Implementation Conditions for Integrating Physical Activity into Oncology Care: A Logic Model from a Qualitative Study – ACTI-MAP

Abstract Purpose Cancer and its treatments negatively affect physical function and increase fatigue, contributing to a decline in patients’ physical activity (PA) levels. Although PA is recommended as part of oncology care pathways due to its well-established benefits, its integration into routine clinical practice remains limited and heterogeneous. This study aimed to identify the key elements influencing PA implementation in oncology care and to develop an implementation logic model. Methods A qualitative study was conducted using semi-structured interviews with healthcare professionals involved in oncology care pathways across multiple centers in France. Data were analyzed using the Consolidated Framework for Implementation Research (CFIR), the Expert Recommendations for Implementing Change (ERIC) taxonomy, and Proctor’s implementation outcomes framework. Findings were synthesized into an Implementation Research Logic Model (IRLM), linking determinants, strategies, mechanisms, and outcomes. Findings: Twenty-two interviews were conducted across 12 centers, classified as having low (n = 2), medium (n = 5), or high (n = 5) levels of PA integration. Analysis identified two interrelated themes: (1) the engagement and roles of three key actors, highlighting the complementary contributions of institutional decision-makers, physician opinion leaders, and PA professionals/coordinators in legitimizing, supporting, and operationalizing PA integration.; and (2) multidisciplinary collaboration, emphasizing the role of HCP knowledge and training, recognition of PA professional roles, interprofessional communication, and integration of PA within existing workflows and care pathways. Across these themes, 12 determinants, 17 implementation strategies, and 17 mechanisms were identified, influencing appropriateness, acceptability, adoption, penetration, and sustainability. These elements influenced key implementation outcomes, including appropriateness, acceptability, adoption, penetration, and sustainability. Conclusion This study suggests that PA implementation in oncology care is shaped by a dynamic interplay between contextual conditions, implementation strategies, and underlying mechanisms.