Ben Chue

Purpose We successfully implemented the American College of Sports Medicine’s (ACSM’s) Exercise is Medicine® (EIM) initiative in a community oncology clinic. This study evaluated the impact of the evidence-based exercise intervention, adhering to ACSM guidelines on patient outcomes. Methods Using a quasi-experimental research design, An experienced ACSM-certified cancer exercise trainer delivered a 12-week biweekly, online group exercise intervention to 19 patients undergoing chemotherapy. Fifteen (78.8%) completed pre/post-self-report surveys on the program’s acceptability and impact, change in physical activity vital signs (PAVS), and health-related quality of life (HRQOL). We also assessed exercise uptake and PAVS at each clinic visit. Data were analyzed using t-tests and content analysis. Results On average, participants were 60 years, female (94%), non-Latino/White (60%), had stage IV cancer (92.3%), And had been receiving chemotherapy for An average of 10 months. The intervention was acceptable (86.4% enrollment) and had excellent retention (89.5%), with moderate adherence (68%). No adverse events were reported. Reasons for lack of adherence were medical reasons and treatment side effects. Compared to baseline, participants reported non-statistically significant increased aerobic exercise and improvements in HRQOL post-intervention. Participants rated the intervention as satisfactory, acceptable, and suitable (all > 4 out of 5 on a Likert scale). In open-text comments, six (40%) of the participants appreciated being asked about PAVS at the clinic, while three (20%) did not. Conclusions Patients undergoing chemotherapy, the majority of whom had stage IV cancer, could safely participate in an online group exercise program. Larger studies among different patient populations are needed.

Purpose Despite proven benefits, few cancer patients exercise during chemotherapy. The American College of Sports Medicine’s Exercise is Medicine® (EIM) initiative describes a model to integrate exercise into oncology care, based upon assessing patients’ ability to exercise safely, advising on exercise benefits, and referring patients to exercise. We developed and tested a strategy to implement EIM in a community-based oncology clinic, to assess-advise-refer 20 patients undergoing chemotherapy to a 3-month online exercise class, and measured implementation outcomes. Methods Using a community-based provider participation in research (CBPPR) model, researchers and staff co-designed and tested a 4-level implementation strategy, with a goal of assessing-advising-referring 20 cancer patients to exercise. Surveys and interviews were conducted with 12 (100%) staff at baseline and post-implementation on acceptability/appropriateness/feasibility, perceptions of individual implementation roles, and organizational strengths/conditions. Data were analyzed using correlations, t-tests, and content analysis. Results The proposed strategy was revised in collaboration with staff who requested assistance for recruitment and data collection. EIM was successfully implemented with 41 (92%) patients assessed, 37 (90%) advised, and 22 (60%) referred to exercise classes. Barriers to implementation were staff shortages and time constraints; facilitators included research team supports. Staff’s perceived organizational strengths were positively correlated with exercise promotion acceptability, appropriateness, and feasibility. There were no statistically significant changes in implementation outcomes (acceptability/appropriateness/feasibility) post-implementation. Conclusions Using a collaborative model, EIM was successfully implemented in a community oncology clinic; however, the clinic required significant support from the research team. Adaptations to the EIM process may be required to improve implementation outcomes.