Co-designing strategies to enhance engagement in telehealth exercise classes among cancer survivors: a participatory study applying identity leadership theory and introducing the SIGN framework
Year: 2026
Type: article
Abstract: PURPOSE: To identify and evaluate consumer-informed strategies that online exercise leaders can use to enhance engagement in online exercise classes for people living with cancer, using social identity leadership theory as a guiding framework. METHOD: We used a participatory design involving adults with a history of blood cancer. Fourteen participants attended online co-design workshops to generate strategies that online exercise leaders could use to demonstrate their engagement in the four aspects of social identity leadership. Twenty-nine unique strategies were identified and thematically grouped using both social identity leadership theory and inductive analysis. These strategies were then rated by 18 participants on their potential to enhance commitment and appeal (0-100 scales). RESULTS: Strategies were categorised into four domains-The SIGN Framework: Social support and connection, Individualisation and inclusion, Goals, monitoring and feedback, and Novelty. The highest-rated strategies primarily fell within the Individualisation and inclusion and Goals, monitoring and feedback domains, including tailoring exercises, setting personalised goals, adapting sessions based on well-being, and providing regular feedback. These behaviours aligned with the social identity leadership process Identity advancement, whereby leaders act in the group's interest by supporting group members' needs and progress. Qualitative findings highlighted that leaders who validate individuals' needs and preferences strengthen their sense of inclusion and group belonging. Strategies involving Social support and connection (e.g., establishing group rules) and Novelty (e.g., weekly themes) were appreciated by some participants but received more mixed ratings. CONCLUSION: Online exercise leaders who act in the group's interest and offer personalised support may enhance engagement and group identification among cancer survivors. The SIGN framework offers a practical guide for translating social identity leadership into online exercise settings. IMPLICATIONS FOR CANCER SURVIVORS: Supporting exercise leaders to apply social identity leadership strategies may increase motivation, connection, and long-term participation in online programs for cancer survivors.
Source: Journal of Cancer Survivorship
Institutions: The University of Melbourne, Australian National University
Language: English
Topic: Cancer survivorship and care
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,790
OpenAlex ID: W7128006092