Abstract / Summary
In Wales, there are over 1,000 new cases of cancer each month, making it one of the leading causes of morbidity and mortality. Cancer prehabilitation interventions are designed to improve a patient’s lifestyle and, in-turn, their physical and psychological resilience prior to treatment. Cardiff and Vale University Health Board, one of seven health boards within NHS Wales, have developed Prehab2Rehab, a personalised, multimodal prehabilitation and recovery intervention to support eligible cancer patients in the region. Prehabilitation staff provide a personalised, multimodal intervention to improve patients’ levels of exercise, nutrition and mental health prior to treatment. This paper outlines a process evaluation of Prehab2Rehab, with the aim of investigating programme staff and patient reflections on the programme. A mixed methods approach was taken. This paper presents the qualitative insights from the study, collected through semi-structured interviews with Prehab2Rehab and wider cancer pathway staff ( n = 14) and patients with experience of the programme ( n = 15) to understand their perspectives and experiences. Interviews were conducted between April and November 2024 and analysed through inductive thematic analysis. Secondary data collected by the Prehab2Rehab team provided an overview of programme attendance. Analysis of the interviews and secondary data were triangulated to answer the evaluation questions. Most patients found the programme to be feasible, acceptable and had positive experiences, but patients with more available time, social support and better physical capacity were able to engage better. The majority of patients interviewed felt the exercise and diet support and guidance had supported them to make improvements to their lifestyle. Equally, patients benefitted from peer support from people going through similar experiences, who they met through Prehab2Rehab. However, there is a need for improved post-treatment support or rehabilitation to ensure these behaviours are sustained. This process evaluation indicates that Prehab2Rehab is providing a positive patient experience that enables eligible patients to make changes to their lifestyle in terms of exercise and diet in the build-up to treatment for cancer. Prior to treatment, Prehab2Rehab participants have improved knowledge and confidence to be physically active and/or improve their nutrition. However, there are areas of improvement that could improve the efficiency and impacts of the programme.