Inclusive prehab (I-Prehab) to address inequity in cancer outcomes

Prehabilitation (prehab) prepares people for cancer treatment and helps them during treatment to eat well and to be physically active and emotionally resilient.

Background

Prehab can lead to fewer treatment complications and better cancer outcomes, including longer life. It can also produce service cost savings. If prehab services are to be inclusive for all, changes are required to improve access and to support participation.

Aim

We will work with patients, carers, cancer workers, and cancer service managers to make (coproduce) and evaluate I-Prehab. I-Prehab will be a toolkit to support cancer workers to raise awareness of and encourage participation in prehab services for cancer patients. It will be designed to overcome access barriers and provide tools to support adherence, particularly for those from socially deprived and ethnic minority communities. We will study patients receiving treatment for upper gastrointestinal, bowel, lung, or breast cancer.

Design and methods

The research will be in 4 stages, planned and delivered in partnership with representatives of socially deprived and ethnic minority communities:

Stage 1. A review of relevant published research to find out what is known about culturally appropriate support for physical activity, nutrition, and emotional resilience.

Stage 2. Investigate in detail the current prehab practices in all eight NHS organisations treating cancer in Wales.

Stage 3. Workshops with people affected by cancer and service providers to use the findings of stages 1 and 2 to produce I-Prehab.

Stage 4. Test whether it is possible to deliver I-Prehab. This will include checking whether cancer workers will complete I-Prehab education and then use I-Prehab, whether they find it useful and finding out about patients’ experiences.

Patient and Public Involvement representatives agree with clinician team members. There is significant potential for patient health benefit through improved access to prehabilitation by people from socially deprived and ethnic minorities communities. Three patient and public members wished to be co applicants for the research to lead and coordinate public involvement activities. They will join the I-Prehab research team and will contribute to data analysis, design of methods, patient facing documents, impact plan and effective sharing of the outcomes to maximise dissemination.

Dissemination

We will work with our partner organisations to distribute I-Prehab across Wales and the rest of the UK. We will share the research findings with healthcare professionals, hospital managers and people affected by cancer through NHS training, charities, the press, social media, conferences, public meetings, and in scientific and professional journals.