Building consensus and identifying priorities: using a Delphi technique to define core elements and clinical determinates for a nutrition model of care for people with cancer

PURPOSE: Access to cancer nutrition care is often poor, and it can be challenging for cancer services to put models of care into practice. The aim of this study was to seek consensus from consumers of cancer services and nutrition experts on the core elements and key clinical determinants for a nutrition model of care for people with cancer. METHODS: A two-round, national online Delphi study was conducted February-May 2025. Proposed items were presented to a national panel of nutrition experts and consumers. Agreement was rated on an 11-point Likert scale for importance and feasibility against 62 items. Response frequencies were assessed against a priori thresholds to determine consensus ratings. RESULTS: Sixty-nine panellists participated in Round 1 (68.1% nutrition experts, 31.9% consumers) and 60 in Round 2 (68.3% nutrition experts, 31.7% consumers). Strong consensus was reached (both importance and feasibility) for 32 items that underpin cancer nutrition care. Findings identified opportunities for enhancing cancer nutrition care and improving feasibility using strategies beyond workforce and resource allocation, including elevating the value and practice of nutrition care. CONCLUSION: Findings will inform system-level guidance for cancer nutrition care within complex health environments. IMPLICATIONS FOR CANCER SURVIVORS: Consensus regarding the critical elements of a nutrition model of care based on importance and feasibility, and underpinned by national expert consensus, has the potential to address systemic barriers to access and unwarranted variation in care, and bridge the evidence-practice gap.