Table 1 The program model

1. Clinic support and physician referral

• Enlist physician support through program recommendation and direct survivor referral. Physicians are among the most powerful stimuli for promoting health-related behavior change [8].

• Ensure survivor needs regarding referral to a PA program can be balanced within the demands of a busy clinical setting.

• Referral process must be straightforward and all health care providers must understand the value (i.e., likely benefits) of the program, survivor eligibility criteria, and their role in the referral process.

2. Tailored program design based on population needs

• It is critical to consider the specific needs of survivors of specific cancer types and tailor the PA program to best suit the needs of each target group.

3. Integrated wellness education and behavior change strategies

• Provide survivors with tailored educational materials along with professional consultation. This strategy can promote survivor engagement and behavior adoption [5, 18, 23].

• Implement behavior change strategies, including goal setting contracts that allow for the achievement of smaller goals promoting ‘mastery’ as the survivor works towards long-term goals [17].

• Encourage self-monitoring techniques such as PA tracking journals.

• Evaluate adherence through attendance checklists, midterm, and final reports. Follow up with survivors who miss scheduled sessions.

• Monitor survivors and provide results allowing for reflection on program progress (goal achievement) and future goal development based on progress and unique needs (goals).

• Record progress in health records, allowing for the development of a clinical feedback-loop, thereby reinforcing program referral.

4. Individualized PA prescription

• Include a component of personal individualization within the program so that all survivors receive the appropriate PA prescription including all elements of fitness, with their current and previous health history in mind.

• Consider previous and current contraindications, including injury, disease, medications, and treatment side effects.

• Recognize individual goals.

5. Group-based PA classes

• Allow for group interaction and socialization, capitalizing on social support among members, which in turn can improve adherence and enjoyment [15].

6. The promotion of independent PA habits

• Encourage survivors to engage in PA independent of the class and begin to choose activities that specifically interest them.

• Encourage survivors to begin trying other types of PA classes to diversify their experience and allow for further community integration.