A team of researchers, including Dr. Tamika Smith, from the department of epidemiology in the School of Public Health at the University of Alabama at Birmingham, wanted to identify constructs relevant to implementation of evidence-based physical activity (PA) behavior change interventions for rural women cancer survivors from an organizational perspective.

During the development of a PA intervention implementation toolkit, 11 potential interventionists and 19 community and organizational stakeholders completed focus groups stratified by role. Narratives were audio recorded, transcribed, and coded for Consolidated Framework for Implementation Research (CFIR) constructs.

Multiple CFIR constructs were identified: Implementation Process, Intervention, Inner Setting, Outer Setting, and Characteristics of Individuals. Narratives identified rural implementation barriers and facilitators. Unique needs of the cancer were emphasized as important barriers potentially addressed through Adaptability and Readiness implementation strategies. Narratives identified multi-level strategies for targeting the identified constructs.

Fourteen CFIR constructs emerged as potentially important for organizations to consider when implementing PA interventions. Constructs were integrated into our implementation toolkit and research testing their potential mechanisms of action when implementing PA interventions in rural settings is warranted.

Strategies that target the identified constructs may enhance the implementation of PA programs for rural cancer survivors. Cancer survivors can facilitate these efforts by partnering with their health care providers and community organizations.