A Practical Approach to Using Integrated Knowledge Translation to Inform a Community-Based Exercise Study

Abstract

Background: Our aim was to understand cancer survivor needs prior to, and following the Alberta Cancer Exercise (ACE) pilot randomized trial as a means to inform implementation of a province-wide cancer-specific, community-based exercise program. Methods: Questionnaires and semi-structured stakeholder engagement sessions were conducted with cancer survivors to explore preferences, barriers and facilitators/benefits at two timepoints: (1) pre-ACE: prior to initiation of the ACE pilot trial (n = 13 survivors and n = 5 caregivers); and (2) post-ACE: following participation in the ACE pilot trial (n = 20 survivors). Descriptive statistics were used to summarize quantitative data from questionnaires. Stakeholder engagement data were analyzed using a framework analysis approach. Emergent themes were then mapped to actionable outcomes. Results: Pre-ACE, survivors indicated a preference for exercise programs that were (1) supervised by exercise specialists knowledgeable about cancer, (2) included support from other health care providers, (3) were held in community locations that were easily accessible. Post-ACE, participants identified (1) a lack of exercise counseling from health care providers, (2) the need for earlier introduction of exercise in the care pathway, and (3) supported referral to exercise programming. Conclusions: An integrated knowledge translation approach identified actionable outcomes to address survivor needs related to exercise in clinical cancer and community-based contexts.

Trainee-led research using an integrated knowledge translation or other research partnership approaches: a scoping review

“…The included studies were mapped onto the KTA cycle [ 29 ] based on the reported research purpose and objectives, as follows: identify problem ( n = 30) [ 37 – 67 ]; adapt knowledge to local context ( n = 34) [ 37 – 40 , 43 , 44 , 46 , 49 , 52 , 55 , 56 , 61 , 62 , 64 , 65 , 67 – 86 ]; assess barriers/facilitators to knowledge use ( n = 14) [ 39 , 40 , 52 , 56 , 63 , 68 , 72 , 74 , 81 , 83 , 87 – 90 ]; select, tailor, implement interventions ( n = 11) [ 56 , 63 , 68 , 80 , 81 , 83 , 88 – 92 ]; monitor knowledge use ( n = 25) [ 55 , 63 – 65 , 69 , 73 , 80 , 83 , 89 , 91 – 107 ]; evaluate outcomes ( n = 22) [ 48 , 50 , 51 , 62 , 64 , 68 , 71 , 79 , 83 , 91 , 93 , 95 , 100 – 110 ]; sustain knowledge use ( n = 1) [ 79 ...…”

Feasibility of Implementing Cancer-Specific Community-Based Exercise Programming: A Multi-Centre Randomized Trial

“…Despite the growing evidence for the benefit of exercise, overall physical activity levels of individuals with cancer both during and following cancer treatment remain low [ 49 ]. Therefore, improving uptake among those less inclined to exercise will require the integration of strategies such as oncologist recommendation [ 18 ], healthcare provider counseling on exercise options [ 18 , 26 , 50 ], and a tailored multicomponent approach to address exercise-related barriers [ 51 , 52 ]. Additionally, extending participant inclusion into a longer recovery time period after cancer treatment would open opportunities for participants dealing with ongoing cancer-related impairments.…”

“…Moreover, community-based programs offer the opportunity to bring individuals with cancer together to create their own supportive environment and can help build social networks that encourage positive behavior change [ 60 ]. Fifty percent of exercise participants in this trial opted to continue on a fee-for-service basis, with identified facilitators including the support and mentorship of cancer peers, as well as having trained and qualified exercise professionals leading and supporting the classes [ 26 ].…”

“…Our interdisciplinary team conducted a feasibility implementation trial in preparation for our large-scale Alberta Cancer Exercise (ACE) hybrid effectiveness-implementation study [ 25 ]. Qualitative findings related to participant engagement and our integrated knowledge translation approach have been previously published [ 26 ]. Here, we share the ACE feasibility trial results and our experience with initial community-based program implementation.…”

Active Living After Cancer: Adaptation and evaluation of a community‐based physical activity program for minority and medically underserved breast cancer survivors

“…Many barriers exist to successful implementation, such as the training/qualifications of interventionists, participant recruitment, and failing to reach those most in need of programming. This project used multiple implementation strategies 19 to address these barriers, including developing structured training for community health educators; adapting the evidence‐based intervention 17 ; locating the program at sites convenient to participants 29 ; and leveraging a community‐academic partnership and building a network of relationships with community organizations to obtain funding and facilitate implementation. Successful implementation of physical activity programs for cancer survivors must consider not only the intervention evidence base but also the strategies used to implement and sustain the intervention.…”