Perceived Barriers, Facilitators, and Needs Related to Promoting Physical Activity in Cancer Care: Qualitative Insights from Oncology Care Providers

Background: Physical activity (PA) is associated with lower mortality and cancer recurrence risks. Although evidence shows health benefits for cancer patients before, during, and immediately after treatment, PA recommendations are not regularly included in the standard care. Objective: The study aimed to identify perceived knowledge, barriers, and facilitators of oncology providers' PA promotion for cancer patients using the 5A (Assess, Advise, Agree, Assist, and Arrange) framework. Methods: A qualitative research design with phenomenological approach was adopted. A purposive sample of 16 oncology care providers in Nebraska participated in semi-structured interviews via Zoom/phone. Interviews were audio-recorded, transcribed, and imported into MAXQDA 2024 for thematic analysis. Results: Analysis of the qualitative data identified five themes: (i) Perception of PA among oncology care providers suggested that they were able to define PA; (ii) PA counseling practices included advising on PA and assessment; (iii) Barriers to PA counseling included lack of guideline awareness, insufficient training, low prioritization, uncertainty about responsibility, time constraints, limited resources, lack of referral systems, patient health conditions, and environmental factors; (iv) Facilitators were identified as acknowledged health benefits for cancer survivors, awareness of PA recommendations, access to community resources, and support from interdisciplinary teams; and (v) Expressed desire among oncology care providers for training on incorporating PA into oncology care. Conclusions: Oncology providers recognized PA's health benefits for cancer survivors but did not promote it due to inadequate knowledge of guidelines and lack of resources. These barriers require improved PA counselling education to help providers incorporate PA into clinical care.