Lessons learned on strategies for promoting exercise program adherence among cancer survivors: A case study

Research Objectives: Explore cancer survivor and staff experiences in a clinical cancer exercise recovery program (CERP) with the goal of identifying aspects of program delivery that may be linked to adherence in post-treatment exercise programs.

Design: A qualitative case study consisting of one-time semi-structured interviews with program participants and staff.

Setting: Hospital-based exercise and rehabilitation center for cancer survivors in Los Angeles, CA, USA.

Participants: Participants were recruited by maximum variation sampling and consisted of cancer survivors (n=18; female n=13; male n=5) and CERP trainers (n=2). Cancer survivors ranged from 34 to 87 years old and had received treatment for diverse types of cancer (e.g., breast, multiple myeloma). Trainers were recruited among current staff members. Identifying demographic information (e.g., gender, age) was not collected for trainers to maintain anonymity.

Interventions: Not applicable.

Main Outcome Measures: Participants engaged in a semi-structured interview of around 45 minutes duration. Data were analyzed using a two-step content analysis. First, data were analyzed using an inductive approach. The data was then examined deductively using the Quality Parasport Participation Framework as a guide. While initially developed for sport among people with disabilities, this Framework has since demonstrated applicability for cancer survivors in exercise settings.

Results: Findings highlight programmatic conditions and delivery strategies that cancer survivors and staff linked to program adherence. Particularly relevant programmatic conditions include the program environment (i.e., safety, comfort), trainer knowledge (i.e., understanding of the cancer experience), and activity characteristics (i.e., no cost for participation). Key strategies included social support, autonomy supportive goal setting, communication guidelines, and individualized tailored programming. These conditions and strategies enhanced the quality of participant experiences and was linked to increased motivation to continue exercising during and after program involvement.

Conclusions: As evidence continues to grow for the benefits of exercise in survivorship, understanding how to optimize exercise programs and experiences can assist in creating interventions that promote adherence to cancer exercise guidelines.

Author(s) Disclosures: The authors declare no relevant conflicts of interest that relate to the research described in this paper.