First-Year Implementation of the EXercise for Cancer to Enhance Living Well (EXCEL) Study: Building Networks to Support Rural and Remote Community Access to Exercise Oncology Resources

Chad W. Wagoner, Julianna Dreger, Melanie R. Keats, Daniel Santa Mina, Margaret L. McNeely, Colleen Cuthbert, Lauren C. Capozzi, George J. Francis, Linda Trinh, Daniel Sibley, Jodi Langley, Joy Chiekwe, Manuel Ester, Aude-Marie Foucaut and S. Nicole Culos-Reed ()
Additional contact information
Chad W. Wagoner: Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
Julianna Dreger: Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
Melanie R. Keats: School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
Daniel Santa Mina: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada
Margaret L. McNeely: Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada
Colleen Cuthbert: Faculty of Nursing, University of Calgary, Calgary, AB T2N 4V8, Canada
Lauren C. Capozzi: Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
George J. Francis: Department of Clinical Neurosciences, University of Calgary, Calgary, AB T2N 4N1, Canada
Linda Trinh: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada
Daniel Sibley: Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON M5S 2W6, Canada
Jodi Langley: School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
Joy Chiekwe: School of Health and Human Performance, Faculty of Health, Dalhousie University, Halifax, NS B3H 4R2, Canada
Manuel Ester: Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada
Aude-Marie Foucaut: Health Educations and Promotion Laboratory, UR 3412, University Sorbonne Paris North, F-93000 Bobigny, France
S. Nicole Culos-Reed: Faculty of Kinesiology, University of Calgary, Calgary, AB T2N 1N4, Canada

IJERPH, 2023, vol. 20, issue 3, 1-18

Abstract: Barriers to exercise-oncology programs remain for those living with and beyond cancer in rural and remote communities, including geographic isolation and access to programs. The EXercise for Cancer to Enhance Living Well (EXCEL) study was designed to support exercise-oncology implementation in rural and remote communities across Canada. The purpose of this analysis was to evaluate the first-year reach, adoption, and implementation of the EXCEL study. Reach outcomes included participant characteristics, study enrolment, and referral type (self vs. healthcare-provider [HCP] referral). Adoption outcomes included the number of clinical contacts, trained qualified exercise professionals (QEPs), and QEPs delivering EXCEL exercise classes. Implementation outcomes included retention, adherence, assessment completion rates, and adverse-event reporting. A total of 290 individuals living with cancer enrolled in EXCEL in year one, with an 81.4% retention to the study intervention. Most participants self-referred to EXCEL (75.8%). EXCEL’s HCP network consisted of 163 clinical contacts, and the QEP network included 45 trained QEPs, 22 of whom delivered EXCEL classes. Adherence to the exercise intervention was 78.2%, and only one adverse event (mild) was reported. Fitness assessment and patient-reported outcome completion rates were above 85% pre- and post-intervention. EXCEL has developed HCP and QEP networks supporting exercise referral and online delivery, and the intervention is meeting feasibility markers. These implementation findings will inform the continued gathering of feedback across stakeholders to ensure that best evidence informs best practices.

Keywords: physical activity; exercise; cancer; online exercise; network development; RE-AIM; underserved; healthcare provider; qualified exercise professional (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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