title: Enablers and barriers in delivery of a cancer exercise program: the Canadian experience.
abstract: Exercise is an important therapy to improve well-being after a cancer diagnosis. Accordingly, cancer-exercise programs have been developed to enhance clinical care; however, few programs exist in Canada. Expansion of cancer-exercise programming depends on an understanding of the process of program implementation, as well as enablers and barriers to program success. Gaining knowledge from current professionals in cancer-exercise programs could serve to facilitate the necessary understanding.
  
  
  
  Key personnel from Canadian cancer-exercise programs (n = 14) participated in semistructured interviews about program development and delivery.
  
  
  
  Content analysis revealed 13 categories and 15 subcategories, which were grouped by three organizing domains: Program Implementation, Program Enablers, and Program Barriers. ■ Program Implementation (5 categories, 8 subcategories) included Program Initiation (clinical care extension, research project expansion, program champion), Funding, Participant Intake (avenues of awareness, health and safety assessment), Active Programming (monitoring patient exercise progress, health care practitioner involvement, program composition), and Discharge and Follow-up Plan.■ Program Enablers (4 categories, 4 subcategories) included Patient Participation (personalized care, supportive network, personal control, awareness of benefits), Partnerships, Advocacy and Support, and Program Characteristics.■ Program Barriers (4 categories, 3 subcategories) included Lack of Funding, Lack of Physician Support, Deterrents to Participation (fear and shame, program location, competing interests), and Disease Progression and Treatment.
  
  
  
  Interview results provided insight into the development and delivery of cancer-exercise programs in Canada and could be used to guide future program development and expansion in Canada.
authors.affiliation: Princess Margaret Cancer Centre, Toronto, ON; ; University of Guelph-Humber, Toronto, ON; ; University of Toronto, Toronto, ON;
authors.forename: D
authors.initials: D
authors.lastname: Santa Mina
authors.affiliation: Princess Margaret Cancer Centre, Toronto, ON;
authors.forename: A
authors.initials: A
authors.lastname: Petrella
authors.affiliation: Princess Margaret Cancer Centre, Toronto, ON;
authors.forename: K L
authors.initials: KL
authors.lastname: Currie
authors.affiliation: University of Guelph-Humber, Toronto, ON;
authors.forename: K
authors.initials: K
authors.lastname: Bietola
authors.affiliation: University of Toronto, Toronto, ON; ; University Health Network, Toronto, ON;
authors.forename: S M H
authors.initials: SM
authors.lastname: Alibhai
authors.affiliation: Princess Margaret Cancer Centre, Toronto, ON; ; University of Toronto, Toronto, ON;
authors.forename: J
authors.initials: J
authors.lastname: Trachtenberg
authors.affiliation: School of Kinesiology and Health Science, York University, Toronto, ON; ; Cancer Care Ontario, Toronto, ON.
authors.forename: P
authors.initials: P
authors.lastname: Ritvo
authors.affiliation: Princess Margaret Cancer Centre, Toronto, ON; ; University of Toronto, Toronto, ON;
authors.forename: A G
authors.initials: AG
authors.lastname: Matthew
keywords: Exercise; program development; qualitative analysis; rehabilitation; survivorship