# Breast cancer survivors’ perspectives on a clinical decision tool to support individualized exercise prescriptions and discussions

## TL;DR

This study explores how breast cancer survivors view a tool to help healthcare providers prescribe personalized exercise plans.

## Contribution

The study introduces a prototype clinical decision tool for individualized exercise prescriptions and evaluates survivors' perspectives.

## Key findings

- Most survivors found the tool useful for education and encouraging exercise.
- Younger survivors were less confident in discussing exercise with providers compared to older survivors.
- Improving daily tasks, quality of life, and energy were top benefits highlighted by survivors.

## Abstract

To examine breast cancer survivors’ perspectives on the prototype (paper-draft) of a clinical decision tool to support individualized exercise prescriptions and discussions within clinical settings.

A sample of ≥90 female breast cancer survivors aged ≥35 years across the U.S. were recruited to complete an online survey that collected data on survivors’ characteristics and perspectives of a prototype of the tool. Survey items were adapted from validated pre-existing instruments and refined via cognitive interviews.

Ninety-eight of the 142 individuals screened were deemed eligible and completed the survey. Most breast cancer survivors agreed that a tool would be useful (84.7%) and increase confidence to discuss exercise with a healthcare provider (74.5%). Among tool uses, the highest agreement was found for education (84.1%) and encouragement to exercise (79.3%). Improving the ability to do everyday tasks (74.0%), quality-of-life (72.6%), and energy (71.4%) were rated as the top exercise benefits to include in a tool. Agreement on tool usefulness, uses, and inputs varied by survivors’ demographic, clinical, and contextual characteristics. For example, agreement that a tool would increase their confidence to discuss exercise was lower among younger survivors (<50 years, 67.7%) than older survivors (≥50 years, 78.5%).

An evidence-based clinical decision tool offering individualized exercise information could support exercise prescriptions and discussions within clinical settings. However, a one-size-fits-all tool may not address existing disparities in exercise participation. Further research among underserved women is needed.

The online version contains supplementary material available at 10.1007/s00520-026-10358-x.