To address the lack of access to supportive cancer care resources, the purpose of this study was to examine the feasibility of a tailored exercise program for neuro-oncology patients. Patients with a primary brain tumour diagnosis, >18 years, and able to consent in English were recruited at two tertiary cancer centres in Alberta. Recruitment occurred via electronic medical record as well as self-referral. A 12-week, tailored exercise intervention with health coaching was delivered in both one-on-one and group-based formats, either in-person or online. Measures of feasibility included tracking referral, enrollment, intervention completion and adherence, measurement completion, fidelity, participant satisfaction, and safety. Participant-reported outcomes and functional fitness were assessed at baseline and 12-weeks. Objective physical activity was tracked via a Garmin activity tracker. Recruitment occurred between April 2021-December 2022. N=70 patients enrolled into the study and n=51 completed the intervention. Referral rate was 31%, enrollment rate was 66%, and intervention completion and adherence rates were 82.3% and 89.7%. At baseline and 12-weeks, measurement completion rates were 100% and 77.4% for patient-reported outcomes, and 98.4% and 75.8% for functional fitness. Average wear-time for the activity tracker was 72.8%. Fidelity of intervention delivery was 100% for exercise sessions and 87.8% for health coaching. Overall participant satisfaction was 86.5%. No major and four minor adverse events occurred. Delivery of a tailored neuro-oncology exercise program with referral included via electronic medical record is feasible. Future work is needed to optimize tailored programming as well as to address factors critical for implementation into standard cancer care.

Background: Physical activity (PA) can improve the physical and psychosocial health of individuals with cancer, yet PA levels remain low. Technology may address PA maintenance barriers in oncology, though the intervention effectiveness to date remains mixed. Qualitative research can reveal the nuances of using technology-based PA maintenance tools. The present study aimed to understand the perspectives of individuals with cancer on using an app to support PA maintenance. Methods: Individuals were interviewed after using a self-monitoring app for 24 weeks, asking about their app use, ease of use, and perceived value for supporting PA. Analyses were guided by an interpretive description. Results: Eighteen individuals were interviewed. The participants were 37–75 years old; lived in seven Canadian provinces/territories; identified as White, South Asian, or Indigenous; and had eight different cancers. Four themes were developed: some did not need the app to stay physically active, some valued the app for helping them maintain their PA, the user experience ranged from intuitive to confusing, and the time burden of app use ranged from acceptable to overwhelming. Conclusions: The participants provided insights on using a self-monitoring app to improve PA maintenance in oncology. Work is needed to capture additional perspectives and apply findings to the development of technology-based PA maintenance tools.

The purpose of this study was to gather patient and caregiver perspectives of adult neuro-oncology patients participating in a 12-week exercise program (i.e., the Alberta Cancer Exercise-Neuro-Oncology; ACE-Neuro study). Patients and their caregivers were invited to participate in semi-structured interviews across study delivery. A qualitative photo elicitation methodology within a patient-oriented research approach was used. Interpretive description and a constructivist philosophy guided the investigation, analysis, and dissemination of findings. A patient partner was included as a member of the research team. N = 51 patients completed the ACE-Neuro study, of which 28 patients and nine caregivers participated in interviews (n = 37). Working with the patient partner, five themes were created and are presented as a story of neuro-oncology patients on their journey to accessing and participating in ACE-Neuro: (1) The Exposition: I Have Cancer…Now What?; (2) The Rising Action: Trials and Triumphs of Participation; (3) The Pivotal Moment: It’s More Than Exercise; (4) The Resolution: Tailored Not Templated…The Ideal Program for Me; and (5) The Epilogue: Key Factors for Sustained Delivery. The findings from this work address the lack of qualitative exploration for understanding the neuro-oncology exercise experience and will inform the sustainable implementation of programming to meet patients’ needs.

Exercise is an evidence-based strategy shown to reduce the negative side effects associated with cancer treatment for individuals living with and beyond cancer (LWBC). Healthcare providers (HCPs) play a critical role in promoting exercise for these individuals. Notwithstanding, several barriers hinder HCPs’ ability to discuss and support exercise in clinical practice. EXCEL is an exercise intervention designed to address health disparities in access to exercise oncology resources for rural/remote individuals LWBC, including a referral pathway for HCPs to use. The purpose of this study was to evaluate HCP experiences using the EXCEL exercise referral pathway. We employed an interpretive description methodology, using semi-structured interviews to assess HCP experiences with EXCEL. Overall, HCPs felt empowered to refer to exercise when they were supported in doing so. The findings highlighted (1) a need for a better understanding of the role of exercise professionals and their integration into cancer care; (2) the need for efficient referral systems including embedding referrals into existing health care electronic record systems; and (3) sharing patient feedback with exercise oncology programs back to the HCPs to drive continued referrals.