Abstract
Despite the well-established benefits of physical activity for cancer survivors, the vast majority of survivors are not sufficiently active to reap these benefits. While cancer-specific physical activity guidelines exist, it remains unclear whether there are sufficient resources to support these recommendations. The purpose of this qualitative study was to describe the available cancer-specific physical activity programs for cancer survivors in Atlantic Canada and explore barriers and enablers to program implementation. Interviews were conducted with a purposefully selected sample of oncology healthcare professionals, administrators, and cancer-specific physical activity program leaders to examine the attitudes and practices of key stakeholders with respect to physical activity and cancer-specific programming. Thirty participants, including 7 oncologists, 7 nurses, 6 allied healthcare professionals, 5 administrators, and 5 program leaders, completed an interview. Three over-arching themes emerged, including (1) knowledge, attitudes and need for physical activity; (2) implementation barriers; and (3) implementation enablers. The results of this study suggest that cancer survivors in Atlantic Canada may require additional resources and support with respect to physical activity throughout their cancer care journey.
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References
Canadian Cancer Statistics Advisory Committee (2018) Canadian Cancer Statistics 2018. Canadian Cancer Society, Toronto. Available at: cancer.ca/Canadian-Cancer-Statistics-2018-EN
Buffart LM, Galvao DA, Brug J, Chinapaw MJ, Newton RU (2014) Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge gaps and future research directions. Cancer Treat Rev 40:327–340. https://doi.org/10.1016/j.ctrv.2013.06.007
Warburton DER, Bredin SSD (2017) Health benefits of physical activity: a systematic review of current systematic reviews. Curr Opin Cardiol 32:541–556. https://doi.org/10.1097/HCO.0000000000000437
Hills AP, Street SJ, Byrne NM (2015) Physical activity and health: “what is old is new again”. Adv Food Nutr Res. https://doi.org/10.1016/bs.afnr.2015.06.001
Pedersen BK, Saltin B (2015) Exercise as medicine - evidence for prescribing exercise as therapy in 26 different chronic diseases. Scand J Med Sci Sports 25:1–72. https://doi.org/10.1111/sms.12581
Garcia DO, Thomson CA (2014) Physical activity and cancer survivorship. In: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition, vol 29, pp 768–779. https://doi.org/10.1177/0884533614551969
Sabiston CM, Brunet J (2012) Reviewing the benefits of physical activity during cancer survivorship. Am J Lifestyle Med 6:167–177
Loprinzi PD, Lee H (2014) Rationale for promoting physical activity among cancer survivors: literature review and epidemiologic examination. Oncol Nurs Forum 41:117–125. https://doi.org/10.1188/14.ONF.117-125
Lynch BM, Dunstan DW, Vallance JK, Owen N (2013) Don’t take cancer sitting down: a new survivorship research agenda. Cancer 119:1928–1935. https://doi.org/10.1002/cncr.28028
Neil SE, Gotay CC, Campbell KL (2014) Physical activity levels of cancer survivors in Canada: findings from the Canadian Community Health Survey. J Cancer Surviv 8:143–149. https://doi.org/10.1007/s11764-013-0322-6
Dennis DL, Waring JL, Payeur N, Cosby C, Daudt HM (2013) Making lifestyle changes after colorectal cancer: insights for program development. Curr Oncol 20:493–e511. https://doi.org/10.3747/co.20.1514
Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvao DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL, and American College of Sports Medicine (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc. https://doi.org/10.1249/MSS.0b013e3181e0c112
Santa Mina D, Petrella A, Currie KL, Bietola K, Alibhai SM, Trachtenberg J, Ritvo P, Matthew AG (2015) Enablers and barriers in delivery of a cancer exercise program: the Canadian experience. Curr Oncol 22:374–384. https://doi.org/10.3747/co.22.2650
Sandelowski M (2000) Whatever happened to qualitative description? Res Nurs Health 23:334-340
Creswell JW (2013) Research design: qualitative, quantitative, and mixed methods approaches. Sage Publications Inc, Thousand Oaks
Corbin J, Strauss A (2008) Basics of qualitative research: techniques and procedures for developing grounded theory. Sage Publications Inc, Thousand Oaks
Nowell LS, Norris JM, White DE, Moules NJ (2017) Themetic analysis: striving to meet the trustworthiness criteria. Int J Qual Method 16:1–13
Smith L, Croker H, Fisher A, Williams K, Wardle J, Beeken RJ (2017) Cancer survivors’ attitudes towards and knowledge of physical activity, sources of information, and barriers and facilitators of engagement: a qualitative study. Eur J Cancer Care 26. https://doi.org/10.1111/ecc.12641
Fong AJ, Faulkner G, Jones JM, Sabiston CM (2018) A qualitative analysis of oncology clinicians’ perceptions and barriers for physical activity counselling in breast cancer survivors. Support Care Cancer 26:3117–3126. https://doi.org/10.1007/s00520-018-4163-8
Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC (2009) Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 4. https://doi.org/10.1186/1748-5908-4-50
Guerrero EG, Frimpong J, Kong Y, Fenwick K, Aarons GA (2018) Advancing theory on the multilevel role of leadership in the implementation of evidence-based health care practices. Health Care Manag Rev:1. https://doi.org/10.1097/HMR.0000000000000213
Urquhart R, Kendell C, Folkes A, Reiman T, Grunfeld E, Porter GA (2018) Making it happen: middle managers’ roles in innovation implementation in health care. Worldviews Evid-Based Nurs 15:414–423. https://doi.org/10.1111/wvn.12324
Urquhart R, Porter GA, Sargeant J, Jackson L, Grunfeld E (2014) Multi-level factors influence the implementation and use of complex innovations in cancer care: a multiple case study of synoptic reporting. Implement Sci 9:121. https://doi.org/10.1186/s13012-014-0121-0
Lal S, Urquhart R, Cornelissen E, Newman K, Van Eerd D, Powell BJ, Chan V (2015) Trainees’ self-reported challenges in knowledge translation, research and practice. Worldviews Evid-Based Nurs 12:348–354. https://doi.org/10.1111/wvn.12118
Lennox L, Maher L, Reed J (2018) Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare. Implement Sci 13:27. https://doi.org/10.1186/s13012-017-0707-4
Saunders B, Sim J, Kingstone T, Baker S, Waterfield J, Bartlam B, Burroughs H, Jinks C (2018) Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant 52:1893–1907. https://doi.org/10.1007/s11135-017-0574-8
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This research was funded in part by the Nova Scotia Health Authority Cancer Care Program.
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Informed consent was obtained from all participants prior to inclusion in the study. The authors Institutional Review Board approved this study prior to implementation. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Shea, K.M., Urquhart, R. & Keats, M.R. Physical Activity and Cancer Care in the Atlantic Canadian Provinces: an Examination of Provider Beliefs, Practices, Resources, Barriers, and Enablers. J Canc Educ 35, 946–953 (2020). https://doi.org/10.1007/s13187-019-01546-x
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DOI: https://doi.org/10.1007/s13187-019-01546-x