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 (Preprint)
Bibliographic record
Abstract
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. CLINICALTRIAL ClinicalTrials.gov NCT04956133; https://clinicaltrials.gov/ct2/show/NCT04956133 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/59302
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.036 | 0.028 |
| Meta-epidemiology (narrow) | 0.005 | 0.003 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.005 | 0.003 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.004 | 0.002 |
| Research integrity | 0.005 | 0.007 |
| Insufficient payload (model declined to judge) | 0.096 | 0.013 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".