129 - Oncology Clinicians’ Perspectives Related to Discussing Physical Activity with Adolescent and Young Adults with Cancer: A Qualitative Study

Publication Number: 2124.129

Reba M. Manicheril, Childrens Hospital of Philadelphia, Pittsburgh, PA, United States; Polina Poliakova, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Margaret Jankowski, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Alexandra Psihogios, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Tracey Jubelirer, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Jonathan Mitchell, CHOP, Philadelphia, PA, United States; Lisa Schwartz, Children's Hospital of Philadelphia/UPENN, Philadelphia, PA, United States; Sara King-Dowling, Children's Hospital of Philadelphia, Philadelphia, PA, United States

Background: Increasing evidence supports that physical activity (PA) is safe and beneficial for children and adults during cancer treatment. Despite this, adolescents and young adults (AYA) report limited communication and counseling from pediatric oncology providers about PA.

Objective: The purpose of this study was to examine pediatric oncology clinicians’ perceptions of PA as well as the barriers and facilitators to discussing PA with their AYA patients.

Design/Methods: Semi-structured interviews were conducted with pediatric oncology clinicians [n=10: physicians (n=6), physical therapists (n=2), and nurse practitioners (n=2)] who provided care to AYA. Using a rapid qualitative approach, detailed interview notes were entered into a structured template, summarized and reviewed, and distilled into themes representing PA perceptions, barriers and facilitators.

Results: All providers were supportive of encouraging their patients to engage in PA and identified physical, psychological and social benefits. Most (90%) recognized PA as a clinical priority and that it was within their scope of practice to discuss PA. Reported barriers to PA discussions included both patient- and provider-level factors. Patient-level barriers included psychosocial (e.g. family fear/anxiety, PA beliefs/motivation), socio-economic (e.g. limited resources, environmental constraints) and medical factors (e.g. treatment symptoms, PA contraindications). Provider-level barriers included limited time, competing medical priorities, inconsistent messaging from other members of the care team, and limited knowledge of PA guidelines. Facilitators centered on patient and provider education on the benefits and current PA recommendations though evidence-based sources. Providers also endorsed that PA was typically discussed more often with patients who prioritized PA. Suggestions for enhancing PA discussions included implementing routine patient PA assessment and screening, and prompts and resources within the electronic medical record to help facilitate PA discussions.

Conclusion(s): Despite recognizing the importance of PA for AYA during cancer treatment, oncology providers face multilevel barriers to discussing PA with patients. Addressing these barriers through offering PA education for patients and providers, and equipping providers with age-appropriate resources to counsel patients, may enhance PA discussions in oncology care. Future research should explore feasible and sustainable methods for implementing PA screening in pediatric oncology settings and embedding educational resources on PA within the electronic medical record.