Background: Physical activity has numerous benefits for children with cancer, yet participation and support during treatment remains inconsistent. Understanding stakeholder perspectives is crucial to designing effective physical activity programs that are acceptable to this unique population and feasible to implement in practice.
Objective: This qualitative study aims to explore key stakeholder views regarding the delivery of physical activity advice and programs during childhood cancer treatment to provide enhanced recommendations and support for implementation in practice.
Methods: Semi-structured interviews were conducted with oncology healthcare professionals (e.g., paediatric oncologists, nurses, exercise physiologists, physiotherapists) and families (parents or childhood cancer survivors [aged >18 years at recruitment]). Participants were recruited through consumer panels, community organisations, and social media. Interview questions were designed and thematically analysed using the RE-AIM framework to explore implementation barriers and facilitators.
Results: Twenty-seven participants were interviewed (n=10 parents/survivors, n=7 nurses, n=4 paediatric oncologists, n=4 exercise physiologists, n=2 physiotherapists). Thematic analysis identified four key barriers: 1. Lack of funded hospital-based programs and dedicated exercise staff, 2. Treatment-related side-effects, 3. Variability in referral patterns to physical activity programs and access to exercise professionals across sites, 4. Need for flexible, patient-centred approaches to accommodate symptom-burden. Four key facilitators were identified: 1. Health professional and parental endorsement for the benefits of being active during different treatment phases, 2. Parents’ desire for structured, individualized exercise guidance, 3, Innovative strategies to promote engagement (e.g., utilising technology for gamification and video examples) and providing simple equipment (e.g. resistance bands, bike pedals), 4. Flexible activity programming adjusted around symptoms.
Conclusion: There is disconnect between the perceived importance of physical activity and its implementation in for children receiving treatment for cancer. There is a need to balance structured programs with tailoring for individual circumstances and use of technology could help overcome limited hospital resources and patient engagement.