# Perceived Barriers, Facilitators, and Needs Related to Promoting Physical Activity in Cancer Care: Qualitative Insights from Oncology Care Providers

## TL;DR

Oncology care providers recognize the benefits of physical activity for cancer patients but face barriers like lack of training and resources, suggesting the need for better education and support to promote physical activity in cancer care.

## Contribution

The study provides novel qualitative insights into the barriers and facilitators oncology providers face when promoting physical activity, offering actionable recommendations for education and policy changes.

## Key findings

- Oncology providers value physical activity but struggle with limited training and unclear guidelines.
- Barriers include time constraints, lack of referral systems, and uncertainty about responsibility for promoting physical activity.
- Providers expressed a desire for training and practical guidelines to integrate physical activity into cancer care.

## Abstract

Regular physical activity can help people with cancer recover and feel better, but oncology care providers (e.g., oncologists, nurses, and allied health professionals) often struggle to include physical activity advice in routine care. We interviewed 16 cancer doctors, nurses, and support staff to learn how they view physical activity counseling, the obstacles they face, and what would help them support cancer survivors in staying active. While providers value physical activity, they reported barriers such as limited training, unclear guidelines, time constraints, and patient health concerns. To address these gaps, we recommend improving provider education, offering practical exercise guidelines, fostering interdisciplinary collaboration, and implementing supportive policies and reimbursement models. Future research should explore scalable strategies to promote physical activity in oncology care. These efforts can enhance survivorship care and improve long-term health outcomes.

Background: Physical activity (PA) is associated with lower mortality and cancer recurrence risks. Although evidence shows health benefits for cancer patients before, during, and immediately after treatment, PA recommendations are not regularly included in the standard care. Objective: The study aimed to identify perceived knowledge, barriers, and facilitators of oncology providers’ PA promotion for cancer patients using the 5A (Assess, Advise, Agree, Assist, and Arrange) framework. Methods: A qualitative research design with a phenomenological approach was adopted. A purposive sample of 16 oncology care providers in Nebraska participated in semi-structured interviews via Zoom/phone. Interviews were audio-recorded, transcribed, and imported into MAXQDA 2024 for thematic analysis. Results: Analysis of the qualitative data identified five themes: (i) Broad and inclusive conceptualizations of PA among oncology care providers suggested that they were able to define PA; (ii) Current Practices in PA Counseling included advising on PA and assessment; (iii) Barriers to PA counseling included lack of guideline awareness, insufficient training, low prioritization, uncertainty about responsibility, time constraints, limited resources, lack of referral systems, patient health conditions, and environmental factors; (iv) Facilitators were identified as acknowledged health benefits for cancer survivors, awareness of PA recommendations, access to community resources, and support from interdisciplinary teams; and (v) Expressed desire among oncology care providers for training on incorporating PA into oncology care. Conclusions: Oncology providers recognized PA’s health benefits for cancer survivors but did not promote it due to inadequate knowledge of guidelines and lack of resources. These barriers require improved PA counselling education to help providers incorporate PA into clinical care.