Purpose:

The multicenter randomized controlled Physical Activity and Dietary intervention in OVArian cancer (PADOVA) trial assesses the effectiveness of a combined supervised moderate-to-high intensity exercise and nutritional intervention during chemotherapy. In addition, an extensive process evaluation is conducted to gain insight into how and why this intervention is (in)effective. The purpose of this presentation is to describe the results of semi-structured interviews that were conducted as part of this process evaluation to assess both intervention participants’ and implementers’ perceptions on the acceptability of the intervention.   

Methods:

Semi-structured interviews are conducted among both intervention participants (i.e., 122 adult women with primary epithelial ovarian cancer who are scheduled to undergo first-line (neo)adjuvant chemotherapy) and implementers (i.e., oncology physical therapists and dieticians). The first 25% of participants and 18 intervention implementers (n=6 dieticians; n=12 physical therapists) are invited for semi-structured interviews conducted by a researcher. Interviews are transcribed verbatim, and data analysis is performed concurrently with data collection. Thematic analysis is conducted following the 6 steps by Braun & Clarke (2006), using Atlas.ti version 8.4.

Results:

Physical therapists reported that participants were able to adhere to the exercise protocol better than expected, although they did report the exercise protocol was not achievable for some participants because of physical complaints (e.g., knee complaints). Dieticians were generally satisfied with the dietary intervention protocol, although they stated that the protein intake goal was not always achievable. They suggested to adapt the number of dietary sessions to individual needs and preferences. Participants indicated that the intervention contributed to their recovery, and that they were surprised to experience their body to be stronger than expected. Reasons for not being able to adhere to the intervention were being too sick or too tired. Participants suggested the dietary intervention could be improved by offering face-to-face dietary counselling closer to home. 

Conclusions:

These findings could be helpful in raising awareness about the acceptability and beneficial effects of participation in a combined tailored physical activity and dietary intervention in ovarian cancer patients undergoing chemotherapy. 

Background: The majority of the cancer care workforce have favourable attitudes and opinions of exercise for cancer patients, and report that exercise is safe and beneficial, nevertheless, insufficient time and uncertainty of what to recommend are reported as common barriers to discussing and/or counselling their patients about exercise. The limited research about cancer care clinician's communication with their patients about exercise suggests that a timely discussion about regular exercise can be reassuring, informative and motivational for patients. The purpose of this research was to explore the perceived barriers and facilitators impacting on the cancer care workforce's capacity to implement exercise counselling and an exercise referral pathway for their patients.

Methods: A series of focus groups (N=7) were conducted with cancer care clinicians and practitioners (n=62) (i.e., oncologists, haematologists specialising in cancer, oncology nurses, physiotherapists, exercise physiologists, social workers and psychologists) working with cancer patients throughout Sydney, Australia. The focus group interviews were audio-recorded, transcribed, and analysed using thematic content analysis.

Results: Two overarching themes, and associated subthemes, emerged from the data: 1) Factors impacting the knowledge-to-action gap, highlights the challenges and barriers clinicians and practitioners face in implementing exercise counselling and a referral pathway, inclusive of the funding structure; current referral process (i.e., only available via general practitioner/Medicare); lack of exercise specific knowledge and education to confidently advice/counsel patients; limited access and opportunity for professional development/training specific to exercise for cancer care, and 2) Recommendations for a consistent and efficient way forward, describes an action-orientated exercise counselling and referral pathway approach, inclusive of an oncologist-initiated brief communication exchange; distribution of a variety of cancer-specific, tailored exercise resources for patients (e.g., videos, online, hard copy); access to exercise physiologists with cancer care expertise; initial exercise consultation prompted by exercise physiologist.

Conclusions: This study has identified important factors influencing exercise counselling and referral by the cancer care workforce, and has presented potential approaches for incorporating exercise into usual cancer care. Future testing is required to determine feasibility and practicality of these approaches.  

Background: Across the cancer continuum, the importance and health benefits of exercise for cancer survivors are well documented. Health organizations recommend cancer survivors engage in up to 150 minutes/week of exercise however little is known about cancer survivors’ experiences with and preferences for exercise programs.

Purpose: The STAY Fit Trial is a three-armed randomized controlled trial comparing the effects of a 12-week yoga, aerobic walking and stretching-toning exercises on cognitive function among adult cancer survivors. This abstract presents participant experiences and preliminary data evaluating the feasibility of a group exercise program.

Methods: Sedentary cancer survivors between 30-70 years were invited to participate in the STAY Fit trial. Participants engaged in 150 minutes/week of exercise over 2 or 3 group sessions. After the 12-weeks, participants (N=51, males=5, mean age=54.36 ±9.9) completed a program feedback and evaluation to determine perceived benefits of exercise, overall satisfaction and enjoyment with the program, and feedback regarding the suitability of the exercise sessions.

Results: Majority of the participants completed the program feedback and evaluations (42/51). Average attendance ranged between 68-80% and participants reported experiencing a variety of health benefits. These self-reported health benefits included physical outcomes such as improved fitness, flexibility, strength as well as psychological benefits such as improved focus, sleep, body image and reduced pain. On average participants reported being satisfied with the STAY Fit program (4.5/5) and there were no significant differences between the exercise groups. On average participants reported that the dose of exercise was “just right” and neither “too long” or “too short”.

Conclusions: The exercise prescription of 150 minutes/week was well tolerated by the study participants. No program related adverse events were reported and participants perceived health benefits over the 12-weeks. Our findings have implications for designing and promoting exercise programs for this population across their lifespan. Exercise adherence can be a challenge for cancer survivors and future studies need to examine barriers to exercise experienced by cancer survivors to maximize adherence and therefore the benefits of exercise.