IMplementation of Physical Activity for Children and adolescents on Treatment (IMPACT) for Cancer Diagnoses in Alberta: Protocol for a Single-Arm, Mixed-Methods, Hybrid Effectiveness-Implementation Trial
Notice bibliographique
Résumé
BACKGROUND: Physical activity (PA) is feasible, safe, beneficial, and recommended for pediatric patients with cancer. Nevertheless, PA levels remain low due to treatment-related effects (eg, fatigue, pain), isolation and immunosuppression, geographic and transportation barriers, and limited access to population-specific programming. Delivering PA by videoconference may address some of these barriers. Thus, IMplementation of Physical Activity for Children and adolescents on Treatment (IMPACT) was developed. IMPACT is an individualized, tailored PA intervention delivered by an exercise professional over videoconference and is being evaluated in a hybrid effectiveness-implementation trial. OBJECTIVE: The objectives of this trial include (1) assessing the effectiveness of IMPACT on participants' device-measured PA (primary effectiveness outcome) and secondary effectiveness outcomes, including participant- and caregiver-reported PA and participant- and caregiver-reported quality of life, symptoms, cognitive function, resource use, and participant physical fitness outcomes (ie, participants' aerobic endurance, lower body flexibility, shoulder flexion range of motion, balance, functional mobility); and (2) assessing the implementation of IMPACT and the trial through evaluating recruitment, indices of feasibility, delivery time, expertise, cost, fidelity of intervention delivery, and adverse events. METHODS: A single-arm, mixed-methods, type II hybrid effectiveness-implementation trial is being conducted, and the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework is guiding evaluation. Pediatric patients with cancer and blood disorders diagnosed between 5 and 18 years of age are being recruited in Alberta. Following informed consent/assent and baseline assessments (ie, participants' device-measured PA, participant- and caregiver-reported outcomes, participant physical fitness outcomes), participants receive individualized, tailored PA sessions up to 3 times/week for 15-45 minutes/session over 12 weeks from an exercise professional via videoconference. Assessments are then completed postintervention (with the addition of a participant and caregiver interview) and at 6- and 12-month follow-ups. With respect to RE-AIM, reach covers referral and participation rates, participants' and caregivers' personal and medical information, and the proportion of participants from rural versus urban locations. Effectiveness includes participants' device-measured PA, participant- and caregiver-reported outcomes, and participant physical fitness outcomes. Adoption covers sources of referral. Implementation includes recruitment, feasibility, delivery time, expertise, cost, fidelity of intervention delivery, and adverse events. Maintenance includes participants' and caregivers' desire for ongoing access to PA, and participant- and caregiver-reported PA levels at 6- and 12-month follow-ups. Throughout the trial, quality improvement cycles occur every 6 months. RESULTS: Funding was obtained in April 2022. Participant recruitment began in March 2022 and will conclude in December 2025. Interim analyses and additional analyses of selected trial data have been conducted, and publications are forthcoming. Full trial results will be analyzed and published following trial cessation. CONCLUSIONS: This work will provide insights into the effects of, and factors influencing, the implementation of an individualized, tailored PA intervention delivered by videoconference. Findings may support continued exploration of videoconference delivery as a strategy to ensure that more pediatric patients can access and benefit from PA. TRIAL REGISTRATION: ClinicalTrials.gov NCT04956133; https://clinicaltrials.gov/ct2/show/NCT04956133. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/59302.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,052 | 0,030 |
| Méta-épidémiologie (sens strict) | 0,007 | 0,003 |
| Méta-épidémiologie (sens large) | 0,007 | 0,005 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,005 | 0,004 |
| Communication savante | 0,005 | 0,003 |
| Science ouverte | 0,005 | 0,003 |
| Intégrité de la recherche | 0,006 | 0,008 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,059 | 0,009 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».