What patients with cancer require from their clinicians to enable uptake of exercise as part of cancer care: A mixed methods study

Abstract Purpose Despite robust evidence and a series of evidence-based guidelines stating the benefits of exercise for cancer patients, uptake remains low. This study aimed to explore and describe what patients with cancer require from their clinicians to enable uptake of exercise as part of cancer care. Methods Concurrent mixed methods design. Participants included adult cancer patients. Online questionnaires and semi-structured telephone interviews explored patient preferences for receiving information about the role of exercise in cancer care. Quantitative data were analysed using standard descriptive statistics and an interpretive descriptive approach was used to inform qualitative analysis. Results Participants included 456 cancer patients. A randomly selected sub-set of 30 patients completed an interview. Many participants (n = 280/61.6%) reported discussion with clinicians as the way they mostly preferred to receive exercise information. Receiving exercise information shortly after being diagnosed and before starting treatment (n = 186/41.1% and n = 90/19.9%) were the timepoints mostly preferred for being informed about exercise. Information that was personalised and described exercise as being important to their cancer care was reported to be more likely to influence exercise behaviour. Clinician actions/provision of resources ranked as most helpful were: referral to cancer-specific exercise specialist (n = 330/76.6%) or program (n = 310/71.8%), and written exercise recommendations from a doctor/nurse (n = 234/54.3%). Conclusions and Implications for Cancer Survivors Cancer patients would be more likely to consider exercise as part of their cancer care if their clinicians initiated an informed conversation about exercise, introduced early in the care continuum, using personalised and cancer-specific messaging, that was supported by referral to cancer-specific exercise services.