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Physical activity referral to cardiac rehabilitation, leisure centre or telephone-delivered consultations in post-surgical people with breast cancer : a mixed methods process evaluation

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Hubbard_et_al_2018_Pilot_and_Feasibility_Studies_CC.pdf (672.9Kb)
Date
01/06/2018
Author
Hubbard, Gill
Campbell, Anna
Fisher, Abi
Harvie, Michelle
Maltinsky, Wendy
Mullen, Russell
Banks, Elspeth
Gracey, Jackie
Gorely, Trish
Munro, Julia
Ozakinci, Gozde
Keywords
Breast cancer
Health Behaviour
Complex intervention
Physical activity
Cancer survivorship
Rehabilitation
RC0254 Neoplasms. Tumors. Oncology (including Cancer)
RD Surgery
NDAS
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Abstract
Background Physical activity (PA) programmes effective under ‘research’ conditions may not be effective under ‘real-world’ conditions. A potential solution is to refer patients to existing PA community-based PA services. Methods A process evaluation of referral of post-surgical patients with early-stage breast cancer to cardiac rehabilitation exercise classes, leisure centre with 3-month free leisure centre membership or telephone-delivered PA consultations for 12 weeks. Quantitative data were collected about PA programme uptake and reach, patient engagement with the PA programme, delivery and fidelity and PA dose. Qualitative data were collected about patient experiences of taking part in the PA programmes. Audio-recorded qualitative interviews of participants about the programmes were analysed thematically. Quantitative data were reported descriptively using means and SD. Results In Phase I, 30% (n = 20) of eligible patients (n = 20) consented, 85% (n = 17) chose referral to leisure centre, and 15% (n = 3) chose cardiac rehabilitation. In Phase II, 32% (n = 12) consented, 25% (n = 3) chose leisure centre and 75% (n = 9) chose telephone-delivered PA consultations. Walking at light intensity for about an hour was the most common PA. All Phase I participants received an induction by a cardiac rehabilitation physiotherapist or PA specialist from the leisure centre but only 50% of Phase II participants received an induction by a PA specialist from the leisure centre. Four themes were identified from qualitative interviews about programme choice: concerns about physical appearance, travel distance, willingness to socialise and flexibility in relation to doing PA. Four themes were identified about facilitators and barriers for engaging in PA: feeling better, feeling ill, weight management, family and friends. Conclusions The current community-based PA intervention is not yet suitable for a definitive effectiveness randomised controlled trial. Further work is needed to optimise PR programme reach, PA dose and intervention fidelity.
Citation
Hubbard , G , Campbell , A , Fisher , A , Harvie , M , Maltinsky , W , Mullen , R , Banks , E , Gracey , J , Gorely , T , Munro , J & Ozakinci , G 2018 , ' Physical activity referral to cardiac rehabilitation, leisure centre or telephone-delivered consultations in post-surgical people with breast cancer : a mixed methods process evaluation ' , Pilot and Feasibility Studies , vol. 4 , 108 . https://doi.org/10.1186/s40814-018-0297-1
Publication
Pilot and Feasibility Studies
Status
Peer reviewed
DOI
https://doi.org/10.1186/s40814-018-0297-1
ISSN
2055-5784
Type
Journal article
Rights
© The Author(s). 2018. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
Description
Funding: Breast Cancer Now (Pilot Study 2014NovSP422) and Scotland Chief Scientist Office (CGA/16/14).
Collections
  • University of St Andrews Research
URI
http://hdl.handle.net/10023/13687

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