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Promoting physical activity for people living with or beyond cancer: Using mixed-methods of health services research (evidence synthesis, qualitative research and a survey).


Project Description

Background
There are over 2 million people in the UK living with or beyond cancer. The number of people diagnosed is increasing, but the number dying is decreasing, leading to more people surviving after a cancer diagnosis. Physical activity can reduce the chance of recurrence, decrease the development of co-morbid conditions and improve quality of life. However, 1.6 million of the 2 million cancer survivors do not achieve recommended levels of physical activity. NICE has made general recommendations on different modes of physical activity promotion: brief advice in primary care, exercise referral schemes, pedometers and community-based schemes for walking and cycling. However, evidence is lacking about their effectiveness and implementation with people living with or beyond cancer, particularly in underserved groups such as people with head and neck cancer. Key questions on use, impact and delivering remain. What is their uptake? Are they integrated into routine oncology care and routine primary care? Are they used consistently across different socio-economic groups? Does their use exacerbate health inequalities?
Aim
The overall aim is to promote physical activity in people living with or beyond cancer, across primary and secondary care, and in a range of socio-economic groups while reducing inequalities.
Objectives
1. To review the evidence describing current policy/guidance informing PA for cancer, to determine the effectiveness of interventions, explore barriers (including health inequalities) and facilitators, the views of patients and clinicians and the implementation of effective interventions.
2. To establish current physical activity promotion practice, noting examples of good practice (in terms of uptake, retention, person-centred approaches, tackling inequalities) and gaps in provision (in terms of location, use of evidence-based approaches, groups served).
3. To explore the views and opinions of patients with head and neck cancer on physical activity interventions, across different geographies and socioeconomic groups.
4. To develop an implementation guide to inform practice across primary and secondary care.
Study design
Mixed-methods approach using: evidence synthesis, qualitative research, survey of current practice, co-production of research and outputs with patients and health provider stakeholders (NHS, government, other agencies). There will be four inter-related work packages:
WP1 Evidence synthesis - A review of current policies and guidance informing physical activity for cancer. Evidence synthesis involving a review of reviews of effectiveness. A broad ranging systematic review exploring barriers to and facilitators of effective (and equitable) interventions, describing users and providers’ experience and the implementation of interventions in real world settings.
WP2 Stakeholder survey - Online survey of providers, in prioritised area of head and neck cancer, informed by project advisory group and evidence synthesis (also by focus groups below). This survey will establish current practice and will map published evidence to regional practice. In particular, we will attempt to identify gaps in provision and perceived health inequalities.
WP3 Qualitative focus groups - Focus groups with patients living with or beyond head and neck cancer. These focus groups will discuss attitudes to physical activity and exercise, perceived barriers and facilitators, experience of physical activity promotion and programmes (whether cancer focussed or not) and will explore the acceptability of using wearable technology for recording, monitoring and promoting physical activity.
WP4 Implementation summary/guide - Structured overview of findings with implications for implementation, including input from the project advisory group. This will inform the delivery of existing physical activity promotion in cancer services and in primary care. In particular, it will inform how to tackle health inequalities in this area.
Project Advisory Group (PAG)
The PAG will assist with the development of a relevant project plan and will comment on all four work packages. It will inform areas of focus, provide an ‘authentic’ interpretation of evidence and support dissemination for impact.

Application is by CV and Cover Letter. The Cover Letter must detail your interest in the studentship, related experience and training and suitability for the position. Applications to be sent to Professor Nefyn Williams.

Funding Notes

This studentship is funded by the Institute for Population Health Sciences. Bursary: £15,009 per annum (stipend in line with RCUK rates)

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