Abstract
PurposeExercise is efficacious for people living after a cancer diagnosis. However, implementation of exercise interventions in real-world settings is challenging. Implementation outcomes are defined as ‘the effects of deliberate and purposive actions to implement new treatments, practices, and services’. Measuring implementation outcomes is a practical way of evaluating implementation success. This systematic review explores the implementation outcomes of exercise interventions evaluated under real-world conditions for cancer care.MethodsUsing PRISMA guidelines, an electronic database search of Medline, PsycInfo, CINAHL, Web of Science, SportsDiscus, Scopus and Cochrane Central Registry of Controlled Trials was conducted for studies published between January 2000 and February 2020. The Moving through Cancer registry was hand searched. The Implementation Outcomes Framework guided data extraction. Inclusion criteria were adult populations with a cancer diagnosis. Efficacy studies were excluded.ResultsThirty-seven articles that described 31 unique programs met the inclusion criteria. Implementation outcomes commonly evaluated were feasibility (unique programs n = 17, 54.8%) and adoption (unique programs n = 14, 45.2%). Interventions were typically delivered in the community (unique programs n = 17, 58.6%), in groups (unique programs n = 14, 48.3%) and supervised by a qualified health professional (unique programs n = 14, 48.3%). Implementation outcomes infrequently evaluated were penetration (unique programs n = 1, 3.2%) and sustainability (unique programs n = 1, 3.2%).ConclusionsExercise studies need to measure and evaluate implementation outcomes under real-world conditions. Robust measurement and reporting of implementation outcomes can help to identify what strategies are essential for successful implementation of exercise interventions.Implications for cancer survivorsUnderstanding how exercise interventions can be successful implemented is important so that people living after a cancer diagnosis can derive the benefits of exercise.
Highlights
Cancer is a leading cause of disease burden worldwide
Robust measurement and reporting of implementation outcomes can help to identify what strategies are essential for successful implementation of exercise interventions
Implications for cancer survivors: Understanding how exercise interventions can be successful implemented is important so that people living after a cancer diagnosis can derive the benefits of exercise
Summary
Cancer is a leading cause of disease burden worldwide. In 2020, 19.2 million new cases of cancer and 9.9 million cancer-related deaths occurred globally [1]. Exercise is important in addressing the sequala of disease and impacts of a cancer diagnosis, as demonstrated in the robust efficacy base of systematic reviews, metaanalyses and meta reviews [4,5,6,7,8,9,10,11]. CPGs are evidence-based statements that include recommendations to optimise patient care [12]. The consensus statement provides exercise prescription recommendations for common cancer-related health outcomes including depression, fatigue and quality of life [13]. The ACSM is one of many organisations worldwide that recommend exercise be incorporated within the routine care for people with cancer [14,15,16,17]
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