Community-based Exercise Programs For Cancer Survivors: Using The Consolidated Framework For Implementation Research To Identify Barriers And Facilitators To Program Implementation

Abstract

PURPOSE: Exercise is recommended as an intervention to reduce the side effects of cancer treatment both during treatment and beyond. New ACSM guidelines for cancer survivors have been recently published, alongside a recommendation for all oncology clinicians to ‘Ask, Advise and Refer’ to appropriate exercise programs. Based on this, there is a need to understand how to best translate exercise oncology programs from research into community-based settings. The purpose of this scoping review is to describe the characteristics of existing exercise programs for cancer survivors conducted outside of a research laboratory (i.e., home- or community-based settings) mapped to a common implementation science framework in order to identify potential strategies for future implementation interventions. METHODS: A systematic search of published literature was conducted for exercise programs or interventions including individuals diagnosed with cancer either undergoing treatment or who have completed treatment in which participants exercise at home, or in a community-based setting. Data were extracted using the Oxford Implementation Index and coded under the five domains of the Consolidated Framework for Implementation Research. RESULTS: A total of 46 publications describing 30 individual programs from around the world were identified. Only 11 publications had the specific goal of reporting on program implementation and development. Most programs included both aerobic and resistance exercise, targeting either breast cancer survivors, or any cancer. A variety of intervention and individual characteristics were described. Reporting of implementation factors related to the inner and outer setting and implementation process were minimal. Partnerships with oncology clinicians appears to be a key facilitator to implementation success. CONCLUSIONS: This scoping review summarizes the implementation characteristics of existing programs that have been reported in the literature and can serve as a resource for those developing future community-based exercise oncology programs. Findings support the need for implementation science to inform best practices for program implementation.