Developing a Complex Intervention Plan for Physical Activity in Overweight and Obese Endometrial Cancer Patients: A Multimethod Study

Aims and Objectives: This study aims to develop a comprehensive physical activity (PA) intervention tailored for overweight and obese patients with endometrial cancer (EC). It integrates theoretical frameworks, empirical evidence, expert opinions, and stakeholder perspectives to assist clinical providers in implementing standardized PA guidelines. Background: Obesity is a significant risk factor for EC and is closely linked to treatment outcomes. Although previous studies have focused on the role of PA in weight loss and survival, they lack detailed, evidence-based guidance specifically tailored for EC patients. Design and Methods: We developed a PA instruction program using the Evidence-Based Nursing Practice Pathway and the Medical Research Council's Framework for Complex Interventions. The development process consisted of three phases: a preparatory phase, the development and implementation of evidence-based interventions, and the refinement of the program through Delphi consultation. Results: The program framework was developed using multiple methods, including evidence searches (guidelines and expert consensus), semistructured interviews, and expert consultations. It encompasses preinstruction, implementation methods, and strategies for maintaining PA. Instructional materials such as posters, brochures, videos, and checklists were created to facilitate clinical integration. Conclusions: This study is the first to develop a tailored PA program for overweight EC patients. The rigorous design, based on complex intervention frameworks and expert input, has the potential to improve clinical practice, enhance tumor remission rates, and improve fertility outcomes. Relevance to Clinical Practice: ClinicalTrials.gov_identifier: NCT06312917.