Delivering resistance training to people with cancer in regional, rural, and remote Australia: a qualitative study of exercise professional’s perspectives

Abstract Introduction Resistance training is an essential component of exercise oncology programs embedded into high-quality cancer survivorship models of care, however health professionals working in regional, rural, and remote Australia face genuine implementation challenges. This study aims to explore exercise professionals’ perspectives on the role and implementation of resistance training for people with cancer living in regional, rural, and remote Australia. Methods Semi-structured interviews were conducted with 10 qualified exercise professionals involved in the prescription or delivery of resistance training to people with cancer living in regional, rural, and remote Australia. Interviews explored the perceptions of exercise professionals towards resistance training for people with cancer; systemic and contextual factors shaping implementation of resistance training in regional, rural or remote locations; and the barriers and facilitators to the delivery of resistance training in these contexts. Data were interpreted and analysed using reflexive thematic analysis. Results Three themes were developed: (1) role and value of resistance training, (2) healthcare capacity and capability, and (3) enhancing resistance training quality and implementation. Participants emphasised the role of resistance training to restore physical function, improve quality of life, and manage side effects. Beliefs on the value of resistance training were shaped by personal experiences, professional practice, and emerging evidence. Implementation of high-quality resistance training was influenced by workforce capacity, availability and access to appropriate equipment and qualified exercise professionals, and referral processes. Participants highlighted opportunities to enhance quality delivery of resistance-based exercise through targeted policy reform, sustainable funding, and improved education and professional development for rural health professionals. Conclusion To improve resistance training accessibility, quality, and effectiveness for people with cancer in regional, rural and remote areas of Australia, exercise professionals highlight the need for systemic, policy, and procedural reforms to mitigate the effects of geographical isolation and rural-specific barriers. Improvements in referral processes, education, professional development, and workforce capacity and capability, are essential to enable meaningful and sustainable improvements in exercise oncology services in these locations.