Recent guidelines concerning exercise for people with cancer provide evidence-based direction for exercise assessment and prescription for clinicians and their patients. Although the guidelines promote exercise integration into clinical care for people with cancer, they do not support strategies for bridging the guidelines with related resources or programs. Exercise program accessibility remains a challenge in implementing the guidelines, but that challenge might be mitigated with conceptual frameworks (“pathways”) that connect patients with exercise-related resources. In the present paper, we describe a pathway model and related resources that were developed by an expert panel of practitioners and researchers in the field of exercise and rehabilitation in oncology and that support the transition from health care practitioner to exercise programs or services for people with cancer. The model acknowledges the nuanced distinctions between research and exercise programming, as well as physical activity promotion, that, depending on the available programming in the local community or region, might influence practitioner use. Furthermore, the pathway identifies and provides examples of processes for referral, screening, medical clearance, and programming for people after a cancer diagnosis. The pathway supports the implementation of exercise guidelines and should serve as a model of enhanced care delivery to increase the health and well-being of people with cancer.

Multiple health behavior change (MHBC) interventions have great potential for enhancing health and well-being following cancer diagnosis and treatment. However, the characteristics and effects of MHBC interventions remain elusive for cancer survivors. The main purpose of this study was to evaluate the effectiveness of MHBC interventions on healthy eating and physical activity behaviors among cancer survivors. A secondary aim was to examine the effect of using a simultaneous and sequential design approach to MHBC (ie, changing both behaviors at the same time or one after the other). Randomized controlled trials reporting the impact of a MHBC intervention on both healthy eating and physical activity behaviors among cancer survivors were retrieved from MEDLINE, Cochrane Library, and PsycINFO. A total of 27 MHBC interventions were identified; most (92.6%) were designed to promote simultaneous change in both behaviors and assessed end-of-treatment effect among breast cancer survivors. MHBC interventions led by nurses or multidisciplinary teams showed the most compelling evidence for small to moderate improvement in both behaviors, with interventions that lasted ≥17 weeks more likely to improve both behaviors. This study identifies research priorities and provides preliminary evidence for clinical decision making and advancements in MHBC intervention design and delivery for clinical oncology.

Background: Dragon boat offers an opportunity to increase physical activity (quantity participation) in breast cancer survivors; however, quality participation experiences have yet to be explored. Quality participation is one’s subjective perceptions and experiences. While there is evidence to suggest dragon boat may offer a quality experience, further exploration is needed. Purpose: Guided by a conceptual framework to promote a positive, quality experience in parasport context, the purposes were: (a) to explore strategies that are used to foster elements of quality participation in dragon boat teams for breast cancer survivors and (b) to understand the context in which these strategies are implemented within these teams (i.e., quality participation conditions). Materials and methods: After completing a guiding questionnaire, current and previous leaders on dragon boat teams completed a structured, follow-up telephone interview. Transcripts were thematically analyzed inductively and deductively mapped onto a framework. Results: Leaders fostered quality participation through elements of challenge and mastery and conditions of the social and physical environments. Facilitating strategies included creating friendly competition, using social media to celebrate success, creating mentorship opportunities and being outside, respectively. Conclusions: Future research is encouraged to explore identified strategies for consistency to gain a clearer understanding of quality experiences within dragon boat.