Supportive Care in Cancer

, Volume 26, Issue 9, pp 3117–3126 | Cite as

A qualitative analysis of oncology clinicians’ perceptions and barriers for physical activity counseling in breast cancer survivors

  • Angela J. Fong
  • Guy Faulkner
  • Jennifer M. Jones
  • Catherine M. Sabiston
Original Article



Few breast cancer survivors (BCS) engage in sufficient physical activity (PA) to gain physical and mental health benefits. This may be due to a lack of appropriate PA information and support. While key messengers of PA information could be oncology clinicians, many do not consistently counsel their patients on PA.


To examine factors affecting PA counseling in clinicians and inform future strategies.


Focus groups were conducted with clinicians (N = 27) at four cancer hospitals to better understand factors that affect PA counseling. Focus group discussions were transcribed verbatim and analyzed using inductive thematic analysis.


Clinicians perceived a lack of training and knowledge related to PA and BCS. Clinicians also discussed being unsure of when to integrate PA counseling into different phases of survivorship. Similarly, clinicians experienced barriers from hospital administration to maintain patient flow in-clinic, which decreased opportunities for PA counseling. Additionally, lack of awareness of community-based programs within large areas served by hospitals also decreased clinicians’ self-efficacy for counseling. In order to facilitate PA counseling, clinicians wanted resources that promote patient-managed PA, available on multiple platforms (e.g., printed and online). Continued education, highlighting recent research and effective implementation of PA, was noted as an important facilitator.


Researchers are encouraged to develop research agendas and test educational strategies that are integrated into current practice, empirically test barriers that developed from this study with a larger, representative sample to determine salient barriers and develop PA counseling strategies that are clinician-initiated but not dependent on clinicians.


Breast cancer Physical activity Exercise Health care providers Knowledge translation 



Guy Faulkner is supported by a Canadian Institutes of Health Research-Public Health Agency of Canada Chair in Applied Public Health. Catherine Sabiston holds a Canada Research Chair (Tier II) in Physical Activity and Mental Health.

Authors’ contributions

Conceptualization AF, CS; methodology AF, GF, JJ, CS; analysis AF, CS; initial draft of manuscript AF; and revisions AF, GF, JJ, CS.


This research is supported by the Canadian Breast Cancer Foundation (#499062).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animal participants performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Angela J. Fong
    • 1
    • 2
  • Guy Faulkner
    • 3
  • Jennifer M. Jones
    • 4
  • Catherine M. Sabiston
    • 1
  1. 1.Faculty of Kinesiology and Physical EducationUniversity of TorontoTorontoCanada
  2. 2.School of Kinesiology and Health StudiesQueen’s UniversityKingstonCanada
  3. 3.School of KinesiologyUniversity of British ColumbiaVancouverCanada
  4. 4.Cancer Rehabilitation and Survivorship Program, Princess Margaret Cancer CentreUniversity Health NetworkTorontoCanada

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