A qualitative exploration of patient and clinician needs and preferences for a physical activity intervention during breast cancer chemotherapy

Background: Early intervention with physical activity (PA) during active cancer treatment is critical for improved health outcomes, but often difficult to deliver. We assessed patients’ and clinicians’ needs and preferences for a PA intervention during chemotherapy via semi-structured interviews. Methods: We conducted virtual semi-structured interviews from May 2022 to May 2023 with patients with stage I-III breast cancer and oncology clinicians recruited from a Midwestern comprehensive cancer center and community settings. We identified themes using deductive and inductive thematic analysis informed by the Consolidated Framework for Implementation Research. Results: Patients (n = 16) were mostly White, non-Hispanic (93.8%) females (100%) with an average age of 56.0 ± 12.0 years. Clinicians (n = 11) were primarily medical oncologists (45%) with > 10 years of experience (54%). Participants overwhelmingly viewed PA programs as beneficial and stated that they should be integrated into standard care during chemotherapy. Participants felt that if PA programs were presented as part of treatment, patients would be more likely to engage and adhere. Regarding intervention structure, patients preferred a flexible program that allowed them to decide when and how they would complete PA. They desired remote activities to increase the convenience of the program and overcome physical and logistical barriers such as chemotherapy side effects and transportation. They also wanted some in-person group elements for social support and accountability, with individual options for patients concerned with potential disease exposure. Clinicians expressed strong support for PA programs delivered by a physical therapist with oncology training and automated referrals in the electronic health record. Conclusions: Both patients and clinicians support PA programs delivered during chemotherapy. Key features of desirable PA programs were supervision by physical therapists, flexibility and convenience with both in-person and remote options, and group and individual components to facilitate patient participation. These findings can inform the design and implementation of future PA programs during chemotherapy for breast cancer.