Purdy Graeme M, Sobierajski Frances M, Dolgoy Naomi D, McNeely Margaret L
Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada.
Rehabilitation Medicine, Cross Cancer Institute, Edmonton, AB, Canada.
J Cancer Surviv. 2022 Apr;16(2):374-387. doi: 10.1007/s11764-021-01032-8. Epub 2021 Mar 31.
Studies in exercise oncology are increasingly evaluating the implementation of cancer-specific exercise programming in real-world settings. Evaluating current implementation efforts and identifying current research gaps may inform future implementation. This scoping review explores studies implementing cancer-specific exercise programs to determine their pragmatic characteristics and evaluate potential for translation into practice.
A systematic literature search was conducted using five databases (up to July 2020) to identify implementation studies that used qualitative or quantitative methods. Program pragmatism was evaluated using the PRECIS/RE-AIM tool.
Fourteen articles were included for review. While programs were moderately pragmatic (average: 3.4; range: 2.8-4.2), variability was observed between scoring domains. Programs scored higher (more pragmatic) in domains typical for effectiveness studies, including participant eligibility, follow-up intensity, primary trial outcome, and analysis of primary outcome. In contrast, programs scored lower (less pragmatic) in domains aligned with implementation science, including intervention flexibility, adoption, implementation, and maintenance. Limited information was reported regarding program fidelity, adaptations, and maintenance/sustainability.
Researchers should consider the pragmatism of interventions, the nuances of program adoption and implementation at the setting level, and the transition and integration of programming into the healthcare system. Future studies may benefit from the inclusion of decision-makers and implementation experts and shifting focus towards flexible programming. PRECIS/RE-AIM may facilitate the evaluation of programs throughout the study design and implementation process.
The implementation of pragmatic exercise programs that are both scalable and sustainable is needed so that cancer survivors can experience exercise-related benefits beyond research settings.
运动肿瘤学研究越来越多地评估在现实环境中实施针对癌症患者的运动方案。评估当前的实施工作并找出当前的研究差距可能为未来的实施提供参考。本范围综述旨在探索实施针对癌症患者的运动方案的研究，以确定其实际应用特点，并评估其转化为实际应用的潜力。
使用五个数据库（截至2020年7月）进行系统的文献检索，以识别采用定性或定量方法的实施研究。使用PRECIS/RE-AIM工具评估方案的实用性。
纳入14篇文章进行综述。虽然方案具有一定程度的实用性（平均分为3.4；范围为2.8 - 4.2），但在评分领域之间存在差异。在有效性研究的典型领域，包括参与者资格、随访强度、主要试验结果和主要结果分析方面，方案得分较高（更具实用性）。相比之下，在与实施科学相关的领域，包括干预灵活性、采用、实施和维持方面，方案得分较低（实用性较差）。关于方案的保真度、调整以及维持/可持续性的信息报道有限。
研究人员应考虑干预措施的实用性、在机构层面方案采用和实施的细微差别，以及方案向医疗保健系统的过渡和整合。未来的研究可能受益于纳入决策者和实施专家，并将重点转向灵活的方案设计。PRECIS/RE-AIM可能有助于在整个研究设计和实施过程中评估方案。
需要实施既具有可扩展性又具有可持续性的实用运动方案，以便癌症幸存者能够在研究环境之外体验到与运动相关的益处。
