Sports Medicine

Exercise Professionals in the Cancer Center: Experiences, Recommendations, and Future Research In 2018, the Clinical Oncology Society of Australia published a landmark position statement calling for exercise to be integrated as standard practice in cancer care. Efforts to implement this directive in the years ahead will come with many practical challenges. We suggest that for the successful integration of exercise therapy to occur, exercise professionals and their services will have to become a respected, visible, and promoted part of the cancer treatment center itself (i.e., “part of the woodwork”). However, we are aware of no report in the literature documenting the role or experiences of an exercise professional working within a cancer center, or practical recommendations for the implementation and evaluation of exercise services in this setting. Therefore, we detail the experiences of an accredited exercise physiologist, to our knowledge, one of the first to be employed on a full-time basis within a cancer center in Australia (M.M.). On the basis of this case study, we provide practical recommendations for exercise professionals seeking to integrate exercise services within the cancer treatment setting. In addition, we present a model of care involving a key role for the exercise professional, which could be implemented to improve patient care and health outcomes throughout cancer treatment and beyond. Although our article is written from an Australian perspective, our recommendations may be relevant to and/or adapted for health care systems in other countries.

Original Investigation
Translational Formative Evaluation before Scale-up of a Physical Activity Intervention for Older Men
McKay, Heather A.; Mackey, Dawn C.; Gray, Samantha M.; More
Translational Journal of the American College of Sports Medicine. 4(14):106-113, July 15, 2019.

Abstract
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Introduction
Despite irrefutable health benefits of physical activity, older adults remain among the least active Canadians. To achieve population health, physical activity interventions that proved effective in controlled research settings must be delivered at scale to reach broader populations of older adults across multiple settings. Formative evaluations are essential, as they identify barriers and enablers to implementation across levels of stakeholder groups and settings. Thus, we conducted a formative evaluation of a choice- and evidence-based physical activity intervention (Men on the Move) designed for scalability.

Methods
We adopted key elements of two implementation frameworks that place characteristics of the innovation, prevention delivery system, prevention support system, and prevention synthesis and translation system at the core of implementation success. Guided by the Interactive Systems Framework for Dissemination and Implementation, data were collected from delivery partners, including 1 leader from a key provincial recreation organization, 6 recreation directors/coordinators and 3 activity coaches, and 14 participants (older men). This research team participated in prevention support and prevention synthesis and translation systems. Two trained interviewers conducted telephone interviews with delivery partners, and five trained interviewers and a notetaker conducted in-person interviews with participants.

Results
Five themes emerged from analyses of delivery partner interviews: support, activity coaches, intervention delivery, Men on the Move continuation, and the absence of men. Two themes emerged from our analyses of participant data: monitoring and connectedness.

Conclusion
Lessons learned from this formative evaluation will guide the adaptation of the intervention to context and population for scale-up across British Columbia, Canada. In so doing, we aim to bridge the know–do–scale-up gap, which is imperative as we seek to improve older adult health at the population level.