Aim. To explore enablers to exercise conversations among cancer health professionals.
Methods. Multidisciplinary healthcare professionals delivering clinical care to people with cancer were invited to take part in online questionnaire, semi-structured interviews and clinical communication workshops. Health professionals who directly provide exercise services were excluded. Questionnaire and interviews explored health professional information and resource needs to facilitate exercise recommendations. Communication workshops explored training needs to overcome challenges in discussing exercise. Quantitative data were analysed using standard descriptive statistics. Qualitative data were analysed using interpretive description analysis framework.
Results. Participants were aged 48±11years, 84% female and 68% nurses. 383 participants responded to an online questionnaire, 31 to semi-structured interviews and 18 took part in clinical communication workshops. Top ranked resources that facilitated health professional exercise discussions included having referral options for exercise services (91%), and having a quick, simple referral process (91%). Information on tailoring exercise discussions according to performance status (86%), different symptoms (78%), exercise delivery options (77%) and people who have never exercised (74%) were identified as opportunities to enable exercise discussions. Seventy-four percent of health professionals said they would routinely use exercise evidence summaries with patients, while 74% said that information on the cost of exercise services would help routine discussion. Common communication challenges focused on how to introduce exercise into consultations, provide personalised recommendations, explore difficulties of exercising and, develop a shared decision on plan of action, within time constrained consultations.
Conclusions. Oncology health professionals recognise mitigable barriers to routinely using exercise as part of usual care. Pragmatic solutions include: low-burden referral options to cancer-specific exercise services, evidence-based information summaries, information to help tailor the exercise discussion, and information on the cost of exercise. These data are informing the development of co-designed strategies and tools to support clinician-patient conversations about exercise as a component of routine clinical-practice.