Exercise Interventions for Survivors of Cancer Living in Rural or Remote Settings: A Scoping Review

Abstract

Background: Survivors of cancer who are considered “hard to reach” have less engagement in survivorship programming and lower overall health status, well-being, quality of life, and survival. These include individuals who live in rural areas. There is a need to determine the availability, characteristics, feasibility, and effectiveness of exercise programs for individuals with cancer living in rural settings. Purpose: To conduct a scoping review describing the current literature on available exercise programming for survivors of cancer who live in rural or remote settings. Methods: Data Sources: Six databases were searched for studies. Study Selection: 105 abstracts were identified through literature searches; 84 studies remained for title and abstract screening after duplicates were removed. Thirty-three articles were included in full-text review. Data Extraction: Data related to participant characteristics, intervention characteristics, study design, and outcomes were extracted from full texts. Data Synthesis: Descriptive quantitative summaries are provided for result variables, and a narrative analysis was performed. Discussion and Limitations: Thirteen articles were selected for data extraction. The majority of interventions were phone-based walking programs for survivors of breast cancer. The interventions described were held in only 2 countries. The most common outcomes assessed were physical activity level, quality of life, and anxiety/depression. Conclusion: This scoping review highlighted the lack of accessible exercise programs for this subset of hard-to-reach survivors of cancer. This review found that there are few exercise programs accessible for survivors living in rural and remote areas, suggesting one reason for low engagement in physical activity and highlighting the need to devise novel means to implement exercise interventions for this population.

Psychological correlates of physical activity and exercise preferences in metropolitan and nonmetropolitan cancer survivors

“…Future research might consider the consistency of preferences and correlates among Australian metropolitan and nonmetropolitan survivors when designing and testing PA interventions. As nonmetropolitan survivors are disadvantaged and have greater comorbidities and support needs than their urban counterparts, 23 tailoring interventions to suit rural survivors may involve similar intervention materials, exercise type, structure, and setting, but with more contact or supportive components 22 …”

“…Cancer survivors living in regional and remote areas have worse health outcomes and greater survivorship‐related burden than their metropolitan counterparts 23,24 . Given that psychosocial factors and needs appear to differ by region, 22,25 ascertaining whether exercise preferences and resulting attitudes and confidence differ by geographical classification may inform the design and potential tailoring of future interventions 22 …”

“…19 There is also limited research examining whether PA correlates are consistent across cancer survivors living in nonmetropolitan and metropolitan areas in Australia, with previous research limited to a handful of studies with small samples. [20][21][22] Such comparisons are important given a third of Australians reside in nonmetropolitan regions, 23 and nonmetropolitan survivors experience unique PA barriers. 20,21 Cancer survivors living in regional and remote areas have worse health outcomes and greater survivorship-related burden than their metropolitan counterparts.…”

“…20,21 Cancer survivors living in regional and remote areas have worse health outcomes and greater survivorship-related burden than their metropolitan counterparts. 23,24 Given that psychosocial factors and needs appear to differ by region, 22,25 ascertaining whether exercise preferences and resulting attitudes and confidence differ by geographical classification may inform the design and potential tailoring of future interventions. 22 This study aimed to identify relations between a core set of social cognition factors derived from multiple theories, exercise preferences, and PA participation in Australian cancer survivors across nonmetropolitan and metropolitan areas.…”

“…23,24 Given that psychosocial factors and needs appear to differ by region, 22,25 ascertaining whether exercise preferences and resulting attitudes and confidence differ by geographical classification may inform the design and potential tailoring of future interventions. 22 This study aimed to identify relations between a core set of social cognition factors derived from multiple theories, exercise preferences, and PA participation in Australian cancer survivors across nonmetropolitan and metropolitan areas. Exercise preferences are hypothesized to correlate with attitudes, PBC, and selfefficacy, which are in turn hypothesized to be associated with greater intention, as measured by motivational readiness.…”