Author Identifier

Mary A Kennedy

https://orcid.org/0000-0002-1411-539X

Date of Award

2021

Document Type

Thesis - ECU Access Only

Publisher

Edith Cowan University

Degree Name

Doctor of Philosophy

School

School of Medical and Health Sciences / Exercise Medicine Research Institute

First Supervisor

Professor Daniel Galvão

Second Supervisor

Professor Robert Newton

Third Supervisor

Professor Dennis Taaffe

Fourth Supervisor

Professor Sara Bayes

Fifth Supervisor

Dr Nicolas Hart

Abstract

Exercise is recognised as an important therapeutic adjunct to cancer treatment, but it is not routinely included in oncology patient care. One reason for this may be because little is known about effective implementation of evidence-based interventions in this context. The research presented in this thesis addresses the research to practice gap in exercise oncology by exploring the implementation of an existing co-located model of exercise delivery from an organisational perspective. The participatory implementation mapping framework guided the project, which resulted in a series of six interrelated studies that provide a comprehensive understanding of the challenges to integrating exercise into oncology care and present promising solutions.

The overall aim of the research project was to explore the process of implementing exercise into routine care within an oncology organisation. A scoping review of implementation barriers in exercise oncology confirmed a complex web of challenges across the healthcare system underpins the current research to practice gap in exercise oncology. An evaluation of a co-located exercise clinic demonstrated the safety and effectiveness of the exercise programming, but revealed implementation challenges across the organisation that impeded utilisation of the service. An implementation plan to support the service was developed with key stakeholders based on the evaluation findings. A contextually specific implementation plan was then integrated into organisational practices and found to offer promise for supporting the incorporation of exercise as part of routine care. Finally, the potential to share the implementation strategies developed for the co-located exercise clinic across the organisation’s network was explored and confirmed the need to consider each individual context in implementation planning.

The project and its results represent both an original contribution to knowledge and a primer for those interested in moving evidence-based interventions into practice in exercise oncology and more broadly.

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