Exercise Interventions for Survivors of Cancer Living in Rural or Remote Settings: A Scoping Review

Background: Survivors of cancer who are considered “hard to reach” have less engagement in survivorship programming and lower overall health status, well-being, quality of life, and survival. These include individuals who live in rural areas. There is a need to determine the availability, characteristics, feasibility, and effectiveness of exercise programs for individuals with cancer living in rural settings. Purpose: To conduct a scoping review describing the current literature on available exercise programming for survivors of cancer who live in rural or remote settings. Methods: Data Sources: Six databases were searched for studies. Study Selection: 105 abstracts were identified through literature searches; 84 studies remained for title and abstract screening after duplicates were removed. Thirty-three articles were included in full-text review. Data Extraction: Data related to participant characteristics, intervention characteristics, study design, and outcomes were extracted from full texts. Data Synthesis: Descriptive quantitative summaries are provided for result variables, and a narrative analysis was performed. Discussion and Limitations: Thirteen articles were selected for data extraction. The majority of interventions were phone-based walking programs for survivors of breast cancer. The interventions described were held in only 2 countries. The most common outcomes assessed were physical activity level, quality of life, and anxiety/depression. Conclusion: This scoping review highlighted the lack of accessible exercise programs for this subset of hard-to-reach survivors of cancer. This review found that there are few exercise programs accessible for survivors living in rural and remote areas, suggesting one reason for low engagement in physical activity and highlighting the need to devise novel means to implement exercise interventions for this population.