Development and preliminary evaluation of a rehabilitation consult for survivors of head and neck cancer: an intervention mapping protocol

Abstract

BackgroundEvidence suggests that rehabilitation interventions can improve function and quality of life in survivors of head and neck cancer (HNC), but there is a lack of coordinated, integrated services, and those offered are inconsistent. To address these gaps, we will develop and conduct preliminary evaluation of a rehabilitation consult, built on the theoretical foundations of goal setting and self-management, and composed of a brief functional evaluation, a resource compendium, and collaborative goal-setting and action planning processes.Methods/designThe development of the rehabilitation consult will be guided by intervention mapping, which consists of six steps: 1. Needs assessment; 2. Definition of program objectives; 3. Selection of theory-based intervention methods; 4. Production and pretesting; 5. Adoption, implementation and sustainability planning; 6. Process and effect evaluation. Within the intervention mapping framework, an iterative process of constructing drafts and mini-evaluations with consumers and experts will be used, modifying the rehabilitation consult intervention until a version suitable for formal evaluation is established. The rehabilitation consult will then be evaluated using a prospective, mixed method, single group design with 30 survivors of head and neck cancer. Outcomes will be assessed pre- and post-intervention and at 6-month follow-up.DiscussionSurvivors of head and neck cancer have among the most complex rehabilitation needs of all cancer patients. The rehabilitation consult is expected to improve knowledge and uptake of rehabilitation resources and strategies in survivors of head and neck cancer and thereby improve long-term function and quality of life. If the rehabilitation consult is effective in cancer patients with such high and diverse needs, this project will produce a toolkit that will be adaptable for other types of cancer in other jurisdictions.

Interventions developed with the Intervention Mapping protocol in the field of cancer: A systematic review

“…The very first task of the IM protocol is to establish a participatory planning group to include the views and field experiences of all the relevant stakeholders. Six studies reported clearly such a participatory planning group including all the relevant stakeholders . Two other studies reported interviews with the stakeholders outside the scope of a planning group .…”

“…Reasons for exclusion are described in the flowchart in Figure 1 according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses recommendations. 17 Sixteen intervention/development studies were identified [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33] referring to 15 interventions.…”

Development and Pre-Testing of a Rehabilitation Planning Consultation for Head-and-Neck Cancer

“…Using our previously developed rehabilitation needs assessment 8 , a list of potential concerns amenable to rehabilitation was developed to help individual survivors prioritize and develop goals. That list evolved into the Brief Rehabilitation Assessment for Survivors of Head-and-Neck Cancer (brash).…”

“…Access to rehabilitation for survivors of hn cancer is limited by a lack of convenient, affordable, hn-cancer-specific services; lack of awareness about rehabilitation; lack of confidence on the part of the hn cancer clinical team about the quality and value of existing community-based services; and survivor challenges with self-advocating for services 7 . Our goal was to develop and evaluate a rehabilitation planning consultation (rpc) for survivors of hn cancer to be integrated within the existing health system 8 .…”

“…The advisory panel was consulted at all key development junctures. We used literature review, focus groups, and advisory panel input to establish the rehabilitation needs of survivors, a preliminary version of which is published in the research protocol for the present project 8 . In the previously conducted step 2, the investigative team and advisory panel defined these objectives for the rpc:…”