Abstract
BackgroundPhysical activity (PA) programmes effective under ‘research’ conditions may not be effective under ‘real-world’ conditions. A potential solution is to refer patients to existing PA community-based PA services.MethodsA process evaluation of referral of post-surgical patients with early-stage breast cancer to cardiac rehabilitation exercise classes, leisure centre with 3-month free leisure centre membership or telephone-delivered PA consultations for 12 weeks. Quantitative data were collected about PA programme uptake and reach, patient engagement with the PA programme, delivery and fidelity and PA dose. Qualitative data were collected about patient experiences of taking part in the PA programmes. Audio-recorded qualitative interviews of participants about the programmes were analysed thematically. Quantitative data were reported descriptively using means and SD.ResultsIn Phase I, 30% (n = 20) of eligible patients (n = 20) consented, 85% (n = 17) chose referral to leisure centre, and 15% (n = 3) chose cardiac rehabilitation. In Phase II, 32% (n = 12) consented, 25% (n = 3) chose leisure centre and 75% (n = 9) chose telephone-delivered PA consultations. Walking at light intensity for about an hour was the most common PA. All Phase I participants received an induction by a cardiac rehabilitation physiotherapist or PA specialist from the leisure centre but only 50% of Phase II participants received an induction by a PA specialist from the leisure centre. Four themes were identified from qualitative interviews about programme choice: concerns about physical appearance, travel distance, willingness to socialise and flexibility in relation to doing PA. Four themes were identified about facilitators and barriers for engaging in PA: feeling better, feeling ill, weight management, family and friends.ConclusionsThe current community-based PA intervention is not yet suitable for a definitive effectiveness randomised controlled trial. Further work is needed to optimise PR programme reach, PA dose and intervention fidelity.Trial registrationISRCTN11183372.
Highlights
Physical activity (PA) programmes effective under ‘research’ conditions may not be effective under ‘real-world’ conditions
A concern for breast cancer clinical teams is that only 16% of breast cancer survivors are meeting PA recommended guidelines [13], and sedentary time remains high in the first year following treatment for breast cancer [14]
This paper focuses on the following study’s objectives: (1) quantify PA programme uptake and reach, patient engagement with the PA programme, PA programme delivery and fidelity and PA dose and (2) qualitatively explore patient experiences of taking part in the PA programmes
Summary
Physical activity (PA) programmes effective under ‘research’ conditions may not be effective under ‘real-world’ conditions. Professional bodies in different countries, including the UK, have published detailed PA prescription guidelines for people with cancer [8,9,10,11,12]. These bodies concur that unless advised otherwise, all cancer survivors should aim to meet national PA recommendations for the general public (currently ≥ 150 min of moderate intensity aerobic activity per week, plus two sessions of muscular strength and endurance and some daily flexibility/balance exercises). Patients need effective evidence-based programmes to support them to increase PA
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