“It Will Only Work If Everyone is on Board”: A Needs and Context Assessment to Inform Exercise Oncology Implementation Within a Public Healthcare Organisation

Abstract

Introduction

Exercise has well-established benefits across the cancer continuum for people living with and beyond cancer, yet the exercise oncology field faces a research-to-practice gap. Understanding the factors that influence implementation in any given context is essential to ensure implementation strategies have the greatest likelihood of success. The study mapped onsite exercise oncology services, staff-reported implementation barriers and facilitators, organisational readiness, and experiences reported by people living with or beyond cancer, across a large public healthcare organisation.

Methods

Staff and people living with and beyond cancer across cancer care centres within the public healthcare organisation completed an online survey. Data were analysed using descriptive statistics and manifest content analysis.

Results

Across 10 regions, 115 participants completed the survey (59 staff and 56 people living with and beyond cancer). Although both groups valued and viewed exercise as important, organisation-wide and region-specific constraints were evident, particularly the absence of onsite exercise professionals and absent or unclear referral pathways. Among people living with and beyond cancer, 54% received an exercise discussion and 13% received a referral.

Conclusion

Across the organisation, strong support for exercise did not translate into action, as mainly outer and inner setting barriers restricted routine discussions, referrals and service delivery. Although regions within the same organisation shared several contextual factors, region-specific conditions that hindered or facilitated implementation were present. Findings reinforce that the development of implementation strategies and plans depends on a clear understanding of the context in which they will occur. These findings are informing an implementation plan in a pilot region.