JMIR Publications

ABSTRACT

Background:

Physical activity (PA) is safe and beneficial for children and adolescents diagnosed with cancer. Yet most engage in low levels of PA. We developed IMPACT (IMplementation of Physical Activity for Children and adolescents on Treatment), a PA intervention delivered by videoconference to enhance PA among young people during treatment for cancer and blood disorder diagnoses. IMPACT is being evaluated in a type II hybrid effectiveness-implementation trial in Alberta. Early visual analyses suggest IMPACT may enhance PA and aspects of quality of life and physical function. However, despite high referral rates, participation, retention, and adherence rates are startlingly low. Findings signal the positive effect of IMPACT for those who participate while underscoring the necessity of implementation adaptations. Based on these early findings, a demonstrated desire for PA at sites across Canada, and funding support to scale IMPACT beyond Alberta, IMPACT must be first reimagined through active collaboration with research users, those who will refer to and/or use/benefit from IMPACT.

Objective:

Over the next 5 years our larger research program will i) co-adapt IMPACT and prepare for scaling (Phase 1) and ii) implement and evaluate co-adapted IMPACT across additional provinces in Canada (Phase 2). Specific aims for Phase 1 co-adaptation work are detailed herein and include: (i) identifying necessary IMPACT modifications, (ii) examining site-specific factors influencing IMPACT implementation, and (iii) developing an implementation research logic model to guide continued scaling.

Methods:

An integrated knowledge translation and patient-oriented research approach and pragmatic orientation have been adopted. A multiple perspective mixed-methods study is underway. Descriptive surveys and interviews, guided by the Consolidated Framework for Implementation Research 2.0, are being conducted with key research user groups, including children and adolescents diagnosed with cancer and blood disorder (on- and off-treatment), carers, healthcare providers, and support organization personnel. Data will be analyzed using descriptive statistics and framework analysis. An implementation research logic model will be co-developed with participants and IMPACT co-adaptation advisory board members and program partners and collaborators.

Results:

Funding was secured and initial ethics approval was granted June 10, 2025. Additional administrative and full approvals were secured subsequently. Recruitment started July 2025 in BC and is commencing across sites in a staggered manner. Full results (i.e., all site-specific modifications and implementation strategies and final version of the implementation research logic model) are expected to be submitted for publication late 2026.

Conclusions:

Co-adaptation of IMPACT with research users will enhance the likelihood of relevance, acceptability, and uptake nationally. Resulting data will inform a model to guide continued scaling and a larger trial evaluating the co-adapted IMPACT intervention across additional provinces. This work reimagines IMPACT for broader applicability across varied Canadian contexts.