Moving forward together: A protocol to co-adapt and scale a physical activity intervention delivered by videoconference for pediatric cancer and blood disorder patients and survivors in British Columbia, Ontario, and the Maritime provinces (Preprint)

BACKGROUND Physical activity (PA) is safe and beneficial for children and adolescents diagnosed with cancer. Yet most engage in low levels of PA. We developed IMPACT (IMplementation of Physical Activity for Children and adolescents on Treatment), a PA intervention delivered by videoconference to enhance PA among young people during treatment for cancer and blood disorder diagnoses. IMPACT is being evaluated in a type II hybrid effectiveness-implementation trial in Alberta with planned scaling to additional Canadian provinces. Drawing on early findings and lessons learned from IMPACT in Alberta, and recognizing variation across provinces, co-adaptation of IMPACT is needed to enhance relevance, acceptability, and uptake. OBJECTIVE (i) Identify necessary IMPACT modifications, (ii) examine site-specific factors influencing IMPACT implementation, and (iii) develop an implementation research logic model to guide continued scaling. METHODS An integrated knowledge translation and patient-engaged approach was adopted and a pragmatic mixed-methods study is underway. Descriptive surveys and interviews, guided by the Consolidated Framework for Implementation Research 2.0, are being conducted with research users, including children and adolescents diagnosed with cancer and blood disorder (on- and off-treatment), carers, healthcare providers, and support organization personnel. Data will be analyzed using descriptive statistics and framework analysis. An implementation research logic model will be co-developed. RESULTS - CONCLUSIONS Co-adaptation of IMPACT with research users will strengthen relevance, acceptability, and uptake nationally. Resulting data will inform a model to guide continued scaling and a larger trial evaluating the co-adapted IMPACT intervention across additional provinces. This work reimagines IMPACT for broader applicability across varied Canadian contexts. CLINICALTRIAL