Exercise Counseling and Referral Practices Among Oncology Care Physicians in Latin America: A Multinational Survey Study.

A minority of oncology physicians in Latin America routinely assessed physical activity at every visit despite a majority doing some form of routine assessment.

• 454 physicians completed the survey with a response rate of 29.5%
• 62.5% routinely assessed physical activity
• Only 26.4% assessed physical activity at every visit
• Survey was conducted December 2024–February 2025 across Latin America

Half of oncology physicians regularly recommended exercise to patients, and more than a quarter never referred patients to exercise programs.

• 50.7% regularly recommended exercise
• 27.1% never referred patients to exercise programs
• Participants included medical, surgical, radiation oncologists, and palliative care specialists

Cultural norms favoring rest and provider insecurity or lack of knowledge were major barriers to exercise counseling.

• 76.7% of respondents identified cultural norms favoring rest as a barrier
• 65.9% identified provider insecurity or lack of knowledge as a barrier
• Patient factors such as fatigue, side effects, and low motivation were also cited as barriers

Medical oncologists and hospital-based providers were more likely to assess, recommend, and refer patients to exercise programs compared to other provider types.

• Medical oncologists and hospital-based providers showed higher rates of assessment, recommendation, and referral (all P < .01)
• Analyses used Chi-square tests and regression to examine predictors of counseling behaviors

Prior training strongly predicted exercise counseling behaviors, while years in practice was negatively associated with counseling.

• Prior training strongly predicted counseling behaviors (P < .001)
• Years in practice was negatively associated with counseling behaviors
• Personal exercise experience and institutional support were identified as promoters of counseling

Promoters of exercise counseling and referral included prior training, personal exercise experience, and institutional support.

• These promoters were identified through a culturally adapted questionnaire assessing practices, barriers, promoters, and demographics
• The survey was conducted in both Spanish and Portuguese to capture the Latin American context
• Findings support the need for targeted educational interventions and system investments