Table 3.

Descriptive example of consistent implementation strategies identified across sites using the Expert Recommendations for Implementation Change taxonomy

Adapt and tailor to context
Promote adaptability	Referrals are accepted through multiple mediums (i.e., email, phone, and formal referral forms). Multiple different types of exercise are available and offered to patients.
Change infrastructure
Change record system	Systems (i.e., EMR) are changed, updated or developed to ensure that exercise is included and monitored, consistent with other cancer treatments.
Develop stakeholder interrelations
Develop academic partnerships	Academic partnerships are used to initiate services. Academic partnerships continue to be developed to trial new interventions, expand existing services and support quality improvement efforts.
Identify and prepare champions	A champion exists who advocates for the exercise EBI. Typically this person is determined, respected in their field and able to transcend hierarchal structures to influence across the system (i.e., to influence delivery staff, organisational executives and policymakers).
Inform local opinion leaders	Influential people (i.e., specialists, nurses and (where position exists) care coordinators) are identified and engaged to promote exercise EBI. They promote the EBI via speaking roles at forums, testimonials in marketing materials, or because they have a seat at the executive table.
Involve executive boards	Status/progress reports that document the impact of exercise EBIs are developed and fed through to the executive level. The purpose of this is to secure buy-in for the EBI and support requests for increased resourcing.
Promote network weaving	Organisations facilitate opportunities for staff to network (i.e., social events, multi-disciplinary meetings) and build relationships across disciplines. These relationships are leveraged by staff to create efficiencies in workflows (i.e., corridor conversations to prompt referrals and dovetailing clinical appointments to create a seamless service for patients).
Engage consumers
Increase demand	Consumer activism is fostered so that patients demand and act for the exercise EBI (i.e., involved in public presentation, drafting policy documents and leading petitions for the service).
Intervene with patients, consumers to enhance uptake and adherence	Multiple strategies are applied to enhance adherence to exercise EBIs (i.e., regular phone calls, maintaining an exercise diary, providing home exercise programs (i.e., using Physitrack), use of technology (i.e., tracking exercise via apps/pedometers) and organising social coffee catch-ups amongst patients).
Involve patients’ consumers and family members	Patients are engaged with implementation efforts via fundraising initiatives and raising the profile/value of the service (see increase demand).
Prepare patients and consumers to be active participants	A soft-entry approach is adopted across EBIs where the first contact offers a light-touch introduction to exercise. This aims to build the patients capacity and ownership over their involvement in the exercise EBI.
Use mass media	Organisations use mass media sources (i.e., social media, websites, print media) to raise awareness about the exercise EBI.
Provide interactive assistance
	Strategies were not identified from this category that were consistent across sites.
Support clinicians
Develop resource sharing agreements	Formal and informal relationships are established with community-based exercise services. These agreements are used to facilitate referral to other exercise programs in the area if the existing program is at capacity, or to offer an alternate exercise service if the core program does not meet consumer needs.
Facilitate relay of clinical data to providers	Clinical information about the patient’s engagement and progress through the exercise EBI is relayed to referral sources at regular intervals.
Train and educate stakeholders
Conduct ongoing training	The workforce has access to regular ongoing training in cancer care (i.e., via journal club, professional development courses and one-off training courses in exercise oncology).
Develop educational materials	Organisations use a range of educational materials to support the delivery of exercise EBIs (i.e., exercise recommendations for managing fatigue, referral prioritisation forms, how to refer form, scripts that guide new staff in how to deliver a typical exercise EBI session).
Distribute educational materials	Dissemination of educational materials typically occurs via email blasts and regular internal communication channels (i.e., newsletters).
Use evaluative and iterative strategies
Develop and implement tools for quality monitoring	Templates are developed that guide clinical and operational aspects of the EBI (i.e., initial assessment and re-assessment forms that guide subjective and objective assessments and established care plans, exercise programming forms, consumer attendance records, forms to track referral rates to programs).
Develop and organise a quality monitoring system	A system is developed (i.e., tracking through Excel or EMR) that pools the individual data collected through the quality monitoring tools to track the overall impact of the EBI. This information is used for corporate reporting, to develop business cases and to advocate for the EBI (see involve executive boards).
Obtain and use patient, consumer, and family feedback	PROs are collected typically via surveys or focus groups prior to a patient’s involvement in the program to inform the EBI content. Post-program satisfaction with the service is captured.
Use financial strategies
Access new funding	Diverse funding sources are pursued to deliver exercise EBI. This includes funding from grants, donations, philanthropic organisations and fundraising efforts.
Place innovation on fee for service list	Delivery staffs are allied health professionals (AEPs/physiotherapists), with their services funded through the universal healthcare systems in Australia (Medicare) or activity-based funding (for in-hospital care).

AEPs Accredited exercise physiologists, EBI evidence-based intervention, EMR electronic medical record, PROs patient-reported outcomes