Background: Exercise and diet are critical components of supportive cancer care, yet referrals to these allied health specialists are infrequent. Needs-analysis assessments, to prioritise people most at risk of poor treatment outcomes, may help improve referral rates and appropriateness. However, current needs-analysis practices for diet and exercise referrals in Australian oncology settings are unknown, as are provider recommendations for improvement.
Procedures: Health and medical professionals involved in cancer care (>500 hours of experience) were recruited via convenience and snowball sampling. Participants completed a survey about their service’s current needs-analysis practices for exercise and diet referrals and provided recommendations for improvement. Quantitative data were descriptively summarised; qualitative responses were thematically analysed.
Results: Participants (n=100) included medical (26%), nursing (26%) and allied health (48%) professionals from public and private services across all Australian states (80% metropolitan, 20% regional-rural). Overall, 57% of professionals reported that their service used a needs-analysis assessment, most commonly for nutrition screening (29%). Common tools included the Malnutrition Screening Tool (MST), Body Mass Index (BMI), and 24-hour food recall for diet; and BMI, 6-minute walk test, and Supportive Care Needs Survey for exercise. Diet-based assessments led to referrals 38% of the time, whereas exercise-based assessments led to referral 16% of the time. A majority (62%) of respondents expressed a desire for improved evidence-based needs-analysis tools. Priorities included the need for pre-treatment screening, cancer- and treatment-specific tools, and a brief standardised tool integrating both diet and exercise. Other provider-informed recommendations for implementation and improvement will be discussed.
Conclusions and clinical implications: Although exercise and diet are critical to cancer care, formalised needs-analysis and referral rates remain low, with assessments often prioritising diet alone. Exercise-related assessment and referral follow-through are particularly lacking. Clinicians desire concise, standardised tools, which further research can develop to enhance referral consistency, equitable access, and patient outcomes.