An organizational approach to exploring the determinants of community-based exercise program implementation for breast cancer survivors.

Abstract

The majority of breast cancer survivors do not engage in sufficient levels of exercise. Community-based exercise programs (CBEP) may mitigate low rates of exercise participation; however, few programs exist. Previous research exploring the determinants of CBEP implementation for cancer survivors is limited in that it has predominantly focused on cancer survivor perspectives or it has failed to rely on a theoretical framework to explore determinants to implementation across various implementation domains. An organizational exploration of the determinants of CBEP implementation for breast cancer survivors is warranted to guide future program implementation. The purpose of this study was to apply the Consolidated Framework for Implementation Research (CFIR) to explore the determinants of CBEP implementation for breast cancer survivors from a program provider perspective. Data collection and analysis were guided by the CFIR. Program providers completed an online questionnaire and an interview. Transcripts were analyzed using inductive content analysis. Resulting codes were deductively mapped onto the CFIR. Seven barriers and seven facilitators were identified, with three key influencers (e.g., program awareness, financial support, and knowledge regarding the benefits of exercisefor breast cancer survivors) cited as both barriers and facilitators to program implementation. Barriers primarily operated within the outer setting (e.g., needs and resources) domain of the CFIR, whereas facilitators and key influencers operated across multiple CFIR domains (e.g., culture and planning). Study findings provide insight into the current challenges to CBEP implementation experienced by program providers and highlight potential avenues for future exercise program development and implementation.