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Lombardo R, Russo GI, Romagnoli M, Tema G, Nacchia A, Franco A, Cicione A, Franco G, Tubaro A, De Nunzio C. Yoga, benign prostatic hyperplasia and lower urinary tract symptoms: a new path for clinical trials. Prostate Cancer Prostatic Dis 2024:10.1038/s41391-024-00788-1. [PMID: 38233471 DOI: 10.1038/s41391-024-00788-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/22/2023] [Accepted: 01/05/2024] [Indexed: 01/19/2024]
Affiliation(s)
| | | | | | - Giorgia Tema
- Department of Urology, Sapienza University, Rome, Italy
| | | | | | | | | | - Andrea Tubaro
- Department of Urology, Sapienza University, Rome, Italy
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Fox IN, Wassersug R. Case studies on psychosocial factors that help make exercise programmes for prostate cancer patients self-sustaining. BMJ Support Palliat Care 2024; 13:e1056-e1063. [PMID: 35101863 DOI: 10.1136/bmjspcare-2021-003370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 01/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Patients with prostate cancer (PCa) benefit from regular exercise, but it is difficult for patients to maintain an exercise regime. We examined two exercise programmes that have proven to be self-sustaining with the goal of identifying features they share that may contribute to their success. METHODS We compared the FC Prostata football (soccer) league in Denmark and the 'Butts in a Boat' (BIAB) dragon-boating team in Canada. The FC Prostata Project Coordinator and the BIAB team leaders provided information on their programmes' history and structure. RESULTS Both programmes are team-based with regularly scheduled intense exercise at their core. In both cases, social activities evolved spontaneously, starting with the men going out for food and/or drinks after practices. The sustainability of these programmes may be driven by the regular socialisation linked to the fitness activities. CONCLUSIONS Our case studies suggest that exercise programmes for PCa patients may have a good chance of being self-sustaining, if they are: (1) centred around intense exercise, (2) of a team nature, (3) structured to promote egalitarianism and avoid one-on-one competition within teams, yet (4) have some competitions between teams. The data suggest that informal social activities organised by patients after team practices may be important for building fellowship and strengthening patients' commitment to exercise both for themselves and for their team members.
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Affiliation(s)
| | - Richard Wassersug
- Department of Cellular and Physiological Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
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Siapno AED, Quintanilla NE, Piqueiras E, Litwin MS. A qualitative study of barriers and facilitators for health behavior change in low-income men with prostate cancer. Support Care Cancer 2024; 32:81. [PMID: 38175287 DOI: 10.1007/s00520-023-08272-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Low-income prostate cancer survivors, who typically have worse outcomes and greater all-cause mortality, often have poor health-promoting behaviors. Our objective was to assess perceived facilitators of and barriers to healthy behavior change by interviewing low-income men with prostate cancer who received no-cost treatment through a state-funded program. METHODS Between September 2021 and April 2022, we conducted semi-structured interviews with 19 men (ages 60-75). Purposive sampling was utilized from participants of a cohort of men with prostate cancer from low-income backgrounds. Interviews were recorded, transcribed, and then coded by the authors to generate salient themes via thematic analysis. RESULTS We found internal characteristics and structural characteristics that functioned independently and in concert to promote and/or hinder healthy behavior change. Internal characteristics such as motivations (prostate cancer diagnosis, self-perceptions, support system, and preferences) and determination, defined as level of motivation, drove behavior actualization. Structural characteristics that influenced behavior change included resources (access to food and opportunities for exercise) and social support. CONCLUSIONS These outcomes suggest that motivation and determination can serve as protective facilitators encouraging healthy behaviors despite structural barriers low-income prostate cancer survivors may face. However, motivations challenged by financial constraints were not sufficient to guide healthy behavior change. With this in mind, we recommend that interventions promoting healthy behavior change among this population should focus on identifying and strengthening internal assets such as motivations, self-perceptions, preferences, and support systems.
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Affiliation(s)
- Allen E D Siapno
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
| | - Nancy E Quintanilla
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Eduardo Piqueiras
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Mark S Litwin
- Department of Urology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Health Policy & Management, The Fielding School of Public Health, University of California, Los Angeles, CA, USA
- School of Nursing, University of California, Los Angeles, CA, USA
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Shirazipour CH, Raines C, Diniz MA, Salvy SJ, Haile RW, Freedland SJ, Asher A, Tomasone JR, Gresham G. The 24-Hour Movement Paradigm: An integrated approach to the measurement and promotion of daily activity in cancer clinical trials. Contemp Clin Trials Commun 2023; 32:101081. [PMID: 36875555 PMCID: PMC9974421 DOI: 10.1016/j.conctc.2023.101081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/11/2023] [Accepted: 01/28/2023] [Indexed: 02/02/2023] Open
Abstract
Increased physical activity (PA), improved sleep, and decreased sedentary behavior (SB) are essential components of supportive care for cancer survivors. However, researchers and health care professionals have achieved limited success in improving these behaviors among cancer survivors. One potential reasoning is that, over the past two decades, guidelines for promoting and measuring PA, sleep, and SB have been largely siloed. With greater understanding of these three behaviors, health behavior researchers have recently developed a new paradigm: the 24-Hour movement approach. This approach considers PA, SB, and sleep as movement behaviors along a continuum that represent low through vigorous intensity activity. Together these three behaviors form the sum of an individual's movement across a 24-hour day. While this paradigm has been studied in the general population, its usage is still limited in cancer populations. Here, we seek to highlight (a) the potential benefits of this new paradigm for clinical trial design in oncology; (b) how this approach can allow for greater integration of wearable technology as a means of assessing and monitoring patient health outside the clinical setting, improving patient autonomy through self-monitoring of movement behavior. Ultimately, implementation of the 24-Hour movement paradigm will allow health behavior research in oncology to better promote and assess critical health behaviors to support the long-term well-being for cancer patients and survivors.
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Affiliation(s)
- Celina H. Shirazipour
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
- University of California Los Angeles, Los Angeles, CA, USA
| | | | | | - Sarah-Jeanne Salvy
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
- University of Southern California, Los Angeles, CA, USA
| | | | | | - Arash Asher
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
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Ranes M, Wiestad TH, Thormodsen I, Arving C. Determinants of exercise adherence and maintenance for cancer survivors: Implementation of a community-based group exercise program. A qualitative feasibility study. PEC INNOVATION 2022; 1:100088. [PMID: 37213720 PMCID: PMC10194213 DOI: 10.1016/j.pecinn.2022.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/08/2022] [Accepted: 09/28/2022] [Indexed: 05/23/2023]
Abstract
Objective Despite verified knowledge that physical exercise plays an important part in recovery after cancer treatment, multiple studies have shown that maintaining a physically active lifestyle after cancer is challenging. There is a need for qualitative studies to increase understanding into patient experiences and perspectives, and facilitate the design of more sustainable exercise program. This qualitative descriptive feasibility study explores experiences from the implementation of a novel four-month community-based group exercise program for cancer survivors within municipality health service after completion of rehabilitation in the specialist health care service. Methods Fourteen cancer survivors participated in focus group interviews after completing Rehabilitation: Physical activity and Coping - feasibility study. Data were analyzed using the systematic text condensation method. Results We identified a main category, Determinants for exercise adherence and maintenance and four subcategories: peer-support, environment, structure and knowledge. Conclusion A social and supportive exercise environment promotes exercise adherence and maintenance among cancer survivors. This knowledge can be useful for further efforts to implement high quality community-based group exercise programs for cancer survivors. Innovation This study adds knowledge of survivors' experience of a novel community-based group exercise program in clinical practice and can promote the implementation of sustainable community-based exercise programs for cancer survivors.
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Affiliation(s)
- Maria Ranes
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
- Corresponding author at: Department of Oncology and Medical Physics, Haukeland University Hospital, Box 1400, 5021 Bergen, PO, Norway
| | - Tor Helge Wiestad
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - Inger Thormodsen
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
| | - Cecilia Arving
- Department of Oncology and Medical Physics, Haukeland University Hospital, Bergen, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Seven M, Marie Moraitis A. Community-based interventions designed to optimize health behaviors among cancer survivors: an integrative systematic review. Support Care Cancer 2022; 30:8405-8415. [PMID: 35524870 DOI: 10.1007/s00520-022-07097-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 04/27/2022] [Indexed: 01/01/2023]
Abstract
PURPOSE The purpose of this review was to synthesize the evidence on community-based health behavior optimization interventions (physical activity, nutrition, weight management) with a focus on cancer survivors at risk for poor health outcomes. METHODS This integrative review followed the methods and protocol outlined by the Joanna Briggs Institute Methods Manual for systematic reviews and was reported using PRISMA-Scr. Four databases, namely, PubMed, CINAHL, Web of Science, SportDiscus, were searched in March 2021 to identify articles addressing health behaviors among cancer survivors. RESULTS The review included 43 articles describing unique interventions developed through community-based participatory research (CBPR). The majority of community-based interventions were designed to optimize exercise/physical activity (76.7%) exclusively or in combination with nutrition. Non-Hispanic White persons constituted most participants. Most interventions took place as a part of an established community program and recruited from existing community programs to evaluate intervention effects on specific health outcomes. Of the interventions, 88.3% improved at least one outcome measurement. CONCLUSION The current studies have built on the strengths and resources of the community using existing programs. There was a lack of diversity in socioeconomic status and racial/ethnic background among participants of most interventions and inputs from partners such as cancer survivors, community, and healthcare organizations. Multiple health behavior interventions with longitudinal studies are needed for racial/ethnic minoritized cancer survivors. Future research should focus on achieving mutual benefits through iterative processes to develop sustainable community/research partnerships, ensuring long-term commitment, and disseminating knowledge gained from CBPR to and by all involved partners to improve health behaviors.
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Affiliation(s)
- Memnun Seven
- University of Massachusetts Amherst, Elaine Marieb College of Nursing, Amherst, MA, USA.
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McNeely ML, Suderman K, Yurick JL, Nishimura K, Sellar C, Ospina PA, Pituskin E, Lau H, Easaw JC, Parliament MB, Joy AA, Culos-Reed SN. Feasibility of Implementing Cancer-Specific Community-Based Exercise Programming: A Multi-Centre Randomized Trial. Cancers (Basel) 2022; 14:cancers14112737. [PMID: 35681717 PMCID: PMC9179478 DOI: 10.3390/cancers14112737] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/10/2022] [Accepted: 05/18/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND There is growing recognition of the importance of reporting preliminary work on the feasibility of a trial. The present study aimed to assess the feasibility of (1) a proposed fitness testing battery, and (2) processes related to the implementation of cancer-specific exercise programming in a community setting. METHODS/DESIGN A randomized controlled implementation feasibility trial was performed in advance of a large-scale implementation study. Eligible participants within 18 months of a cancer diagnosis were randomized to immediate or delayed community-based exercise at YMCA locations in Calgary and Edmonton, Canada for an 8-week period. The primary outcome for the trial was the feasibility of the physical fitness testing battery, defined as a 70% or greater completion rate across the 24-week study period. The Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework was used to evaluate processes related to implementation of the exercise program across the two sites. RESULTS Eighty participants were recruited, 73 (91%) completed the 8-week trial, and 68 (85%) completed the 16- and 24-week follow-ups. Sixty participants (75%) completed the full physical fitness test battery at each time point, and 59 (74%) completed the patient-reported outcome measures. Statistically significant between-group differences were found in favor of the exercise group for functional aerobic capacity, upper and lower extremity strength, and symptoms. Differences were found between the sites, however, in completion rates and processes related to program implementation. DISCUSSION Findings suggest the need for minor adaptations to the physical fitness battery and outcome measures to better fit the community context. While findings support feasibility, context-specific challenges related to implementation processes were identified.
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Affiliation(s)
- Margaret L. McNeely
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada; (K.S.); (K.N.); (C.S.); (P.A.O.)
- Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3E4, Canada;
- Department of Oncology, Faculty of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada; (E.P.); (J.C.E.); (A.A.J.)
- Correspondence: ; Tel.: +1-780-248-1531
| | - Kirsten Suderman
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada; (K.S.); (K.N.); (C.S.); (P.A.O.)
| | - Janice L. Yurick
- Cross Cancer Institute, Alberta Health Services, Edmonton, AB T6G 1Z2, Canada;
| | - Kathryn Nishimura
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada; (K.S.); (K.N.); (C.S.); (P.A.O.)
- Cross Cancer Institute, Alberta Health Services, Edmonton, AB T6G 1Z2, Canada;
| | - Christopher Sellar
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada; (K.S.); (K.N.); (C.S.); (P.A.O.)
| | - Paula A. Ospina
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada; (K.S.); (K.N.); (C.S.); (P.A.O.)
| | - Edith Pituskin
- Department of Oncology, Faculty of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada; (E.P.); (J.C.E.); (A.A.J.)
- Cross Cancer Institute, Alberta Health Services, Edmonton, AB T6G 1Z2, Canada;
- Faculty of Nursing, University of Alberta, Edmonton, AB T6C 1C9, Canada
| | - Harold Lau
- Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB T2N 4N2, Canada;
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
| | - Jacob C. Easaw
- Department of Oncology, Faculty of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada; (E.P.); (J.C.E.); (A.A.J.)
- Cross Cancer Institute, Alberta Health Services, Edmonton, AB T6G 1Z2, Canada;
| | - Matthew B. Parliament
- Cancer Care Alberta, Alberta Health Services, Edmonton, AB T5J 3E4, Canada;
- Department of Oncology, Faculty of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada; (E.P.); (J.C.E.); (A.A.J.)
| | - Anil A. Joy
- Department of Oncology, Faculty of Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada; (E.P.); (J.C.E.); (A.A.J.)
- Cross Cancer Institute, Alberta Health Services, Edmonton, AB T6G 1Z2, Canada;
| | - S. Nicole Culos-Reed
- Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4N1, Canada;
- Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
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Feasibility of a Remotely Delivered Strength and Balance Training Program for Older Adults with Cancer. Curr Oncol 2021; 28:4408-4419. [PMID: 34898562 PMCID: PMC8628693 DOI: 10.3390/curroncol28060374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 10/07/2021] [Accepted: 10/19/2021] [Indexed: 11/16/2022] Open
Abstract
Falls are a major issue among older adults with cancer and lead to interruptions in cancer treatment. Resistance and balance training can prevent falls in older adults, but minimal evidence is available regarding the older cancer population, who often have unique risk factors. We used a pre-post design to assess the feasibility of a remotely delivered exercise program that progressed in difficulty and its efficacy on lower body strength, balance, and falls in older adults with cancer who had prior in-person exercise experience. Twenty-six older adults with cancer completed the intervention. Attendance rate for the virtual component was 97.6% and for the independent component was 84.7%. Participants perceived the program as rewarding and enjoyable (100%), felt this program prepared them to exercise on their own (92%), were confident to continue exercising on their own (81%), and would recommend the program to other patients (100%). The median balance score at baseline and end-of-study was 4 (IQR = 0). The median chair-stand time decreased from 9.2 s (IQR = 3.13) to 7.7 s (IQR = 4.6). A statistically significant difference in lower body strength (r = 0.68, p = 0.001) was detected post-intervention. The findings from this study can inform the design of a larger randomized trial.
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Implementation barriers to integrating exercise as medicine in oncology: an ecological scoping review. J Cancer Surviv 2021; 16:865-881. [PMID: 34510366 PMCID: PMC9300485 DOI: 10.1007/s11764-021-01080-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 06/24/2021] [Indexed: 11/21/2022]
Abstract
Purpose While calls have been made for exercise to become standard practice in oncology, barriers to implementation in real-world settings are not well described. This systematic scoping review aimed to comprehensively describe barriers impeding integration of exercise into routine oncology care within healthcare systems. Methods A systematic literature search was conducted across six electronic databases (since 2010) to identify barriers to implementing exercise into real-world settings. An ecological framework was used to classify barriers according to their respective level within the healthcare system. Results A total of 1,376 results were retrieved; 50 articles describing implementation barriers in real-world exercise oncology settings were reviewed. Two hundred and forty-three barriers were identified across all levels of the healthcare system. Nearly 40% of barriers existed at the organizational level (n = 93). Lack of structures to support exercise integration and absence of staff/resources to facilitate its delivery were the most common issues reported. Despite the frequency of barriers at the organizational level, organizational stakeholders were largely absent from the research. Conclusions Implementing exercise into routine cancer care is hindered by a web of interrelated barriers across all levels of the healthcare system. Organizational barriers are central to most issues. Future work should take an interdisciplinary approach to explore best practices for overcoming implementation barriers, with organizations as a central focus. Implications for Cancer Survivors This blueprint of implementation barriers highlights critical issues that need to be overcome to ensure people with cancer have access to the therapeutic benefits of exercise during treatment and beyond. Supplementary Information The online version contains supplementary material available at 10.1007/s11764-021-01080-0.
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Sattar S, Haase KR, Bradley C, Papadopoulos E, Kuster S, Santa Mina D, Tippe M, Kaur A, Campbell D, Joshua AM, Rediger C, Souied O, Alibhai S. Barriers and facilitators related to undertaking physical activities among men with prostate cancer: a scoping review. Prostate Cancer Prostatic Dis 2021; 24:1007-1027. [PMID: 34108646 DOI: 10.1038/s41391-021-00399-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/30/2021] [Accepted: 05/19/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Prostate cancer (PC) and its treatments lead to significant acute, chronic, or latent adverse effects that result in declines in patients' physical functions, quality of life and reduced sense of masculinities. Robust evidence shows that physical activity (PA) can improve many health outcomes in men with PC; however, less is known about the facilitators, preferences, and barriers to PA engagement in this population. The purpose of this scoping review is to document the nature and extent of literature related to these aspects of PA participation among men with PC. METHODS We conducted a scoping review of PA among men with PC. Databases searched included Medline, CINAHL, Embase, Rehabilitation & Sports Medicine Source, and SportDiscus from inception to June 30, 2020. Multiple reviewers were used in all screening and data abstractions. RESULTS The search yielded 2788 individual citations after duplicates were removed. Following title and abstract screening, 129 underwent full-text review, and 46 articles were included. Quantitative data related to our research question showed that structured group exercise was the most commonly reported facilitator/preference among men with PC, whereas treatment-related effects and lack of time are the most common barriers. In terms of qualitative data, the most prominent theme noted related to masculinities and gender-specific needs within the context of having PC. CONCLUSION Men with PC have unique facilitators and barriers concerning PA. More work is needed from the research and clinical practice perspectives to enable this population to engage and remain in regular PA.
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Affiliation(s)
- S Sattar
- College of Nursing, University of Saskatchewan, Regina, SK, Canada.
| | - K R Haase
- Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - C Bradley
- Library, University of Regina, Regina, SK, Canada
| | - E Papadopoulos
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - S Kuster
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - D Santa Mina
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada.,University Health Network, Toronto, ON, Canada
| | - M Tippe
- Patient consultant, Toronto, ON, Canada
| | - A Kaur
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - D Campbell
- College of Nursing, University of Saskatchewan, Saskatoon, SK, Canada
| | - A M Joshua
- Department of Medical Oncology, Kinghorn Cancer Centre; Faculty of Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - C Rediger
- Saskatchewan Health Authority, Regina, SK, Canada
| | - O Souied
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - S Alibhai
- University Health Network, Toronto, ON, Canada.,Department of Medicine, Institute of Health Policy, Management, and Evaluation, Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
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11
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Czosnek L, Richards J, Zopf E, Cormie P, Rosenbaum S, Rankin NM. Exercise interventions for people diagnosed with cancer: a systematic review of implementation outcomes. BMC Cancer 2021; 21:643. [PMID: 34053445 PMCID: PMC8166065 DOI: 10.1186/s12885-021-08196-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 04/14/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Exercise is efficacious for people living after a cancer diagnosis. However, implementation of exercise interventions in real-world settings is challenging. Implementation outcomes are defined as 'the effects of deliberate and purposive actions to implement new treatments, practices, and services'. Measuring implementation outcomes is a practical way of evaluating implementation success. This systematic review explores the implementation outcomes of exercise interventions evaluated under real-world conditions for cancer care. METHODS Using PRISMA guidelines, an electronic database search of Medline, PsycInfo, CINAHL, Web of Science, SportsDiscus, Scopus and Cochrane Central Registry of Controlled Trials was conducted for studies published between January 2000 and February 2020. The Moving through Cancer registry was hand searched. The Implementation Outcomes Framework guided data extraction. Inclusion criteria were adult populations with a cancer diagnosis. Efficacy studies were excluded. RESULTS Thirty-seven articles that described 31 unique programs met the inclusion criteria. Implementation outcomes commonly evaluated were feasibility (unique programs n = 17, 54.8%) and adoption (unique programs n = 14, 45.2%). Interventions were typically delivered in the community (unique programs n = 17, 58.6%), in groups (unique programs n = 14, 48.3%) and supervised by a qualified health professional (unique programs n = 14, 48.3%). Implementation outcomes infrequently evaluated were penetration (unique programs n = 1, 3.2%) and sustainability (unique programs n = 1, 3.2%). CONCLUSIONS Exercise studies need to measure and evaluate implementation outcomes under real-world conditions. Robust measurement and reporting of implementation outcomes can help to identify what strategies are essential for successful implementation of exercise interventions. IMPLICATIONS FOR CANCER SURVIVORS Understanding how exercise interventions can be successful implemented is important so that people living after a cancer diagnosis can derive the benefits of exercise.
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Affiliation(s)
- Louise Czosnek
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, 3000, Australia.
| | - Justin Richards
- Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Eva Zopf
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, 3000, Australia
| | - Prue Cormie
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, 3000, Australia
- Peter MacCallum Cancer Centre, Melbourne, Victoria, 3000, Australia
- Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Simon Rosenbaum
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Nicole M Rankin
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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12
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Purdy GM, Sobierajski FM, Dolgoy ND, McNeely ML. Evaluating implementation and pragmatism of cancer-specific exercise programs: a scoping review. J Cancer Surviv 2021; 16:374-387. [PMID: 33791956 DOI: 10.1007/s11764-021-01032-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 03/16/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE Studies in exercise oncology are increasingly evaluating the implementation of cancer-specific exercise programming in real-world settings. Evaluating current implementation efforts and identifying current research gaps may inform future implementation. This scoping review explores studies implementing cancer-specific exercise programs to determine their pragmatic characteristics and evaluate potential for translation into practice. METHODS A systematic literature search was conducted using five databases (up to July 2020) to identify implementation studies that used qualitative or quantitative methods. Program pragmatism was evaluated using the PRECIS/RE-AIM tool. RESULTS Fourteen articles were included for review. While programs were moderately pragmatic (average: 3.4; range: 2.8-4.2), variability was observed between scoring domains. Programs scored higher (more pragmatic) in domains typical for effectiveness studies, including participant eligibility, follow-up intensity, primary trial outcome, and analysis of primary outcome. In contrast, programs scored lower (less pragmatic) in domains aligned with implementation science, including intervention flexibility, adoption, implementation, and maintenance. Limited information was reported regarding program fidelity, adaptations, and maintenance/sustainability. CONCLUSION Researchers should consider the pragmatism of interventions, the nuances of program adoption and implementation at the setting level, and the transition and integration of programming into the healthcare system. Future studies may benefit from the inclusion of decision-makers and implementation experts and shifting focus towards flexible programming. PRECIS/RE-AIM may facilitate the evaluation of programs throughout the study design and implementation process. IMPLICATIONS FOR CANCER SURVIVORS The implementation of pragmatic exercise programs that are both scalable and sustainable is needed so that cancer survivors can experience exercise-related benefits beyond research settings.
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Affiliation(s)
- Graeme M Purdy
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Frances M Sobierajski
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Naomi D Dolgoy
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Margaret L McNeely
- Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada. .,Rehabilitation Medicine, Cross Cancer Institute, Edmonton, AB, Canada.
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13
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Cagas JY, Biddle SJH, Vergeer I. Yoga not a (physical) culture for men? Understanding the barriers for yoga participation among men. Complement Ther Clin Pract 2020; 42:101262. [PMID: 33276223 DOI: 10.1016/j.ctcp.2020.101262] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/03/2020] [Accepted: 11/12/2020] [Indexed: 12/13/2022]
Abstract
Yoga offers an integrated approach to health and well-being that could potentially benefit men. This qualitative descriptive study examined men's perceptions of yoga, and identified barriers and possible facilitators for participation. Twenty-one non-yoga participant men, 18-60 years old, and living in Queensland, Australia, were interviewed. Two major barriers were identified using thematic analysis: (1) preference for other forms of physical activity, and (2) gender-related perceptions and pressures (i.e., perception of yoga as feminine, and presence of "bloke" culture and masculine ideals in society). Potential facilitators included: (1) acceptability of yoga among men, (2) providing brief information sessions, and (3) men-only classes. The non-competitive nature of yoga, in addition to being predominantly undertaken by women, makes it less appealing for men living in Australia. These barriers need to be considered if yoga is to be promoted as an option for men, particularly those not drawn to traditional sports or exercise.
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Affiliation(s)
- Jonathan Y Cagas
- Physically Active Lifestyles (PALs) Research Group, Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia; Department of Sports Science, College of Human Kinetics, University of the Philippines Diliman, Quezon City, Philippines.
| | - Stuart J H Biddle
- Physically Active Lifestyles (PALs) Research Group, Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
| | - Ineke Vergeer
- Physically Active Lifestyles (PALs) Research Group, Centre for Health Research, University of Southern Queensland, Springfield Central, Queensland, Australia
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14
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Suderman K, Dolgoy N, Yurick J, Sellar C, Nishimura K, Culos-Reed SN, Joy AA, McNeely ML. A Practical Approach to Using Integrated Knowledge Translation to Inform a Community-Based Exercise Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113911. [PMID: 32492824 PMCID: PMC7312668 DOI: 10.3390/ijerph17113911] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 05/19/2020] [Accepted: 05/28/2020] [Indexed: 12/17/2022]
Abstract
Background: Our aim was to understand cancer survivor needs prior to, and following the Alberta Cancer Exercise (ACE) pilot randomized trial as a means to inform implementation of a province-wide cancer-specific, community-based exercise program. Methods: Questionnaires and semi-structured stakeholder engagement sessions were conducted with cancer survivors to explore preferences, barriers and facilitators/benefits at two timepoints: (1) pre-ACE: prior to initiation of the ACE pilot trial (n = 13 survivors and n = 5 caregivers); and (2) post-ACE: following participation in the ACE pilot trial (n = 20 survivors). Descriptive statistics were used to summarize quantitative data from questionnaires. Stakeholder engagement data were analyzed using a framework analysis approach. Emergent themes were then mapped to actionable outcomes. Results: Pre-ACE, survivors indicated a preference for exercise programs that were (1) supervised by exercise specialists knowledgeable about cancer, (2) included support from other health care providers, (3) were held in community locations that were easily accessible. Post-ACE, participants identified (1) a lack of exercise counseling from health care providers, (2) the need for earlier introduction of exercise in the care pathway, and (3) supported referral to exercise programming. Conclusions: An integrated knowledge translation approach identified actionable outcomes to address survivor needs related to exercise in clinical cancer and community-based contexts.
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Affiliation(s)
- Kirsten Suderman
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
| | - Naomi Dolgoy
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
| | - Janice Yurick
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada; (J.Y.); (A.A.J.)
| | - Christopher Sellar
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
| | - Kathryn Nishimura
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada;
| | - Anil A. Joy
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada; (J.Y.); (A.A.J.)
| | - Margaret L. McNeely
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada; (K.S.); (N.D.); (C.S.); (K.N.)
- Cross Cancer Institute, Alberta Health Services, 11560 University Avenue, Edmonton, AB T6G 1Z2, Canada; (J.Y.); (A.A.J.)
- Correspondence: ; Tel.: +1-780-248-1531
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15
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Fox L, Wiseman T, Cahill D, Beyer K, Peat N, Rammant E, Van Hemelrijck M. Barriers and facilitators to physical activity in men with prostate cancer: A qualitative and quantitative systematic review. Psychooncology 2019; 28:2270-2285. [DOI: 10.1002/pon.5240] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 09/13/2019] [Accepted: 09/15/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Louis Fox
- Translational Oncology and Urology ResearchKing's College London London UK
| | - Theresa Wiseman
- Applied Health ResearchThe Royal Marsden NHS Foundation Trust London UK
- Health SciencesUniversity of Southampton Southampton UK
| | - Declan Cahill
- Urology SurgeryThe Royal Marsden NHS Foundation Trust London UK
| | - Katharina Beyer
- Translational Oncology and Urology ResearchKing's College London London UK
| | - Nicola Peat
- Cancer Exercise PhysiotherapyGuy's and St Thomas' NHS Foundation Trust London UK
| | - Elke Rammant
- Department of Radiation Oncology and Experimental Cancer ResearchUniversity Hospital Ghent Ghent Belgium
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