Population sciences, translational research, and the opportunities and challenges for genomics to reduce the burden of cancer in the 21st century.

Advances in genomics and related fields are promising tools for risk assessment, early detection, and targeted therapies across the entire cancer care continuum. In this commentary, we submit that this promise cannot be fulfilled without an enhanced translational genomics research agenda firmly rooted in the population sciences. Population sciences include multiple disciplines that are needed throughout the translational research continuum. For example, epidemiologic studies are needed not only to accelerate genomic discoveries and new biological insights into cancer etiology and pathogenesis, but to characterize and critically evaluate these discoveries in well-defined populations for their potential for cancer prediction, prevention and response to treatment. Behavioral, social, and communication sciences are needed to explore genomic-modulated responses to old and new behavioral interventions, adherence to therapies, decision making across the continuum, and effective use in health care. Implementation science, health services, outcomes research, comparative effectiveness research, and regulatory science are needed for moving validated genomic applications into practice and for measuring their effectiveness, cost-effectiveness, and unintended consequences. Knowledge synthesis, evidence reviews, and economic modeling of the effects of promising genomic applications will facilitate policy decisions and evidence-based recommendations. Several independent and multidisciplinary panels have recently made specific recommendations for enhanced research and policy infrastructure to inform clinical and population research for moving genomic innovations into the cancer care continuum. An enhanced translational genomics and population sciences agenda is urgently needed to fulfill the promise of genomics in reducing the burden of cancer.

Building a multiple modality, theory-based physical activity intervention: The development of CardiACTION!

OBJECTIVES: Despite the widely acknowledged benefits of regular physical activity (PA), specific goals for increased population levels of PA, and strongly recommended strategies to promote PA, there is no evidence suggesting that the prevalence of PA is improving. If PA intervention research is to be improved, theory should be used as the basis for intervention development, participant context or environment should be considered in the process, and intervention characteristics that will heighten the likelihood of translation into practice should be implemented (e.g., ease of implementation, low human resource costs). The purpose of this paper is to describe the implementation of the aforementioned concepts within the intervention development process associated with CardiACTION an ongoing randomized 2 × 2 factorial trial. METHODS: The Ecological Model of Physical Activity integrated with Protection Motivation Theory was used to inform the design of the interventions. This integrated model was selected to allow for the development of theory-based individual, environmental, and individually + environmentally targeted physical activity interventions. All intervention strategies were matched to proposed mediators of behavior change. Strategies were then matched to the most appropriate interactive technology (i.e., interactive computer session, automated telephone counseling, and tailored mailings) delivery channel. CONCLUSIONS: The potential implications of this study include determining the independent and combined influence of individual and environment mechanisms of behavior change on intervention effectiveness. In addition, all intervention models are developed to be scalable and disseminable to a broad audience at a low cost.