5.

    Article  PubMed  Google Scholar 

  4. Ezzatvar Y, Ramírez-Vélez R, Sáez de Asteasu ML, Martínez-Velilla N, Zambom-Ferraresi F, Izquierdo M, et al. Physical function and all-cause mortality in older adults diagnosed with cancer: A systematic review and meta-analysis. J Gerontol A Biol Sci Med Sci. 2021;76(8):1447–53. https://doi.org/10.1093/gerona/glaa305.

    Article  PubMed  Google Scholar 

  5. Dittus K, Toth M, Priest J, O’Brien P, Kokinda N, Ades P. Effects of an exercise-based oncology rehabilitation program and age on strength and physical function in cancer survivors. Support Care Cancer. 2020;28(8):3747–54. https://doi.org/10.1007/s00520-019-05163-8.

    Article  PubMed  Google Scholar 

  6. Paulo TRS, Rossi FE, Viezel J, Tosello GT, Seidinger SC, Simões RR, et al. The impact of an exercise program on quality of life in older breast cancer survivors undergoing aromatase inhibitor therapy: A randomized controlled trial. Health Qual Life Outcomes. 2019;17(1):17. https://doi.org/10.1186/s12955-019-1090-4.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Rock CL, Thomson CA, Sullivan KR, Howe CL, Kushi LH, Caan BJ, et al. American Cancer Society nutrition and physical activity guideline for cancer survivors. CA Cancer J Clin. 2022;72(3):230–62. https://doi.org/10.3322/caac.21719.

    Article  PubMed  Google Scholar 

  8. Campbell KL, Winters-Stone KM, Wiskemann J, May AM, Schwartz AL, Courneya KS, et al. Exercise guidelines for cancer survivors: Consensus statement from international multidisciplinary roundtable. Med Sci Sports Exerc. 2019;51(11):2375–90. https://doi.org/10.1249/mss.0000000000002116.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Zhang J, Su M, Cheng J, Zhou S, Liu L, Yao NA. A nationally representative study of aerobic activity and strength training in older cancer survivors and their psychological distress and sleep difficulties. Support Care Cancer. 2022;30(11):9597–605. https://doi.org/10.1007/s00520-022-07370-2.

    Article  PubMed  Google Scholar 

  10. Cheung DST, Takemura N, Chau PH, Ng AYM, Xu X, Lin CC. Exercise levels and preferences on exercise counselling and programming among older cancer survivors: A mixed-methods study. J Geriatr Oncol. 2021;12(8):1173–80. https://doi.org/10.1016/j.jgo.2021.05.002.

    Article  CAS  PubMed  Google Scholar 

  11. Perry CK, Ali W, Solanki E, Winters-Stone K. Attitudes and beliefs of older female breast cancer survivors and providers about exercise in cancer care. Oncol Nurs Forum. 2020;47(1):56–69. https://doi.org/10.1188/20.Onf.56-69.

    Article  PubMed  Google Scholar 

  12. Mikkelsen MK, Nielsen DL, Vinther A, Lund CM, Jarden M. Attitudes towards physical activity and exercise in older patients with advanced cancer during oncological treatment - A qualitative interview study. Eur J Oncol Nurs. 2019;41:16–23. https://doi.org/10.1016/j.ejon.2019.04.005.

    Article  PubMed  Google Scholar 

  13. Rosko A, Huang Y, Jones D, Presley CJ, Jaggers J, Owens R, et al. Feasibility of implementing an exercise intervention in older adults with hematologic malignancy. J Geriatr Oncol. 2022;13(2):234–40. https://doi.org/10.1016/j.jgo.2021.07.010.

    Article  CAS  PubMed  Google Scholar 

  14. Dennett AM, Hirko KA, Porter KJ, Loh KP, Liao Y, Yang L, et al. Embedding lifestyle interventions into cancer care: Has telehealth narrowed the equity gap?. J Natl Cancer Inst Monogr. 2023;2023(61):133–9. https://doi.org/10.1093/jncimonographs/lgac028.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Paterson C, Bacon R, Dwyer R, Morrison KS, Toohey K, O’Dea A, et al. The role of telehealth during the COVID-19 pandemic across the interdisciplinary cancer team: Implications for practice. Semin Oncol Nurs. 2020;36(6):151090. https://doi.org/10.1016/j.soncn.2020.151090.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Gorzelitz JS, Stoller S, Costanzo E, Gangnon R, Koltyn K, Dietz AT, et al. Improvements in strength and agility measures of functional fitness following a telehealth-delivered home-based exercise intervention in endometrial cancer survivors. Support Care Cancer. 2022;30(1):447–55. https://doi.org/10.1007/s00520-021-06415-2.

    Article  PubMed  Google Scholar 

  17. Galiano-Castillo N, Cantarero-Villanueva I, Fernández-Lao C, Ariza-García A, Díaz-Rodríguez L, Del-Moral-Ávila R, et al. Telehealth system: A randomized controlled trial evaluating the impact of an internet-based exercise intervention on quality of life, pain, muscle strength, and fatigue in breast cancer survivors. Cancer. 2016;122(20):3166–74. https://doi.org/10.1002/cncr.30172.

    Article  PubMed  Google Scholar 

  18. Andrioti A, Papadopetraki A, Maridaki M, Philippou A. The effect of a home-based tele-exercise training program on the quality of life and physical performance in breast cancer survivors. Sports (Basel). 2023;11(5):102. https://doi.org/10.3390/sports11050102.

    Article  PubMed  Google Scholar 

  19. Sattar S, Papadopoulos E, Smith GVH, Haase KR, Kobekyaa F, Tejero I, et al. State of research, feasibility, safety, acceptability, and outcomes examined on remotely delivered exercises using technology for older adult with cancer: A scoping review. J Cancer Surviv. 2023; https://doi.org/10.1007/s11764-023-01427-9.

  20. Lama Y, Davidoff AJ, Vanderpool RC, Jensen RE. Telehealth availability and use of related technologies among Medicare-enrolled cancer survivors: Cross-sectional findings from the onset of the COVID-19 pandemic. J Med Internet Res. 2022;24(1):e34616. https://doi.org/10.2196/34616.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Arthur EK, Pisegna J, Oliveri JM, Aker H, Krok-Schoen JL. Older cancer survivors’ perspectives and use of telehealth in their cancer survivorship care in the United States: A ResearchMatch® sample. J Geriatr Oncol. 2022;13(8):1223–9. https://doi.org/10.1016/j.jgo.2022.08.004.

    Article  CAS  PubMed  Google Scholar 

  22. LeBaron V. Challenges and opportunities in designing and deploying remote health monitoring technology for older adults with cancer. Innov Aging. 2022;6(6):igac057. https://doi.org/10.1093/geroni/igac057.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Crabtree BF, Miller WL. Doing qualitative research. United States of America: Sage Publications; 1992.

    Google Scholar 

  24. Coletta AM, Rose NB, Johnson AF, Moxon DS, Trapp SK, Walker D, et al. The impact of a hospital-based exercise oncology program on cancer treatment-related side effects among rural cancer survivors. Support Care Cancer. 2021;29(8):4663–72. https://doi.org/10.1007/s00520-021-06010-5.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Krueger RA. Focus groups: A practical guide for applied research. Sage publications; 2015.

    Google Scholar 

  26. Stokols D. Translating social ecological theory into guidelines for community health promotion. Am J Health Promot. 1996;10(4):282–98. https://doi.org/10.4278/0890-1171-10.4.282.

    Article  CAS  PubMed  Google Scholar 

  27. Dennett A, Harding KE, Reimert J, Morris R, Parente P, Taylor NF. Telerehabilitation’s safety, feasibility, and exercise uptake in cancer survivors: Process evaluation. JMIR Cancer. 2021;7(4):e33130. https://doi.org/10.2196/33130.

    Article  PubMed  PubMed Central  Google Scholar 

  28. O’Brien A, Brennan L, O’Neill L, Connolly D, Guinan E, Reynolds J, et al. Patient experiences of a telehealth multidisciplinary cancer rehabilitation programme: Qualitative findings from the ReStOre@ home feasibility study. Eur J Cancer Care. 2023;2023:7998022. https://doi.org/10.1155/2023/7998022.

    Article  Google Scholar 

  29. Myers SA, Weller S, Schwartz S, Van Patten C, LeVasseur N, Faulkner G, et al. Feasibility of a supervised virtual exercise program for women on hormone therapy for breast cancer. Transl J Am Coll Sports Med. 2022;7(4):e000213. https://doi.org/10.1249/TJX.0000000000000213.

    Article  Google Scholar 

  30. Wonders KY, Gnau K, Schmitz KH. Measuring the feasibility and effectiveness of an individualized exercise program delivered virtually to cancer survivors. Curr Sports Med Rep. 2021;20(5):271–6. https://doi.org/10.1249/jsr.0000000000000846.

    Article  PubMed  Google Scholar 

  31. Mikkelsen MK, Michelsen H, Nielsen DL, Vinther A, Lund CM, Jarden M. “Doing what only I can do”: Experiences from participating in a multimodal exercise-based intervention in older patients with advanced cancer-A qualitative explorative study. Cancer Nurs. 2022;45(2):E514-EE23. https://doi.org/10.1097/ncc.0000000000000987.

    Article  PubMed  Google Scholar 

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Acknowledgements

We would like to thank Dr. Pamela Hansen, Dr. Rebecca Wilson-Zingg, Darren Walker, and the Personal Optimism with Exercise Recovery program staff at the Huntsman Cancer Institute for their support throughout the research process.

Availability of data and materials

De-identified date, quantitative and qualitative, will be made available upon request.

Funding

Research reported in this publication was supported by the University of Utah Graduate Research Fellowship and University of Utah Graduate Research Support Award in Health & Kinesiology.

Author information

Authors and Affiliations

  1. Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA

    Emily R. Dunston, Alec Malouf, Maria Newton, Yang Bai & Adriana M. Coletta

  2. Université de Montréal, School of Kinesiology and Physical Activity Sciences, Faculty of Medicine, Montréal, Québec, Canada

    Leslie W. Podlog

  3. CHU Sainte-Justine Research Center, Montréal, Québec, Canada

    Leslie W. Podlog

  4. Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, GA, USA

    Sonal Oza

  5. The Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT, USA

    Adriana M. Coletta

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Contributions

ERD and AMC were responsible for study conceptualization, data acquisition, quality control of data and algorithms, and manuscript preparation. ERD, AM, and AMC were responsible for data analysis and interpretation. ERD was responsible for statistical analysis. ERD, AMC, LWP, MN, YB, and SO were responsible for study design and manuscript editing. All authors reviewed the manuscript and approved the final version.

Corresponding author

Correspondence to Adriana M. Coletta.

Ethics declarations

Ethical approval

This study was approved by the University of Utah Research Ethics Board (IRB #00156776). All participants consented to participate. This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of University Utah (Date 7/21/2022/#00156776).

Competing interests

The authors declare no competing interests.

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

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Dunston, E.R., Malouf, A., Podlog, L.W. et al. Experiences participating in a telehealth exercise program among older adults with cancer: a qualitative study. J Cancer Surviv (2024). https://doi.org/10.1007/s11764-024-01564-9

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