Bridging the gap between attitudes and action: A qualitative exploration of clinician and exercise professional’s perceptions to increase opportunities for exercise counselling and referral in cancer care |
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| Institution: | 1. School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia;2. IMPACCT, University of Technology Sydney, Sydney, NSW, Australia;3. Cancer Care Centre, St George Hospital, Sydney, NSW, Australia;4. St George and Sutherland Clinical School, University of New South Wales, Sydney, NSW, Australia;5. Translational Cancer Research Network Sydney, Australia;6. Faculty of Health, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia;1. Maastricht University, Department of Family Medicine, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands;2. Maastricht University, Department of Educational Development and Research, School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht, The Netherlands;3. RCSI University of Medicine and Health Sciences, Health Professions Education Centre, Dublin, Ireland;1. University of Kansas School of Medicine, Department of Population Health, Kansas City, KS USA;2. University of Kansas School of Nursing, Kansas City, KS USA;1. University of Newcastle, Department of Rural Health, Tamworth, NSW 2340, Australia;2. Hunter New England Local Health District, Tamworth, NSW 2340, Australia;3. Rheumatology Practice, Tamworth, NSW 2340, Australia;1. Psycho-Oncology Co-operative Research Group (PoCoG), Level 6 (North) Lifehouse (C36Z), School of Psychology, University of Sydney, Sydney 2006 Australia;2. School of Public Health, University of Sydney, 2006 Sydney, Australia;3. Cancer Theme, Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, NSW 2010, Australia;4. St Vincent’s Clinical School, University of NSW, Sydney, Australia;5. School of Psychology, University of Sydney, Sydney 2006, Australia;6. Psychosocial Research Group, Prince of Wales Clinical School, University of NSW, Sydney 2052, Australia;7. Dept of Medical Oncology, Prince of Wales Hospital, 320-346 Barker St, Randwick, NSW 2031, Australia;8. Newborn Screening, Ethics and Disability Studies, RTI International, Washington, DC, USA;1. Department of Family Medicine & Community Health, Medical School, University of Minnesota, 516 Delaware St SE, Minneapolis, MN 55455, USA;2. Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, 1300S. 2nd St., Minneapolis, MN 55454, USA;3. School of Social Work, Smith College, Lilly Hall 23 West St., Northampton, MA 01063, USA;4. Department of Educational Psychology, University of Minnesota, 250 Education Sciences Bldg, 56 E River Rd, Minneapolis, MN 55455, USA;5. Department of Urology, Rush Medical College, 600S Paulina St Suite 524, Chicago, IL 60612, USA;6. Malecare Cancer Support, 63 Avenue A, apt 13i, New York, NY 10009, USA;7. School of Nursing, University of Minnesota, 308 SE Harvard St, Minneapolis, MN 55455, USA;8. Department of Writing Studies, University of Minnesota, 315 Pillsbury Dr SE, Minneapolis, MN 55455, USA;9. Behavioral Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, USA;10. Department of Urology, University of Minnesota, 909 Fulton Street SE, Minneapolis, MN 55414, USA;1. Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Public Health, Charité – Universitätsmedizin Berlin, Berlin, Germany;2. University of Education Freiburg, Department of Public Health and Health Education, Germany;3. Beuth University of Applied Sciences, Berlin, Germany;4. Institute of Social Medicine and Epidemiology, Brandenburg Medical School Theodor Fontane, Brandenburg an der Havel, Germany |
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| Abstract: | ObjectiveThis study aimed to 1) understand factors impacting the implementation of exercise communication and referral, and 2) explore integrated clinical approaches to exercise communication and referral in cancer care.MethodsSeven focus groups (N = 53) were conducted with clinicians and exercise professionals throughout Sydney, Australia. A sub-sample of participants (n = 9) attended a half-day workshop to identifying best practice approaches for moving forward. Data were analysed using thematic content analysis.ResultsTwo themes emerged: 1) Factors impacting the knowledge-to-action gap, inclusive of limited exercise specific knowledge and training opportunities, funding structure, and current referral process, and 2) Recommendations for a consistent and efficient way forward, detailing the need for oncologist-initiated communication, distribution of cancer-exercise resources, and access to exercise professionals with cancer expertise.ConclusionsThis study identified factors (e.g., cancer-exercise specific training, integration of exercise physiologists) influencing exercise counselling and referral. A potential implementation-referral approach accounting for these factors and how to incorporate exercise into a standard model of cancer care, is described. Future testing is required to determine feasibility and practicality of these approaches.Practical ImplicationsA pragmatic model is provided to guide implementation-referral, inclusive of oncologist-initiated communication exchange, relevant resources, and access to exercise professionals with cancer expertise. |
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| Keywords: | Exercise counselling Exercise referral Cancer care workforce Focus groups Implementation |
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