Implementation of the 3-steps Assess-Advise-Refer Exercise (FitARise) Protocol as a Standard Practice in Cancer Care

The University of Hong Kong (HKU)

Status: Not yet enrolling

Conditions: Cancer; Exercise

Treatments: Behavioral: 3-step Assess-Advice-Refer

Study type: Interventional

Funder types: Other

Identifiers

NCT07210905

UW 24-572

Details and patient eligibility

About

This study proposes to evaluate the process and outcome of an implementation program designed to implement the American College of Sports Medicine (ACMS)-recommended exercise assessment, advice, and referral instruction as standard practices in routine cancer care.

Full description

This study aims to test whether using implementing strategies (audit, feedback, facilitation, and adaptable workflow) to adopt the systematic FitARise protocol increases the proportion of eligible patients assessed, advised, and referred compared to control with the availability of the protocol, but without implementation strategies. This study hypothesizes that implementing strategies to promote the protocol's adoption will increase the proportion of eligible patients assessed and advised by oncologists and the proportion of patients referred to the JCICC exercise-based weight management program. For process evaluation, this study aims to use qualitative methods to assess the experience and response to the implementation program. The primary outcome (the reach measurement) is the percentage of eligible patients assessed, advised, and referred based on predefined BMI scores.

Enrollment: 1,800 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria (Cancer patients):

• All cancer patients with BMI score>=23;
• Have completed cancer treatment within the past five years;
• At least 18 years old;
• Are literate in Chinese or English;
• Are eligible to attend the intervention program.

Exclusion Criteria (Cancer patients):

• Patients who have completed cancer treatments for more than five years;
• Non-Cantonese, non-Mandarin, non-English speakers.

Inclusion Criteria (Clinical staff):

- All clinical, medical or surgical oncologists at the study units during the study period.

Exclusion Criteria (Clinical staff):

- No exclusion criterial for staff.

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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1,800 participants in 2 patient groups

Implementation condition

Experimental group

Description:

Under implementation conditions, the FitARise protocol will be implemented in routine oncological clinics using 4 implementation strategies, including audit, feedback, facilitation, and adaptable workflow at the beginning of the study.

Treatment:

Behavioral: 3-step Assess-Advice-Refer

Control condition

No Intervention group

Description:

In the control condition, the clinical outpatient operation is performed as usual. The screening tool and referral forms will be provided to the study sites and clinicians are encouraged eligible patients to adopt the FitARise program. Patients referred to JCICC will be managed following the predefined clinical pathway triage system. A briefing session about the purpose of the implementation program and the introduction of the FitARise protocol will be given to the staff at each study unit before the start of the first 4-months control condition. The briefing session will be recorded for the purpose of fidelity assessment.