# Translating advocacy into action: exploring oncology healthcare professionals’ awareness and use of the Clinical Oncology Society of Australia position statement on exercise in cancer care

## TL;DR

This study explores how Australian oncology healthcare professionals use exercise guidelines for cancer patients and finds that despite agreement on their benefits, few apply them in practice.

## Contribution

The study identifies barriers to implementing exercise recommendations in cancer care and highlights the gap between professional agreement and actual practice.

## Key findings

- Only 35% of healthcare professionals routinely apply COSA exercise recommendations in practice.
- Financial barriers and lack of organizational resources are major obstacles to implementing exercise guidance.
- Just 24% of participants reported their organization revised practices based on COSA recommendations.

## Abstract

The Clinical Oncology Society of Australia (COSA) position statement on exercise in cancer care encourages all healthcare professionals to discuss, recommend, and refer people with cancer to exercise; however, use of these recommendations in practice is unknown.

Oncology healthcare professionals working in Australia were invited to complete a cross-sectional online survey that assessed contextual factors that influence implementation of COSA exercise guidance in cancer care, based on the Consolidated Framework for Implementation Research.

We received 133 survey responses. Most were women (74%), nurses (35%), or oncologists (26%), involved in cancer care for > 10 years (63%), and in a public hospital setting (69%). Most participants agreed that exercise is beneficial (94%) and the COSA recommendations would positively influence patients’ exercise behaviours (94%). However, only 35% routinely apply COSA recommendations in practice, and only 35% believe they are the best person to provide exercise support. Patient-level barriers included needing additional support to access exercise (92%), most commonly financial (74%). Organisational-level barriers included a lack of dedicated resources to support delivering exercise guidance (69%), and not believing providing exercise guidance is an important part of their role (51%). Only 24% agreed their organisation revised practice based on the COSA recommendations.

Despite most oncology healthcare professionals agreeing that exercise is beneficial, and that the COSA recommendations are important for patients, only a minority actually apply the recommendations in their practice. Targeted implementation efforts are needed to facilitate use of COSA exercise guidance in clinical practice.

The online version contains supplementary material available at 10.1007/s00520-025-09633-0.