Strategies to improve participation in exercise programmes during chemotherapy: a modified nominal group technique.

Abstract

Purpose: Exercise can help people manage many of the side effects of chemotherapy treatment. Clear guidelines exist outlining the benefits of exercise during chemotherapy and recommended dosage; however, achieving these guidelines remains problematic. The purpose of this study is to reach an agreement on suitable strategies to improve recruitment, adherence, and retention rates to exercise programmes during chemotherapy with the involvement of key stakeholders.

Methods: This study used a modified nominal group technique (NGT). Participants included individuals with a lived experience of chemotherapy and healthcare professionals working in oncology. Three workshops were carried out, two in-person and one online. The in-person workshops addressed the first four stages of the NGT, introduction, idea generation, round-robin recording, and group discussion. Voting and ranking of ideas occurred during the online workshop.

Results: Nineteen individuals took part in this study, including 12 people with a lived experience of chemotherapy and seven healthcare professionals. The highest-ranked strategy to improve recruitment was to inform individuals about the benefits of exercise at the time of receiving their treatment plan, with 53% of first preference votes. Participants also agreed that direct instruction from their oncologist would have the greatest impact on successful recruitment to an exercise programme, receiving 47% of first preference votes. To enhance exercise adherence, an in-person exercise programme delivered in an exercise facility received 46% of first preference votes. Finally, 43% of participants agreed that the provision of a pedometer would support retention, and 86% of people wanted to receive weekly phone calls/check-ins.

Conclusion: This study provides strategies to overcome barriers to recruitment, adherence, and retention to exercise programmes during chemotherapy, and will help to optimise participant engagement for future interventions.

Implications for cancer survivors: The involvement of key stakeholders in this study will contribute towards ensuring that future interventions are pragmatic and patient-centred.