Knowledge, attitudes, barriers, and practice of oncologists in promoting physical activity to cancer survivors: An international survey.

Abstract

103 Background: Few Survivors are meeting the American Cancer Society recommendations of 150-minutes of moderate-intensity physical activity (PA) per week. Despite patients' wishing to receive PA information from their oncologist, many do not receive PA guidance. Given that oncologists review their patients regularly and are perceived as authority figures, they are in a unique position to promote the uptake of durable PA. Future interventions that bypass the oncologist are unlikely to be scalable and hence there is a need to support oncologists to promote PA. The study aim was to investigate knowledge, attitudes, barriers and practices of oncologists toward PA in survivors, and the association between oncologists' own PA behaviour and PA promotion. Methods: Oncologists (n = 123) completed a survey based on the Theory of Planned Behavior (TPB). Participants reported PA promotion behaviour, PA involvement, attitudes, intentions, social norm, perceived behavioural control (PBC), confidence and knowledge of exercise prescription. Structural equation modelling (SEM) evaluated these associations. Results: Less than half of oncologists reported regularly promoting PA to patients (46%). Only 26% were physically active. TPB SEM pathways explained 54.6% of the variance in PA promotion (CFI = 0.905, SRMR = 0.040). Social norm, was the only significant pathway to intention, but also a significant indirect pathway to PA promotion (p = .007). Confidence to promote PA, PBC and intentions were direct significant pathways to PA promotion (p < .05). Exploratory SEM pathways explained 19.6% of the variance in PA behaviour, which in turn explained 13.1% social norm, 10.7% attitude, 10.0% confidence and 17.8% PA promotion behaviour (CFI = 0.921, SRMR = 0.076). PA behaviour was a direct significant pathway to social norm, attitude, confidence, and PA promotion (p < .05). Conclusions: Oncologists reported a modest ability to promote PA, low PA promotion rates and limited knowledge of exercise prescription. Patient PA promotion may be improved through strategies that increase oncologists' PBC, confidence and their own personal PA participation.