PA engagement in cardio-oncology is shaped by dynamic interactions among capability, opportunity, and motivation across survivor and medical team member contexts, with sustained engagement remaining limited due to fluctuating symptoms, environmental constraints, and clinical uncertainties.
Only 42% of cancer survivors in cardio-oncology care met recommended physical activity guidelines.
The mean cardiovascular health score among cancer survivors was 71.3 (SD 11.9) based on a modified Life's Essential 8 framework.
Physical limitation was the most commonly reported capability barrier to PA engagement among cancer survivors.
Current engagement in PA was the most prevalent capability facilitator, reported by all cancer survivors.
Social environment was the most frequently cited opportunity facilitator for PA among both cancer survivors and medical team members.
Perceived health outcomes was the most prevalent motivational facilitator for PA across both cancer survivors and medical team members.
Medical team members' ability to promote PA was influenced by survivor readiness, clinical context, and resource availability.
The study used the COM-B framework to map multilevel barriers and facilitators to PA in cardio-oncology care from both survivor and provider perspectives.
This research suggests that most cancer survivors in cardio-oncology care are not meeting recommended levels of physical activity, with only about 4 in 10 survivors doing so. Using in-depth interviews with both cancer survivors and members of their medical teams, researchers found that multiple interconnected factors influence whether survivors engage in physical activity. Physical limitations were a universal challenge, but nearly all survivors also pointed to their existing activity habits and social support networks as key motivators and enablers of continued exercise. The study found that both survivors and medical team members valued physical activity highly and believed it could improve health outcomes, yet sustained participation remained difficult. Survivors faced fluctuating symptoms and safety concerns, while healthcare providers were constrained by limited resources, uncertainty about clinical appropriateness, and variability in how ready individual patients were to start or maintain exercise programs. Lack of access to physical activity resources was the most commonly reported barrier among medical team members. This research suggests that simply telling cancer survivors to exercise more is unlikely to be effective on its own. Instead, interventions may need to be flexible and tailored to individual survivors' changing physical conditions, leverage social support systems, improve access to appropriate exercise resources, and support clinicians in having better conversations about physical activity throughout the entire cancer care journey. These findings point to the need for a more coordinated, patient-centered approach to promoting exercise in cancer survivorship care.
Tetrick M, Addison D, Singh R, St George S, Pavia V, Gogineni A, et al.. (2026). Assessment of Physical Activity Engagement and Promotion Among Cancer Survivors in Cardio-Oncology Care: Qualitative Study.. JMIR cancer. https://doi.org/10.2196/104332