{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T18:37:35Z","timestamp":1791916655601,"version":"4.3.4"},"reference-count":42,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["TREC Training Workshop R25CA203650 (PI:  Melinda Irwin)."],"award-info":[{"award-number":["TREC Training Workshop R25CA203650 (PI:  Melinda Irwin)."]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Physical activity after cancer diagnosis has been consistently associated with improvements in quality of life and prognosis. However, few cancer survivors meet physical activity recommendations, and adherence is even lower among those living in rural settings. The purpose of this quasi-experimental study was to evaluate the implementation of a clinic-based physical activity program for cancer survivors at a rural community oncology setting. We also examined changes in quality-of-life measures among 24 cancer survivors participating in the physical activity program and described challenges and opportunities to optimize future implementation efforts in rural settings. Significant pre- to post-program improvements in fatigue (5.5 to 6.8; p = 0.03), constipation (7.7 to 9.0; p = 0.02), pain (6.7 to 8.0; p = 0.007), and sleep quality (p = 0.008) were observed. Participants also reported improved nausea, stamina, depression, stress, and overall physical health after participation in the physical activity program, although the differences were not statistically significant (all p-values &gt; 0.13). However, the reach of the physical activity program was limited, with only 0.59% of cancer survivors participating. Fidelity to the physical activity program was relatively high, with 72.7% of survivors participating in at least five classes. Our findings suggest that physical activity programs in oncological settings may need tailoring to effectively reach rural cancer survivors.<\/jats:p>","DOI":"10.3390\/ijerph182412909","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T09:52:29Z","timestamp":1638870749000},"page":"12909","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Implementation of Physical Activity Programs for Rural Cancer Survivors: Challenges and Opportunities"],"prefix":"10.3390","volume":"18","author":[{"given":"Kelly A.","family":"Hirko","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, MI 48824, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan M.","family":"Dorn","sequence":"additional","affiliation":[{"name":"Department of Exercise and Nutrition Sciences, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY 14214, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4518-3870","authenticated-orcid":false,"given":"James W.","family":"Dearing","sequence":"additional","affiliation":[{"name":"Department of Communications, Michigan State University, East Lansing, MI 48824, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Alfano","sequence":"additional","affiliation":[{"name":"Northwell Health Cancer Institute, New Hyde Park, NY 11042, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annemarie","family":"Wigton","sequence":"additional","affiliation":[{"name":"Munson Healthcare, Traverse City, MI 49684, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn H.","family":"Schmitz","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1249\/MSS.0000000000002116","article-title":"Exercise guidelines for cancer survivors: Consensus statement from International Multidisciplinary Roundtable","volume":"51","author":"Campbell","year":"2019","journal-title":"Med. 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