Development of an Exercise Question Prompt List for Breast Cancer Survivors

High-quality communication about exercise during clinical visits may increase participation among breast cancer survivors. However, survivors' exercise participation and communication preferences remain poorly understood. The aims of this study were to synthesize existing evidence on breast cancer survivors' exercise participation and communication preferences and to refine a question prompt list (QPL) with expert input.

A systematic scoping review was conducted in accordance with PRISMA-ScR guidelines. Five databases were searched for articles reporting survivors' exercise participation and communication preferences worldwide between January 2005 and July 2025. Survivor characteristics and exercise preferences were extracted and used to draft a QPL. Weighted average percentages for preferences were calculated. Experts provided feedback through interviews, and the QPL was iteratively revised accordingly.

Twenty-nine studies were identified. Overall, preferences were found for exercise frequency (77.6%: ≥2 sessions/wk), intensity (63.1%: moderate intensity), and duration (62.9%: 30-60 min/session). Preferred locations included home (29.3%), community recreation facilities (32.9%), and outdoors (31.4%). Supervised exercise (53.4%) and exercising with others (57.7%) were preferred over unsupervised (35.2%) and solo (34.4%) exercise, respectively. Survivors preferred exercise counseling/advice from an exercise specialist (59.3%) and face-to-face delivery (63.7%). Experts (n = 10) viewed the QPL favorably and recommended modifications to improve comprehension, as well as additional questions on willingness to pay and travel for exercise, and interest in diet/nutrition information.

Survivor preferences and expert input are reflected in the novel QPL. With further testing, the QPL may support the delivery of guideline-aligned exercise information. Future research should evaluate the QPL's impact on survivors' exercise participation and psychological antecedents of exercise (eg, self-efficacy).