Community-based Programming Research Articles

Health care needs and health services utilization of people with spinal cord injury living in Jiangsu and Sichuan provinces of China: a cross-sectional community survey

Purpose We aimed to investigate health care needs, health service utilization, and their socio-economic and health-related determinants in people with spinal cord injury (SCI) living in Jiangsu and Sichuan Provinces of China. Materials and Methods A total of 1355 participants with SCI living in the community were recruited using a multi-stage stratified random sample and surveyed by telephone or online. Outcomes evaluated included the presence of health care needs, mode of health service utilization, and specific provider types seen within 12 months preceding the survey. Results The prevalence of healthcare needs was 92%. Needs were higher in Sichuan (98%) as compared to Jiangsu (80%). Of those in need of health care, 38% reported not having utilized care, more in Sichuan (39%) than in Jiangsu (37%). In Jiangsu, inpatient care was more often used than in Sichuan (46% vs. 27%), while in Sichuan outpatient services were utilized more often (33% vs. 17%). On average, 1.6 provider types were seen, with Sichuan reporting fewer different provider types. Conclusions Considerable differences in the prevalence of health care needs and service utilization patterns were found between provinces, mostly in favour of the economically more developed Jiangsu Province. Implications for Rehabilitation People with low income, particularly those below the World Bank poverty line for middle-income countries, had increased health care needs but utilized health care less often. Moreover, environmental barriers contributed significantly to unmet health care needs. This implies the necessity to provide better accessible and more affordable rehabilitation services for people with spinal cord injury (SCI) in China such as community-based rehabilitation programming. Policies for alleviation of poverty in the case of SCI including insurance for catastrophic health expenditure should also be reviewed and adapted where applicable.

Correlates and participation in community-based exercise programming for cancer patients before and during COVID-19.

COVID-19 pandemic restrictions ceased the opportunity for face-to-face group exercise classes with at risk populations, such as cancer patients, forcing an adaptation to online exercise programming. The purpose of this study was to compare the attendance rates and correlates of face-to-face exercise programming pre-COVID-19 to online programming delivered during the first year of pandemic restrictions. The sample was comprised from 1189 patient records between 2018 and 2021. Data analysis was based around the three primary research questions: (i) whether the volume of attendance in online exercise programming differed from the previous face-to-face programming; (ii) whether there were any differences in attendee demographics between online and face-to-face classes; and (iii) whether there were specific correlates of online attendance that can inform future exercise programming. Class attendance increased significantly when online exercise classes were introduced during the first year of the pandemic when compared to face-to-face attendance the prior years (p < .01). Multiple demographic findings were also observed including age, gender, and geographic differences. While COVID-19 has effected the ability to deliver face-to-face exercise programs for cancer patients, online programming has proved a promising delivery model with greater geographical reach. The approach, however, has gender and age differences in program attendance so targeted programming to reach specific cancer patient demographics may need attention. These results add to the continuing research in the area of online exercise and online programming strategies offering an effective option for cancer patients to achieve targeted exercise prescription.

An Ethnographic Model of Stress and Stress Management in Two Canadian Inuit Communities

As part of the first stage of a community-based participatory research project with two communities in the Canadian Arctic—Kangiqsujuaq, Nunavik, and Ulukhaktok, Northwest Territories—we conducted 57 interviews eliciting residents’ perceptions of pressing issues facing their communities, problems affecting health and wellbeing, and how researchers or other organized groups could help alleviate those problems. A recurrent theme that emerged during these interviews was having “no one to talk to.” Here, we focus on understanding why communication was a central theme using a grounded-theory approach to develop a model of Inuit stress management. Inuit in both Kangiqsujuaq and Ulukhaktok codify stress as isumaaluttuq, or excess worry, which often manifests physically and leads to social withdrawal. Because stress is believed to accumulate in the body, managing it involves decisions about whether to “Get It Out” or “Keep It In.” Keep It In is a potentially dangerous strategy because, if the problem does not resolve itself, accumulated stress may have harmful consequences. Inuit viewed talking to others as the most effective means to Get It Out, but respondents also identified numerous barriers to doing so. One important reason for this is that stress is transferable: Talking to others about a problem potentially increases the burden of stress on them. Consequently, Inuit may choose to Keep It In to avoid the potential negative consequences (for others or for oneself) of sharing bad thoughts. Based on this preliminary model, we consider questions for further inquiry and implications for community-based mental health programming in Inuit communities.

Practitioner Review: Psychosis in children and adolescents.

Psychotic symptoms, including hallucinations, delusions, and disorganized thinking and behaviors, are the hallmarks of schizophrenia; but may also present in the context of other psychiatric and medical conditions. Many children and adolescents describe psychotic-like experiences, which can be associated with other types of psychopathology and past experiences (e.g., trauma, substance use, and suicidality). However, most youth reporting such experiences do not have, nor will ever develop, schizophrenia or another psychotic disorder. Accurate assessment is critical because these different presentations have different diagnostic and treatment implications. For this review, we focus primarily on the diagnosis and treatment of early onset schizophrenia. In addition, we review the development of community-based first-episode psychosis programming, and the importance of early intervention and coordinated care.

Immigrants’ Experience of Health Care Access in Canada: A Recent Scoping Review

Existing literature has reported inequities in access to Canadian health care services among immigrants. The aim of this scoping review was (a) to explore research regarding Canadian immigrants' unique experiences in accessing healthcare, and (b) to provide suggestions for future research and programming considering the identified immigrant-specific service gaps in health care.We searched MEDLINE, CINAHL, EMBASE, and Google Scholar, following the Arksey and O'Malley (2005) framework. The review's findings suggest unmet health care access needs specific to immigrants in Canada, with the most common access barriers including communication, socioeconomic, and cultural barriers. The scoping review expands on the immigrant health care experiences and accessibility factors through a thematic analysis. Findings suggest that developing community-based programming, improving training for health care providers in culturally competent care, and policies that address the social determinants of health can improve health care accessibility among immigrants.

Return on investment from service transformation for young people experiencing mental health problems: Approach to economic evaluations in ACCESS Open Minds (Esprits ouverts), a multi-site pan-Canadian youth mental health project.

Mental health problems are common globally, and typically have their onset in adolescence and early adulthood-making youth (aged 11-25) an optimal target for prevention and early intervention efforts. While increasing numbers of youth mental health (YMH) initiatives are now underway, thus far few have been subject to economic evaluations. Here we describe an approach to determining the return on investment of YMH service transformation via the pan-Canadian ACCESS Open Minds (AOM) project, for which a key focus is on improving access to mental health care and reducing unmet need in community settings. As a complex intervention package, it is hoped that the AOM transformation will: (i) enable early intervention through accessible, community-based services; (ii) shift care away toward these primary/community settings and away from acute hospital and emergency services; and (iii) offset at least some of the increased costs of primary care/community-based mental health services with reductions in the volume of more resource-intensive acute, emergency, hospital or specialist services utilized. Co-designed with three diverse sites that represent different Canadian contexts, a return on investment analysis will (separately at each site) compare the costs generated by the intervention, including volumes and expenditures associated with the AOM service transformation and any contemporaneous changes in acute, emergency, hospital or service utilization (vs. historical or parallel comparators). Available data from health system partners are being mobilized to assess these hypotheses. Across urban, semi-urban and Indigenous sites, the additional costs of the AOM transformation and its implementation in community settings are expected to be at least partially offset by a reduction in the need for acute, emergency, hospital or specialist care. Complex interventions such as AOM aim to shift care "upstream": away from acute, emergency, hospital and specialist services and toward community-based programming which is more easily accessible, often more appropriate for early-stage presentations, and more resource-efficient. Carrying out economic evaluations of such interventions is challenging given the constraints of available data and health system organization. Nonetheless, such analyses can advance knowledge, strengthen stakeholder engagement, and further implementation of this public health priority.

Flames of transformation: Igniting better mental and physical health for racialized and gendered North Americans.

COVID-19 is catalyzing both crises and opportunities for communities of color. The crisis of high mental and physical morbidities and mortalities exposes persistent inequities while providing opportunities to celebrate the power of rejuvenated anti-racism movements, fueled partly in response to the extremism of ultra-conservative governments, the circumstances to reflect deeply on racism because of forced stay-at-home-orders, and digital technologies primarily driven by youth. In marking this historical moment of longstanding anti-racism and decolonial struggles, I assert the importance of foregrounding women's needs. In analyzing racism, rooted in colonialism and white supremacy, and its impacts on mental and physical health status, I focus on improving racialized women's lives within the larger context, concentrating on the determinants of health. I contend that fanning the flames to scathe the racist and sexist foundations of North American society will break new ground for sharing wealth, bolstering solidarity and sisterhood, and ultimately improving Black, Indigenous, and Women of Color (BIWOC) health. Canadian BIWOC earn approximately 59 cents to the dollar earned by non-racialized men, creating vulnerabilities to economic downturns, such as the one Canada is currently in. BIWOC care aides, at the bottom of the healthcare hierarchy, are emblematic of other Black, Indigenous, and People of Color (BIPOC), who face risks of frontline work, low wages, poor job security, unpaid sick days and so forth. To that end, policy recommendations include employment equity initiatives that hire groups of racialized women who consciously express solidarity with each other. Cultural shifts within institutions will be key to providing safe environments. Improving food security, internet access and BIWOC-related data collection linked to community-based programming while prioritizing research on BIWOC will go a long way toward improving BIWOC health. Addressing racism and sexism within the healthcare system, aiming for equitable diagnostic and treatment foci, will require transformative efforts including determined leadership and buy-in from all levels of staff, long-term training and evaluation programs, audited by BIPOC communities.

Innovations in Evidence-Based Home Visiting Intended to Engage and Support Families Impacted by Opioid Use Disorder: Three Case Studies from Pennsylvania Pilot Programs

Pregnancy and early parenthood can be challenging transitional times for many families, especially those struggling with opioid use disorder (OUD). Over 8million children live with a parent with SUD and parental drug use has been attributed to rising rates of family instability and child welfare involvement (Lipari & Van Horn, 2017; AFCARS, 2020;). Community-based prevention programming for families with young children, such as evidence-based maternal and child home visiting (EBHV), may we well positioned to engage and support families impacted by the opioid epidemic through early childhood. This paper presents case studies to highlight promising practices for adapting EBHV models to families impacted by SUD from the perspectives of staff and administrators. Data from three pilot sites are presented as case studies. These sites were selected to represent the most innovative and developed adaptations to EBHV for families impacted by substance use from an implementation evaluation of state-funded pilot sites (N = 20) at existing home visiting agencies across Pennsylvania. Data reported here represent semi-structured interviews with 11 individuals. Data were coded to facilitators and barriers nodes to understand the process and impact of pilot implementation. Systems-level collaboration and coordination were key to serving a population already engaged in multiple systems. Engagement of substance use experts allowed home visitors to focus on delivery of evidence-based curricula supporting family stability and child development. External partnerships reduced stigma among home visitors. Across sites, staff struggled with the increased acuity of social complexity of the OUD population. Pregnancy and early parenthood are challenging transitional times for many families, especially those with OUD. Evaluation results demonstrate the promise of systems-based adaptations to community-based prevention programming for families with young children, such as maternal and child home visiting, to better support families impacted by SUD.

Incorporation of peer support in a novel community-based mobile withdrawal management program

Despite the sweeping and deep-rooted impacts of problematic substance use throughout Canada, services remain under-resourced and overwhelmed. Innovative approaches are required if meaningful change is to occur. In this paper, we examine the incorporation of peer support into a novel, community-based outreach withdrawal program which engages with participants where they are situated. Peer support is an evidence-based intervention utilized in a wide range of health care arenas. It employs lived experience as a skillset to address health care needs to complement other components in the therapeutic journey. In the context of an outreach withdrawal service, peer support holds potential to deconstruct the power dynamic that acts as a barrier in conventional withdrawal programs. Peer support promotes the concept of interdisciplinary care, while actively dismantling stigma. More research is required to evaluate outcomes, client satisfaction, and cost-effectiveness with regards to peer support interventions in community-based outreach detoxification programming.

Implementation and Process Evaluation of Alcohol Free for 40: Community-Based Programming to Reduce Alcohol Consumption.

Alcohol consumption is known to increase risk for chronic diseases and other negative health outcomes. Abstinence, even temporary, from alcohol consumption can have positive health impacts. In this article, we describe implementation and process evaluation of Ochsner Eat Fit's Alcohol Free for 40 (AFF40), an annual, 40-day voluntary alcohol abstinence challenge that takes place in six regions of Louisiana. Participants are challenged to abstain from alcohol consumption for 40 days to promote behavior change. To support participants' success, staff conduct pre and post metrics (physical and laboratory) and host community-based events to encourage replacement behaviors. Process evaluation included measures of reach, recruitment, dose, and fidelity through tracking of participant registrations, an exit survey, media analytics, and program activity logs. In 2021, 493 participants enrolled in AFF40, with 347 completing laboratory metrics and 298 completing physical metrics. Majority of exit survey respondents (74.5%) reported no alcohol consumption during the 40-day challenge and that they planned to participate in AFF40 2022 (90.9%). The Eat Fit team documented moderate engagement (48.7% of enrolled participants) in program events. Social and digital impressions and page views recorded 23,591 hits while print media resulted in over 750,000 impressions. AFF40 has shown to be highly engaging for participants and effective in supporting temporary abstinence from alcohol. Incorporating stronger methods and evaluation will enhance future program implementation and community impact. Lessons learned and implications for practice are transferable to other community-based efforts to reduce alcohol consumption.

The Efficacy of Individualized, Community-Based Physical Activity to Aid Smoking Cessation: A Randomized Controlled Trial.

The efficacy of individualized, community-based physical activity as an adjunctive smoking cessation treatment to enhance long-term smoking cessation rates was evaluated for the Lifestyle Enhancement Program (LEAP). The study was a two-arm, parallel-group, randomized controlled trial. All participants (n = 392) received cessation counseling and a nicotine patch and were randomized to physical activity (n = 199; YMCA membership and personalized exercise programming from a health coach) or an equal contact frequency wellness curriculum (n = 193). Physical activity treatment was individualized and flexible (with each participant selecting types of activities and intensity levels and being encouraged to exercise at the YMCA and at home, as well as to use "lifestyle" activity). The primary outcome (biochemically verified prolonged abstinence at 7-weeks (end of treatment) and 6- and 12-months postcessation) and secondary outcomes (7-day point prevalent tobacco abstinence (PPA), total minutes per week of leisure time physical activity and strength training) were assessed at baseline, 7 weeks, 6 months, and 12 months. Prolonged abstinence in the physical activity and wellness groups was 19.6% and 25.4%, respectively, at 7-weeks, 15.1% and 16.6% at 6-months, and 14.1% and 17.1% at 12 months (all between-group P values >0.18). Similarly, PPA rates did not differ significantly between groups at any follow-up. Change from baseline leisure-time activity plus strength training increased significantly in the physical activity group at 7 weeks (P = 0.04). Across treatment groups, an increase in the number of minutes per week in strength training from baseline to 7 weeks predicted prolonged abstinence at 12 months (P ≤ 0.001). Further analyses revealed that social support, fewer years smoked, and less temptation to smoke were associated with prolonged abstinence over 12 months in both groups. Community-based physical activity programming, delivered as adjunctive treatment with behavioral/pharmacological cessation treatment, did not improve long-term quit rates compared to adjunctive wellness counseling plus behavioral/pharmacological cessation treatment. This trial is registered with https://beta.clinicaltrials.gov/study/NCT00403312, registration no. NCT00403312.

The Community School Initiative in Toronto: Mitigating Opportunity Gaps in the Jane and Finch Community in the Wake of COVID-19

COVID-19 significantly impacted the delivery of education with widespread disruptions, particularly disadvantaging racialized and low-income families. Our research project explored how community-based programming can be adapted and mobilized to mitigate opportunity and achievement gaps for Black, Indigenous, people of colour (BIPOC), and those from lower socio-economic backgrounds. The project as a case study examined an afternoon and weekend supplementary academic program called the Community School Initiative (CSI), offered from September 2020 to May 2021 to members of the Jane and Finch community in Toronto, Canada at a subsidized cost. CSI is a partnership between the non-profit organization Youth Association for Academics, Athletics, and Character Education (YAAACE) and the for-profit enterprise Spirit of Math. It delivers a structured math curriculum to students in grades two to eight aged 8 to 14 years, old supported by a team of caring adults including parents, coaches, and Ontario certified teachers. The efficacy and outcomes of the CSI was assessed through surveys with parents (n=33), students (n=33), and teachers (n=4), and a focus group with seven teachers delivering the curriculum in the CSI. We also discuss the significance of how the research was conducted in the wake of COVID-19. Hence, this article is about the findings from the data, but just as much about the community-driven approach to how the research was conducted, by the community and for the community.

APA/APAGS Award for Distinguished Graduate Student in Professional Psychology: Pearis L. Bellamy.

The APA/APAGS Award for Distinguished Graduate Student in Professional Psychology is awarded annually by the APA Board of Professional Affairs (BPA) and the American Psychological Association of Graduate Students (APAGS) to a graduate student who has demonstrated outstanding practice and application of psychology. A 2022 award winner is Pearis L. Bellamy. Bellamy is a doctoral student in the Counseling Psychology program at the University of Florida. In this role, she has conducted research and completed multiple practicum/externship experiences where she has developed and evaluated programs and created healing spaces for underserved populations and survivors of trauma. She has also been active in advocacy on behalf of underserved populations where she organizes others to make actionable change in understanding their privilege and power and in using this education, training, and awareness building to fight racism. Ms. Bellamy's clinical work, scholarly research, and professional interests include culturally mindful clinical interventions and community-based research and prevention programming for survivors of intimate partner violence, sexual assault, and racism with a focus on the Black community. Her professional contributions reflect numerous examples of how she provides healing spaces for underrepresented groups to connect, share experiences, and challenge and resist oppressive systems. For these and other impactful efforts, we believe that Ms. Bellamy is well-deserving of this distinguished award and recognition. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Recidivism among People Convicted of Gun Offenses: A Call to Better Leverage Reentry Resources to Decrease Gun Violence

This study provides a primary step towards exploring whether rehabilitation efforts informed by the risk, needs, responsivity approach should be leveraged to decrease gun violence. Through the use of competing risks survival analyses, we assess the gun offense recidivism patterns of people released from prison that do (n = 1,158) and do not (n = 9,868) have gun crime conviction histories. We then explore whether gun offense recidivism increases along with actuarially based risk, how gun offense histories impact the odds of receiving community-based programming during the transition from prison to the community, and, in turn, whether programming impacts gun offending recidivism. Findings indicate that people with a history of gun offense convictions are at more than twice the hazard of committing gun offenses than similarly situated people without such histories. Predicted subhazards of recidivism and magnitudes of differences between offense history groups increase substantially as actuarially assessed risk for recidivism increases. However, predicted probabilities of receipt of community-based programming do not significantly differ between the groups with and without gun offense histories, and recidivism hazards did not meaningfully differ between those that do and do not receive community-based programs despite their gun offending histories. The results illuminate a need to expand reentry-based services towards addressing the criminogenic needs of people previously convicted of gun offenses.

A Community Based Approach to Deter Childhood Obesity in Title 1 Schools

ABSTRACT Community development is an effort to build resources that increase inhabitants’ ability to improve their life quality. Obesity is a significant health risk to individuals and their communities. In 2016/2017, school screenings showed that 28.3% of first-graders, 35.4% of third-, and 14.1% of sixth-graders in a Florida Panhandle school district were overweight. Additional data revealed an increase in overweight individuals with large proportions of minorities or low-income students. To intervene, individuals from a Historically Black University respond to the structural inequality – obesity and education access to health care by offering nutritional education to ascertain the possibility of deterring childhood obesity using community-based programming. Over 870 students from Title 1 locations participated. A pretest/posttest was given, and T-test results revealed significant behavior changes. Community practitioners can offer educational programs to impact students’ health behaviors at risk of obesity.

Perceived challenges to implementing childhood obesity prevention strategies in pediatric primary care

Childhood is an opportune time to address issues related to weight management, as children with obesity are more likely to have obesity in adulthood, and few successful long-term weight loss strategies exist. In 2007, an Expert Committee established guidelines for integrating obesity prevention into primary care, yet few studies have examined the extent to which pediatric primary care providers provide education about nutrition and physical activity at preventive (i.e., well-child) visits. This study aimed to identify challenges encountered and strategies used by pediatric primary care providers in South Carolina to address childhood obesity. Two focus group discussions (FGDs) were conducted with pediatric primary care providers (n ​= ​23) from a federally qualified health center (FQHC) in South Carolina. Participants responded to a series of semi-structured, open-ended questions about their experiences integrating obesity prevention and treatment into primary care. Focus groups were audio recorded and transcribed verbatim. Two coders used an iterative coding and consensus-building process to identify themes and subthemes, finalize coding, and extract illustrative quotations. Providers reported that families they served experienced many barriers to healthy eating and physical activity, including lack of community-based programming and social determinants of health. Provider-focused challenges were also identified, including time constraints, lack of focus on prevention, and logistic issues. . Providers described multiple strategies to address childhood obesity in their pediatric practice, including using family-centered approaches and tailoring obesity prevention and treatment approaches to patient demographics (e.g., age, ethnicity, comorbid conditions). A number of tools were also described as helpful in promoting physical activity and healthy eating during well-child visits.

Exploring the Relationship Between Quality and Quantity of Physical Activity Participation in Community-Based Exercise Programs for Persons With Physical Disabilities.

Community-based exercise programs for persons with disabilities promote greater quantity of leisure-time physical activity (LTPA) participation among their members, perhaps because of the quality experiences fostered by the program. This study aimed to explore the relationship between quality and quantity of physical activity participation in the context of community-based exercise programming and the role that gender plays in this relationship. Adults with physical disabilities (N = 91; Mage = 55, 49 men) from three community-based exercise programs across Canada completed a survey asking about quality participation (Measure of Experiential Aspects of Participation [MeEAP]) and LTPA. Structural equation modeling was used to examine the relationship between MeEAP scores and LTPA. Quality participation was not related to LTPA, even with gender included as a moderator. Men reported higher levels of LTPA and quality participation than women, highlighting gender differences that should be considered when researching and designing exercise programs for individuals with disabilities.

A community-based adapted exercise program to increase quality of life and self-efficacy among adults with physical disabilities: A mixed-method study.

Self-efficacy is one of the key constructs that directly influence physical activity, community participation, and mental health while acting as a strong influence on the quality of life (QOL) for adults with physical disabilities (AWPDs). There are relatively few studies focusing on a community-based exercise program in this population. This study aims to quantitatively examine a community-based adapted exercise program on the QOL and self-efficacy of AWPDs. In addition, we explored AWPD's perceived benefits of community-based exercise programming and any factors that may influence those perceived benefits. Adults with physical disabilities (N = 50) participated in a 9-week community-based adapted exercise program (90-minute session, twice per week). QOL (WHOQOL-BREF) and self-efficacy were measured at baseline and at the conclusion of the program. A follow-up focus group (n = 22) was conducted at the postprogram. Quantitative data were analyzed by paired t test (α = 0.05). Qualitative data were analyzed by thematic coding and content analysis. Significant improvement with moderate effect size was found across all variables. Two main themes emerged from the qualitative analysis: 1) perceived benefit of exercise program and 2) factors of an exercise program for AWPD. A community-based exercise program and self-efficacy play a large role in the exercise behaviors and QOL of AWPDs. The benefits of exercise and factors identified as promoting exercise may be carefully considered to improve QOL for this population. The finding of this study offers practical recommendations to community-based exercise specialists, which would assist in establishing an appropriate exercise program for AWPDs.

Socioecological Model for Health Care Systems to Address Intimate Partner Violence, Human Trafficking, and Sexual Assault

Health care systems are uniquely positioned to go beyond provision of clinical care for victims of intimate partner violence (IPV), human trafficking (HT), and sexual assault (SA) by interrupting the cycle of violence. Using a trauma-informed approach to patient care, educating staff at every level of the organization to recognize risk factors, and maintaining effective community partnerships can help individuals affected by violence extricate themselves from dangerous domestic situations. Health care systems can also advocate for policies to fund community-based violence-prevention programming as well as remuneration for crime victims.

Health Fitness Professionals’ Perceptions to Offering a Cancer Exercise Program: A Qualitative Study

ABSTRACT Introduction/Purpose The purpose of this study is to qualitatively investigate fitness professionals’ perceptions of barriers and enablers to offering community-based exercise programs targeting cancer survivors at their fitness and/or community centers. Methods A qualitative case study approach incorporating Web-based survey and semistructured interview components was used to evaluate community-based fitness professionals’ programming perceptions. Results A total of seven subjects completed a semistructured interview. Data analysis using content analysis and the constant comparative method process revealed three primary domains with 11 underlying themes: 1) program barriers (education and awareness, physician referral, cost, and care along the cancer continuum); 2) program enablers (champion advocacy, sponsor/funding, personnel, and propositional solutions); and 3) program perceptions (social support, gym atmosphere, and cancer-specific modifications). Conclusions Findings from this qualitative study identified multiple domains and themes articulating health and fitness professionals’ perceptions of key barriers, enablers, and programmatic aspects in offering community-based exercise cancer programming. These results have important implications for guiding the design and delivery of community-based exercise programs for cancer survivors and represent an advance in the current literature surrounding implementation strategies in a clinic-to-community translational model of exercise-based supportive cancer care.