"It has to be more than exercise": Exploring optimal physical activity program delivery for breast cancer survivors across multiple stakeholder groups
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Physical activity is an effective strategy for mitigating the negative physical and psychosocial effects of breast cancer treatment. Accordingly, physical activity programs have been developed to enhance clinical cancer care; however, many communities in Ontario remain without such programs. Further, it is unclear what factors constitute an optimal physical activity program for breast cancer survivors. An integrated knowledge translation approach, defined as the involvement of knowledge users in the co-creation of knowledge, can assist in identifying optimal aspects of physical activity program delivery for breast cancer survivors. Consequently, the purpose of this study was to explore optimal physical activity program delivery for breast cancer survivors across multiple stakeholder groups in the cancer care community, and to develop specific recommendations that can be used to inform the development of physical activity programs for breast cancer survivors. Breast cancer survivors, health care professionals (e.g., oncologists, nurses, and allied health care professionals) and community-based physical activity program providers participated in four 60-minute heterogeneous focus group discussions. Broad discussions about an optimal program environment, program delivery team, and core program practices were encouraged. Focus groups were audio recorded, transcribed verbatim, and subjected to inductive thematic analysis. Participants recommended that physical activity programs for breast cancer survivors should improve cancer literacy, provide opportunities to participate with peers, and foster feelings of self-efficacy. Further, when possible, programs should be delivered in the community, accessible from an environmental and financial perspective, and integrated within the regional network of cancer care. These findings can be extended to provide a foundation for researchers and providers aiming to establish, deliver, and evaluate optimal physical activity interventions and programming for breast cancer survivors.