Facilitators to the implementation of exercise into cancer care: a systematic review
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Kennedy, MA
Cunningham, BJ
Dunn, R
Martin, J
Walker, M
Wallington-Gates, CT
Wright, H
Chan, B
Rose, GL
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Abstract
Purpose: Although governing bodies urge the importance of integrating exercise into routine cancer care, facilitators to implementation have not been systematically identified and collated. This review aimed to summarise facilitators to implement exercise services within real-world settings. Methods: A systematic review of qualitative, quantitative, and mixed-method studies was conducted (three databases, 13th September 2024). Reports were included if they documented the implementation of co-located exercise services (delivered onsite within cancer centres) or referral pathways to external exercise services from cancer centres. The updated Consolidated Framework for Implementation Research (CFIR 2.0) was used to code and synthesise facilitators. Results: Of 8544 search results, 28 reports (full-text articles) describing 29 implementation efforts (structured initiatives to integrate an exercise service within a cancer hospital or centre) were included. One hundred and sixty-four facilitators were identified across all CFIR 2.0 domains. Facilitators existed within all CFIR 2.0 domains; inner setting (30%), implementation process (27%), innovation (21%), individuals (15%), and outer setting (7%). The most frequent CFIR 2.0 constructs identified were (i) access to knowledge and information, (ii) engaging recipients and deliverers, (iii) individual motivation, (iv) innovation adaptability, (v) reflecting and evaluating on the innovation and implementation. Conclusions: The implementation of exercise services within cancer settings is influenced by an interconnected network of facilitators, with an organisation’s resources and willingness playing a central role. This review provides a generalised blueprint of facilitators and considerations to guide stakeholders in their own exercise oncology contexts. Implications for Cancer Survivors: This map of facilitators provides potential opportunities for clinicians, policy makers, and researchers, to advance efforts to embed exercise in routine cancer care, so that all people living with or beyond cancer have the opportunity to benefit from it.
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Journal of Cancer Survivorship
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© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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This publication has been entered in Griffith Research Online as an advance online version.
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Sports science and exercise
Oncology and carcinogenesis
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White, GL; Kennedy, MA; Cunningham, BJ; Dunn, R; Martin, J; Walker, M; Wallington-Gates, CT; Wright, H; Chan, B; Rose, GL, Facilitators to the implementation of exercise into cancer care: a systematic review, Journal of Cancer Survivorship, 2026