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Planning and evaluating an integrated clinical exercise oncology service: an exploratory mixed-methods study.

Ciaran M Fairman1, Shana E Harrington2, Alec R Schumpp2

  • 1Department of Exercise Science, University of South Carolina, Columbia, SC, USA. cfairman@mailbox.sc.edu.

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Integrating exercise oncology into standard care improved physical function and reduced fatigue in cancer patients. Successful implementation requires understanding the healthcare context and engaging stakeholders for sustainability.

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Area of Science:

  • Exercise Oncology
  • Healthcare System Integration
  • Implementation Science

Background:

  • Designing and evaluating exercise oncology services for integration into clinical care.
  • Aims to inform an implementation strategy for sustainable use in standard oncology care.
  • ClinicalTrials.gov Identifier: NCT06039488.

Purpose of the Study:

  • To design and evaluate the integration of an exercise oncology service into a local healthcare system.
  • To inform the development of a sustainable implementation strategy for standard care.

Main Methods:

  • Two-phase, mixed-methods exploratory study.
  • Qualitative methods to understand clinician and administrator perspectives on exercise integration.
  • Evaluation using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, including patient-reported outcomes (BNAT, FACT-F).

Main Results:

  • Context analysis identified key elements: focus on post-primary treatment and streamlined referrals.
  • Phase 2 evaluation: suboptimal reach (2%), significant effectiveness (improved physical function, reduced fatigue; p<0.05).
  • High receptiveness to adoption (75%) and strong potential for maintenance were observed.

Conclusions:

  • Traditional exercise oncology research trials are difficult to integrate into healthcare systems.
  • Successful integration and sustainment necessitate understanding the delivery context and continuous stakeholder engagement.
  • Initial setting exploration is critical for a comprehensive implementation strategy.