"Fear of raising the problem without a solution": a qualitative study of patients' and healthcare professionals' views regarding the integration of routine support for physical activity within breast cancer care.

OBJECTIVE: The benefits of physical activity across the cancer continuum for many adult cancers are well established. However, physical activity is yet to be routinely implemented into health services throughout the world. This study aims to explore patients' and healthcare professionals' views about integrating conversations and support for physical activity into routine care during treatment for breast cancer. METHODS: Healthcare professionals and patients from across the UK living with or beyond breast cancer were invited to take part in semi-structured interviews that were conducted online. Recruitment for the study was advertised on social media, in cancer support groups and newsletters. Data were analysed using inductive thematic analysis. RESULTS: Three themes captured perceptions of integrating support for physical activity in routine breast cancer care among 12 health care professionals (who deliver breast cancer care) and 15 patients. Themes between healthcare professionals and patients overlapped, and therefore, combined themes are presented. These were: (1) current practice; (2) implementation in care and (3) training needs. CONCLUSION: Many healthcare professionals who offer cancer care are reluctant to raise the topic of physical activity with patients, yet patients have suggested that they would like additional support to be physically active from their medical team. Providing healthcare professionals with education regarding the benefits of physical activity to reduce the risk of recurrence along with evidence based low-cost, remote interventions would allow them to integrate conversations about physical activity within routine cancer care for all patients.

Views of the public about Snacktivity™: a small changes approach to promoting physical activity and reducing sedentary behaviour.

BACKGROUND: Many people do not meet the recommended health guidance of participation in a minimum of 150-300 min of moderate intensity physical activity per week, often promoted as at least 30 min of physical activity on 5 days of the week. This is concerning and highlights the importance of finding innovative ways to help people to be physically active each day. Snacktivity™ is a novel approach that aims to encourage people to do small, 2-5 min bouts of physical activity 'snacks' throughout the whole day, such that they achieve at least 150 min of moderate intensity activity per week. However, before it can be recommended, there is a need to explore whether the concept is acceptable to the public. METHODS: A survey to assess the views of the public about Snacktivity™ was distributed to adult patients registered at six general practices in the West Midlands, UK and to health care employees in the same region. RESULTS: A total of 5989 surveys were sent to patients, of which 558 were returned (9.3%). A further 166 surveys were completed by health care employees. A total of 85% of respondents liked the Snacktivity™ concept. The flexibility of the approach was highly rated. A high proportion of participants (61%) reported that the ability to self-monitor their behaviour would help them to do Snacktivity™ throughout their day. Physically inactive participants perceived that Snacktivity™ would help to increase their physical activity, more than those who were physically active (OR = 0.41, 95% CI: 0.25-0.67). Approximately 90% of respondents perceived that Snacktivity™ was easy to do on a non-working day compared to 60% on a working day. Aerobic activity 'snacks' were preferred to those which were strength based. CONCLUSIONS: The Snacktivity™ approach to promoting physical activity was viewed positively by the public and interventions to test the merits of such an approach now need to be developed and tested in a variety of everyday contexts.

More than half of adolescent E-Cigarette users had never smoked a cigarette: findings from a study of school children in the UK.

OBJECTIVES: Electronic cigarettes (ECs) are known for their use as a smoking cessation aid; however, experimental use in adolescence is a growing international concern. The proportion of adolescent EC users who have never used tobacco is rising. EC use is associated with later tobacco initiation in young people. Understanding adolescent beliefs about ECs is needed to inform public health campaigns and school education regarding the EC and the associated risks. STUDY DESIGN: A cross-sectional questionnaire-based design was used. METHODS: As part of a larger study, questionnaires to assess beliefs about ECs and current use were distributed to 499 school pupils aged 11-16 years in a county in England, UK. RESULTS: More than half of EC users had never used tobacco (52.6%), a substantially greater proportion than previously reported in the literature. Adolescents were aware that ECs were less harmful than tobacco but many were unaware that they contain nicotine and the subsequent risk of addiction could lead to later tobacco use. CONCLUSIONS: Given the possible association of EC use and later smoking initiation, education in schools may warrant greater emphasis on ECs, the role of nicotine and the risk of addiction associated with experimentation. Young people who deem ECs as a 'safe' option, and may otherwise have never experimented with tobacco, could be at risk of later tobacco use.