Measures

PERCS primary outcomes relate to evaluating the real-world application of the Triage and Referral System, namely, an implementation analysis using RE-AIM planning and evaluation framework (Table 3) [28]. The RE-AIM framework consists of five dimensions: Reach, Effectiveness, Adoption, Implementation and Maintenance, which help to plan programmes with greater external validity, improve the chances of a programme working in a real-world setting and identify the relative strengths and weakness of an approach. Three dimensions of RE-AIM will be applied to this project: Reach, Effectiveness and Implementation. In this feasibility study, adoption or maintenance of the system will not be assessed.

Implementation outcomes for PERCS study

• Percentage of patients on prehabilitation list who are eligible

• Percentage of referrals to the study from clinical team who are eligible

• Reasons for ineligibility

• Percentage of people enrolled in study from those who were approached for recruitment.

• Reasons for declining participation

• Socio-demographics, medical history and cancer history, inclusion, equality and diversity characteristics of participants.

• Compare to non-participant data, where possible

• Percentage of participants attending scheduled assessments at T0 and T1

• Reason for non-attendance

Reach,

Implementation

• Percentage of participants who did or did not proceed to attend the service they were referred to

• Percentage of participants who attended T0 assessment that attend T1 assessment

• Reasons for non-attendance

Reach,

Implementation

• Level 1 participants: percentage meeting recommended exercise levels at T1

• Level 2 participants: percentage attending local exercise programme at the agreed level of attendance; percentage meeting recommended levels of exercise at T1

• Level 3 participants: proportion of physiotherapy sessions attended per participant; percentage meeting recommended levels of exercise at T1

• Percentage meeting recommended levels of exercise on weekly basis, as per weekly diary

• Change in exercise levels from T0– T1

• Exercise measured by IPAQ and assessment of adherence to ACSM guidelines

Effectiveness,

Implementation

• Time from assessment to referral being sent

• Percentage of referrals accepted at initial site

• Time from referral sent to initial appointment

• Percentage of people triaged to each level

• Percentage triaged to another level after initial triage and why

Reach,

Effectiveness,

Implementation

RE-AIM: Reach, Effectiveness, Adoption, Implementation, Maintenance

At T0, patient demographics, medical history including cancer history and socio-economic data including equality, diversity, and inclusion (EDI) data will be collected using a standardised case report form. EDI data will be collected to meet American Society of Clinical Oncology guidance that research stakeholders should collect and publish aggregate data on diversity of trial participants [29]. The EDI data collection template was developed in line with European Union Equality data collection guidelines [30], in consultation with an external academic EDI specialist.