Barriers to and Facilitators of Physical Activity in Adults Living With and Beyond Cancer, with Special Emphasis on Head and Neck Cancer: A Systematic Review of Qualitative and Mixed Methods Studies

Hannah Doughty*, Ruaraidh Hill, Andrew Riley, ADRIAN MIDGLEY, Joanne Patterson, Lynne M. Boddy, SIMON ROGERS, Michelle Maden, Nefyn Williams

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

2 Citations (Scopus)
9 Downloads (Pure)

Abstract

Purpose
Physical activity can improve health outcomes for cancer patients, however only 30% of patients are physically active. This review explored barriers to and facilitators of physical activity promotion and participation in patients living with and beyond cancer. Secondary aims were to (1) explore similarities and differences in barriers and facilitators experienced in head and neck cancer versus other cancers, and (2) identify how many studies considered the influence of socioeconomic characteristics on physical activity behaviour.

Methods
CINAHL Plus, MEDLINE, PsycINFO, Scopus and Cochrane (CDSR) were searched for qualitative and mixed methods evidence. Quality assessment was conducted using the Mixed Methods Appraisal Tool and a Critical Appraisal Skills Programme Tool. Thematic synthesis and frequency of reporting were conducted, and results were structured using the Capability-Opportunity-Motivation-Behaviour (COM-B) model and Theoretical Domains Framework (TDF).

Results
Thirty qualitative and six mixed methods studies were included. Socioeconomic characteristics were not frequently assessed across the included studies. Barriers included side effects and comorbidities (physical capability; skills) and lack of knowledge (psychological capability; knowledge). Having a dry mouth or throat and choking concerns were reported in head and neck cancer, but not across other cancers. Facilitators included improving education (psychological capability; knowledge) on the benefits and safety of physical activity.

Conclusion
Educating patients and healthcare professionals on the benefits and safety of physical activity may facilitate promotion, uptake, and adherence. Head and neck cancer patients experienced barriers not cited across other cancers, and research exploring physical activity promotion in this patient group is required to improve physical activity engagement.
Original languageEnglish
Article number471
Pages (from-to)1-14
Number of pages14
JournalSupportive Care in Cancer
Volume31
Issue number8
Early online date17 Jul 2023
DOIs
Publication statusPublished - 17 Jul 2023

Keywords

  • Adherence
  • Behaviour change
  • Exercise
  • Oncology
  • Promotion

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