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Objective: This study aimed to 1) understand factors impacting the implementation of exercise communication and referral, and 2) explore integrated clinical approaches to exercise communication and referral in cancer care.Methods: Seven focus groups (N = 53) were conducted with clinicians and exercise professionals throughout Sydney, Australia. A sub-sample of participants (n = 9) attended a half-day workshop to identifying best practice approaches for moving forward. Data were analysed using thematic content analysis.Results: Two themes emerged: 1) Factors impacting the knowledge-to-action gap, inclusive of limited exercise specific knowledge and training opportunities, funding structure, and current referral process, and 2) Recommendations for a consistent and efficient way forward, detailing the need for oncologist-initiated communication, distribution of cancer-exercise resources, and access to exercise professionals with cancer expertise.Conclusions: This study identified factors (e.g., cancer-exercise specific training, integration of exercise physiologists) influencing exercise counselling and referral. A potential implementation-referral approach accounting for these factors and how to incorporate exercise into a standard model of cancer care, is described. Future testing is required to determine feasibility and practicality of these approaches.Practical Implications: A pragmatic model is provided to guide implementation-referral, inclusive of oncologist-initiated communication exchange, relevant resources, and access to exercise professionals with cancer expertise. [ABSTRACT FROM AUTHOR]

Abstract: This study examines how physical activity and perceptions of the built environment differ by degree of urbanisation in Queensland, Australia. A statewide sample of adults (n=1208) completed a CATI survey assessing physical activity and perceptions of the environment in July–August 2005. Results indicate that residents in metropolitan areas were more likely to report the presence of shops and services, footpaths, heavy traffic and physical activity facilities than non-metropolitan residents. Although geographic location was not associated with achievement of sufficient levels of physical activity or walking, a notable interaction in the associations between both physical activity measures and the presence of footpaths in metropolitan and non-metropolitan areas was observed. This finding suggests the presence of a differential mechanism in terms of the relationships between physical activity and environmental supports by geographical location. Such effects require future investigation in terms of replication and understanding. [Copyright &y& Elsevier]