Implementing an exercise oncology model to reach rural and remote individuals living with and beyond cancer: a hybrid effectiveness-implementation protocol for project EXCEL (EXercise for Cancer to Enhance Living Well)
,
Daniel Sibley,
Margaret L McNeely,
Anil Abraham Joy,
Nicole Culos-Reed,
Sarah McKillop,
Guanmin Chen,
Robin Urquhart,
Nicholas Giacomantonio,
Scott Grandy,
Melanie Keats,
Lauren C Capozzi,
Miroslaw Rajda,
Daniel Santa Mina,
Leslie Hill,
Danielle Bouchard,
Julianna Dreger,
Chad W Wagoner,
Colleen Cuthbert,
George J Francis,
Manuel Ester,
Emma McLaughlin,
Max Eisele,
Jodi Langley,
Joy Chiekwe,
Thomas Christensen,
Kristin Campbell,
Amanda Wurz,
Rosemary Twomey,
David Langelier,
Chris Blanchard,
Erin McGowan,
Travis Saunders,
Robert Rutledge,
Tallal Younis,
Lori Wood,
Stephanie Snow,
Judith Purcell,
Carolina Chamorro Vina,
Shabbir Alibhai,
David Eisenstat,
Beverly Wilson,
Danielle Briand,
Terri Billard,
Naomi Dolgoy,
Paula Ospina-Lopez,
Shaneel Pathak
Affiliations
Daniel Sibley
1 Moorfields Eye Hospital NHS Foundation Trust, London, UK
Margaret L McNeely
Department of Physical Therapy, Faculty of Medicine, University of Alberta, Edmonton, Alberta, Canada
Anil Abraham Joy
5 Division of Medical Oncology, Department of Oncology, University of Alberta, Edmonton, Alberta, Canada
Nicole Culos-Reed
3 Kinesiology, University of Calgary, Calgary, Alberta, Canada
Sarah McKillop
Division of Hematology/Oncology, Stollery Children`s Hospital, Edmonton, Alberta, Canada
Guanmin Chen
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
Robin Urquhart
Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
Nicholas Giacomantonio
3 Division of Cardiology, Nova Scotia Health Authority, Halifax, Canada
Scott Grandy
2 School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
Melanie Keats
2 School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
Lauren C Capozzi
1Faculty of Kinesiology, University of Calgary, Calgary, Canada
Miroslaw Rajda
10 Nova Scotia Health Authority, Queen Elizabeth II Health Science Centre, Halifax, Canada
Daniel Santa Mina
Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
Leslie Hill
Danielle Bouchard
Faculty of Kinesiology, University of New Brunswick Fredericton, Fredericton, New Brunswick, Canada
Julianna Dreger
1 Respiratory Research@Alfred, Department of Immunology and Pathology, Monash University, Melbourne, Victoria, Australia
Chad W Wagoner
Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Colleen Cuthbert
Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
George J Francis
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
Manuel Ester
Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Emma McLaughlin
Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Max Eisele
Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Jodi Langley
School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
Joy Chiekwe
School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
Thomas Christensen
School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
Introduction Individuals living with and beyond cancer from rural and remote areas lack accessibility to supportive cancer care resources compared with those in urban areas. Exercise is an evidence-based intervention that is a safe and effective supportive cancer care resource, improving physical fitness and function, well-being and quality of life. Thus, it is imperative that exercise oncology programs are accessible for all individuals living with cancer, regardless of geographical location. To improve accessibility to exercise oncology programs, we have designed the EXercise for Cancer to Enhance Living Well (EXCEL) study.Methods and analysis EXCEL is a hybrid effectiveness-implementation study. Exercise-based oncology knowledge from clinical exercise physiologists supports healthcare professionals and community-based qualified exercise professionals, facilitating exercise oncology education, referrals and programming. Recruitment began in September 2020 and will continue for 5 years with the goal to enroll ~1500 individuals from rural and remote areas. All tumour groups are eligible, and participants must be 18 years or older. Participants take part in a 12-week multimodal progressive exercise intervention currently being delivered online. The reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework is used to determine the impact of EXCEL at participant and institutional levels. Physical activity, functional fitness and patient-reported outcomes are assessed at baseline and 12-week time points of the EXCEL exercise intervention.Ethics and dissemination The study was approved by the Health Research Ethics Board of Alberta. Our team will disseminate EXCEL information through quarterly newsletters to stakeholders, including participants, qualified exercise professionals, healthcare professionals and community networks. Ongoing outreach includes community presentations (eg, support groups, fitness companies) that provide study updates and exercise resources. Our team will publish manuscripts and present at conferences on EXCEL’s ongoing implementation efforts across the 5-year study.Trial registration number NCT04478851.
