Evidence map›Paper›PMID 38985186›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2024

Adopting a systems-thinking approach to optimise dietary and exercise referral practices for cancer survivors.

Ria Joseph, Nicolas H Hart, Natalie Bradford, Fiona Crawford-Williams, Matthew P Wallen, Reegan Knowles, Chad Y Han, Vivienne Milch, Justin J Holland, Raymond J Chan

Abstract read
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In one paragraph

Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Addressing Malnutrition in Australian Hospitals: A Scoping Review to Inform Systems Thinking.Journal of human nutrition and dietetics : the official journal of the British Dietetic Association · 2026
    Article
  2. Article
  3. Article
  4. Article
  5. Barriers and enablers to exercise prehabilitation before breast cancer surgery in an Australian regional health service: patient and clinician perspective.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Ria JosephCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia. ria.joseph@flinders.edu.au.
Nicolas H HartCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
Natalie BradfordCancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology, Brisbane, QLD, Australia.
Fiona Crawford-WilliamsCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
Matthew P WallenCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
Reegan KnowlesCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
Chad Y HanCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
Vivienne MilchCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.
Justin J HollandSchool of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, QLD, Australia.
Raymond J ChanCaring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeService referrals are required for cancer survivors to access specialist dietary and exercise support. Many system-level factors influence referral practices within the healthcare system. Hence, the aim of this study was to identify system-level factors and their interconnectedness, as well as strategies for optimising dietary and exercise referral practices in Australia.

methodsA full-day workshop involving national multidisciplinary key stakeholders explored system-level factors impacting dietary and exercise referral practices. Facilitated group discussions using the nominal group technique identified barriers and facilitators to referral practices based on the six World Health Organisation (WHO) building blocks. The systems-thinking approach generated six cognitive maps, each representing a building block. A causal loop diagram was developed to visualise factors that influence referral practices. Additionally, each group identified their top five strategies by leveraging facilitators and addressing barriers relevant to their WHO building block.

resultsTwenty-seven stakeholders participated in the workshop, including consumers (n = 2), cancer specialists (n = 4), nursing (n = 6) and allied health professionals (n = 10), and researchers, representatives of peak bodies, not-for-profit organisations, and government agencies (n = 5). Common system-level factors impacting on referral practices included funding, accessibility, knowledge and education, workforce capacity, and infrastructure. Fifteen system-level strategies were identified to improve referral practices.

conclusionThis study identified system-level factors and strategies that can be applied to policy planning and practice in Australia.

Indexed as

Cancer SurvivorsReferral and ConsultationAustraliaExerciseFemaleHumansMaleNeoplasmsCancer careDietExerciseHealth systemReferral practicesSystems-thinking

Identifiers

PMID38985186
PMCPMC11236908

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.