Table 1.

Physical activity and cancer survivorship—stages of translational research examples, research needs, and translational impact

Key drivers across all phases: collaboration, knowledge integration, technology, multilevel interventions, and analyses
Research phaseExample(s)Research needsTranslational impact
T0
  • Discovery that exercise is associated with reductions in metabolic syndrome in cancer survivors

  • Discovery that exercise is associated with increased disease-free survival

  • Examine physical activity in relation to chronic conditions, functional outcomes, cancer progression, survival, and potential intermediary endpoints

  • Examination of these relationships in diverse cancer types

  • Assessment of effects of dose–response using observational data

  • Provide scientific justification for future research

  • Identify exercise dosage forfuture intervention studies

T1
  • Initial pilot physical activity intervention trial to examine the relationship between exercise and development of metabolic syndrome

  • Initial pilot physical activity intervention trial to examine inflammation as a potential mechanism underlying the survival benefits of physical activity

  • Cost–benefit analyses of physical activity in comparison with other currently available approaches to symptom and disease management

  • Animal and human models of exercise and cancer survivorship that mimic one another and the real-world

  • Determination of potential mechanisms underlying the health benefits for physical activity (e.g., aerobic fitness) and identification of intermediary markers for prognosis and survival

  • Provide scientific justification for widespread implementation of physical activity interventions

  • Determine safety of physical activity interventions

  • Mechanism data provide evidence for third party reimbursement and more personalized physical activityrecommendations

T2
  • Large intervention trial to test the effects of physical activity on lymphedema in breast cancer survivors

  • Replication of efficacious physical activity interventions in low-resource settings

  • Development of evidence-based physical activity programs and physical activity guidelines

  • Common metrics for comparison

  • Innovative; more practical study designs

  • More diverse participants

  • Multisite collaborations

  • Fractional factorial and pragmatic trials to determine most effective intervention components and physical activity dosage

  • Studies to determine the MINC for specific health benefits

  • Use of technology to increase intervention reach

  • Synthesis of evidence to overcome barriers to physical activity participation

  • Evidence of long-term efficacy of physical activity intervention on behavioral and health outcomes

  • Multilevel analyses of factors influencing physical activity participation and intervention effectiveness

  • Strengthen evidence base

  • Provide evidence-based interventions to be tested in diverse settings

  • More generalizable findings; reductions in health disparities

  • Reduce implementation costs and increased intervention uptake

  • Facilitate development of individualized physical activity program recommendations

  • Increase focus on context and boundary conditions of effects

T3
  • Implementation of evidence-based physical activity programs in multiple, diverse. and low-resource real-world settings

  • Assessment of factors that influence intervention success and implementation

  • Examination of the broader impacts of physical activity (e.g., QOL) and unintended consequences (e.g., sedentary behavior)

  • Implementation of evidence-based programs in multiple, real-world settings

  • Contextual assessment

  • Standardized intervention and training materials

  • Multilevel analyses of factors influencing physical activity participation and intervention effectiveness

  • Assessment of factors that influence the success of the intervention and implementation

  • Prevent and reduce side effects of cancer and its treatments at more global level

  • Establish optimal intervention implementation strategies

  • Establish sustainable infrastructure

  • Provide affordable, effective physical activity programs

  • Provide data on broader impacts of physical activity participation in cancer survivors

T4
  • Measurement of physical activity and prevalence of targeted intervention outcomes (e.g., diabetes, depression) in survivors at the population level

  • Cost-effectiveness analyses for implementing evidence-based interventions in practice

  • Pooling of data resources that monitor physical activity behavior of cancer survivors

  • Pooling of data resources with behavioral and medical usage data

  • Focus on key institutions providing cancer care to conduct quality improvement projects

  • Inform policy development, future discovery, and intervention development

  • Potential improvements in quality of care/patient experience and population health and reduced healthcare costs