Powell, Rachael
Davies, Amy
Rowlinson-Groves, Kirsty
French, David P.
Moore, John
Merchant, Zoe
Funding for this research was provided by:
Greater Manchester (GM) Cancer Alliance
Article History
Received: 30 August 2023
Accepted: 5 December 2023
First Online: 14 December 2023
Declarations
:
: Ethical approval was provided by the NHS Health Research Authority research ethics committee Wales REC 4 (reference 20/WA/0237). Informed consent for patient participants was audio-recorded prior to the interview, using a separate file to the interview recording. Informed consent was given by clinician participants through indicating agreement with a consent statement on the online survey’s cover page, before answering survey questions.
: Study participants consented for anonymised quotes to be used in study reports. No information which could lead to study participants being identified has been included.
: AD and RP’s time on the project was funded by a grant from Greater Manchester (GM) Cancer Alliance. JM, ZM and KRG are associated with the GM Cancer Alliance Prehab4Cancer and Recovery Programme: JM: Clinical Director; ZM: Previously Programme Lead (2018 to 2021), now Allied Health Professional (AHP) Clinical Lead; KRG: GM Active Prehab4Cancer Programme Manager during the running of this study. DF has no conflicts of interest.
: The authorship team consists of (1) individuals with a high level of knowledge of, and involvement with, the Greater Manchester (GM) Cancer Alliance Prehab4Cancer and Recovery (P4C) Programme, and (2) independent, University-employed, research-focussed staff.<b><i>1) Authors involved with the P4C Programme</i></b>JM is the clinical director of the P4C Programme and a consultant anaesthetist. ZM was the P4C Programme Lead during the running of the study and is now the Allied Health Professional Clinical Lead for the P4C Programme. ZM is an occupational therapist by background. KRG was the P4C Programme Manager at GM Active during the running of the study; her role included training of P4C staff and organisation and delivery of the programme’s assessments and exercises. The starting point of the present study was JM and ZM wishing to understand barriers to engagement, and experiences of the programme, so that areas for improvement could be identified and addressed. Thus, whilst it might be thought that JM, ZM and KRG, through their high involvement in the programme, could be biased towards findings which put the programme in a positive light, their aims in establishing the study were actually quite different.These authors’ experience was highly valuable in designing the study with a view to ensuring its feasibility, particularly during COVID-19 restrictions, and to support the research-focussed authors by answering any questions they had about the P4C Programme. Their insights were also valued during the analysis, as they were able to provide context where participants’ meanings lacked clarity, helping us to make sense of the data, and providing additional perspectives on the analysis.It was important to consider access to data sets, because patient and clinician participant samples came from small populations. It was possible that JM, ZM and KRG might be able to recognise participants from transcripts, even after removing identifying details such as names, due to the types of discussions, individuals’ roles, and contextual information which participants might provide during interviews/completing surveys. In order to enable participants to speak and write freely about their perspectives and experiences, without worrying that members of their care team, programme staff, or clinical colleagues might recognise them, we restricted access to datasets. As specified in our data management plan (which was approved by the study Sponsor and Research Ethics Committee), and indicated in participant information, only research-focussed authors, employed by the University of Manchester, accessed full datasets.Although the authors who were involved in the P4C Programme were keen to identify any problems with the programme, we wanted to ensure that the research was led, and controlled by, individuals who were independent of the programme, in order to minimise potential conflict of interest and ensure transparency.<b><i>2) Research-focussed authors</i></b>RP and DF are academic researchers with PhDs in health psychology; AD is a research assistant trained in research methods and health psychology to Master’s level (she carried out participant interviews). RP’s main research focus is psychological factors affecting experiences of medical procedures including surgery. DF conducts research related to enabling physical activity in older adults. AD had previous research experience on a project evaluating an intervention to increase older adults’ physical activity. As such, the research-focussed authors had both methodological expertise, and relevant academic interest, for designing and conducting the present study. No research-focussed author had pre-existing relationships with research participants.One author, RP, also has personal experience as a cancer patient, having received one cancer diagnosis as a young adult, and a second after completion of data collection on the present study, but before completion of analysis. Neither cancer was a type which would have led to routine referral into the P4C Programme, but the latter diagnosis provided some first-hand experience of a cancer diagnosis leading to major surgery and associated challenges. Throughout the data analysis process, RP considered how her own cancer experiences might be affecting her interactions with the dataset. Some issues discussed by participants felt quite salient in respect of her own experiences: the value of personal support outside of that which routine clinical care can provide, and how talking about cancer with individuals with no experience of it can be challenging. We feel that having an author with this experience contributed to the multi-disciplinary value of the research team: we had a cancer patient at the centre of the research and analysis process, alongside the perspectives of professionals involved in programme delivery and independent researchers.