{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:37:38Z","timestamp":1787027858890,"version":"build-2736575974"},"reference-count":46,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T00:00:00Z","timestamp":1786838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009192","name":"Alberta Innovates","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100009192","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/00ynafe15","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000001","name":"Alberta Cancer Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100000001","id-type":"DOI","asserted-by":"crossref"}]},{"id":[{"id":"https:\/\/ror.org\/01k1b2g25","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"crossref","award":["462124"],"award-info":[{"award-number":["462124"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"crossref"}]},{"award":["462124"],"award-info":[{"award-number":["462124"]}],"id":[{"id":"https:\/\/ror.org\/01gavpb45","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Despite recommendations to exercise, many individuals living with and beyond cancer do not achieve or sustain recommended physical activity levels because access to structured exercise support remains limited. We evaluated the real-world delivery of a scalable, community-based exercise model designed to address this gap. Methods: We conducted a hybrid effectiveness\u2013implementation study of a 12-week supervised exercise intervention delivered in community settings across Alberta, Canada (in person or virtual). The primary outcome was the proportion of participants meeting physical activity guidelines at one year. Secondary outcomes included physical fitness and patient-reported outcomes. Results: Among 2570 participants, completion (90.6%) and attendance (77.1%) were high. At one year, the proportion meeting physical activity guidelines increased from 24.1% to 38.9% (p &lt; 0.001), exceeding the prespecified target. At 12 weeks, participants demonstrated clinically meaningful gains in physical fitness, including sit-to-stand performance (+2.8 repetitions; 95% CI, 2.6, 3.9) and six-minute walk distance (+39.9 m; 95% CI, 36.9, 42.8), along with improvements in patient-reported outcomes. Improvements in fatigue and quality of life were smaller among participants receiving chemotherapy. Adverse events were rare (0.5%), with all serious events occurring among participants receiving active cancer treatment. Conclusions: This study demonstrates that structured supervision and behavioural support can be delivered through scalable, community-based models integrated with cancer care and may help patients achieve and sustain recommended physical activity levels. These findings support the translation of established exercise evidence into real-world models of care while highlighting the need for additional strategies to support long-term behaviour change.<\/jats:p>","DOI":"10.3390\/cancers18162641","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:04:36Z","timestamp":1786961076000},"page":"2641","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Scalable Community-Based Exercise to Support Physical Activity in Cancer Care: A Hybrid Effectiveness-Implementation Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4376-4847","authenticated-orcid":false,"given":"Margaret L.","family":"McNeely","sequence":"first","affiliation":[{"name":"Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada"},{"name":"Department of Oncology, University of Alberta, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya","family":"Williamson","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Sellar","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil Abraham","family":"Joy","sequence":"additional","affiliation":[{"name":"Department of Oncology, University of Alberta, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada"},{"name":"Medical Oncology, Cross Cancer Institute, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9677-3918","authenticated-orcid":false,"given":"Kerry S.","family":"Courneya","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, Sport, and Recreation, University of Alberta, 1-113 University Hall, Edmonton, AB T6G 2H9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirin M.","family":"Shallwani","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Easaw","sequence":"additional","affiliation":[{"name":"Department of Oncology, University of Alberta, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada"},{"name":"Medical Oncology, Cross Cancer Institute, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunita","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Oncology, University of Alberta, 11560 University Avenue NW, Edmonton, AB T6G 1Z2, Canada"},{"name":"Research, Data and Analysis, Public Health Sciences Faculty, Henry Ford Hospital, 2799 West Grand Boulevard, Detroit, MI 48202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0947-933X","authenticated-orcid":false,"given":"Harold","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Oncology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce","family":"Cameron","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. Nicole","family":"Culos-Reed","sequence":"additional","affiliation":[{"name":"Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, AB T2N 1N4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,16]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"151176","DOI":"10.1016\/j.soncn.2021.151176","article-title":"Advanced Cancer as a Chronic Disease: Introduction","volume":"37","author":"Pituskin","year":"2021","journal-title":"Semin. Oncol. Nurs."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Courneya, K.S., McNeely, M.L., Booth, C.M., and Friedenreich, C.M. (2024). 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