ABSTRACTPrimary AimTo describe the features of implementation in the setting of primary care (PC) for physical activity (PA) interventions that improved total and moderate to vigorous PA (MVPA).Secondary AimTo assess the scalability potential of effective PC PA interventions.MethodA comprehensive search was conducted across multiple electronic databases to identify relevant studies published between 2012 and 2023. Implementation‐related features were extracted, and the scalability potential of effective PC PA interventions was assessed using the Intervention Scalability Tool (ISAT) as a framework.ResultsTwenty‐six studies met the inclusion criteria after screening. Analysis of the implementation‐related features revealed that effective PC PA interventions showed promising reach with a mean participation rate of 43%. Effective PC PA interventions that increased PA were mostly delivered by nurses and were underpinned by the behavioural change techniques (BCTs) of goal setting, feedback and self‐monitoring. The scalability assessment revealed that remote‐based interventions and those delivered by nurses had moderate to high scores in the scalability domains of fidelity, reach and acceptability, delivery setting and workforce, implementation infrastructure and sustainability.ConclusionPC PA interventions, whether delivered remotely or face‐to‐face, show promise for increasing PA, especially when incorporating BCTs like goal setting and feedback. Using the ISAT, most interventions displayed promise for implementation at scale, but further examination is needed concerning the delivery setting, implementation infrastructure and sustainability of these interventions. Remote‐based (automated PA advice and mailed instructions) PA interventions and those delivered in contact with a nurse showed high scalability potential. Further work that examines the acceptability and effectiveness of other healthcare professionals in intervention delivery would be worthwhile, and more work is needed to assess the utility and effectiveness of remote‐based PA interventions in PC.

Prehabilitation and rehabilitation will be essential services in an ageing population to support patients with cancer to live well through their life spans. Active Together is a novel evidence-based service embedded within existing healthcare pathways in an innovative collaboration between health, academic, and charity organisations. Designed to improve outcomes for cancer patients and reduce the demand on healthcare resources, it offers physical, nutritional, and psychological prehabilitation and rehabilitation support to patients undergoing cancer treatment. The service is underpinned by behaviour change theories and an individualised and personalised approach to care, addressing the health inequalities that might come about through age, poverty, ethnicity, or culture. Meeting the challenge of delivering high-quality services across multiple stakeholders, while addressing the complexity of patient need, has required skilled leadership, flexibility, and innovation. To support patients equally, regardless of geography or demographics, future services will need to be scaled regionally and be available in locations amenable to the populations they serve. To deliver these services across wide geographic regions, involving multiple providers and complex patient pathways, will require a systems approach. This means embracing and addressing the complexity of the contexts within which these services are delivered, to ensure efficient, high-quality provision of care, while supporting staff well-being and meeting the needs of patients.

Background: Physical activity (PA) contributes to the prevention and management of many health conditions. Primary care practitioners have an important role to play in supporting people to be physically active. Aim: This study had the following three aims: 1) to explore GPs‘ awareness and knowledge of the PA guidelines; 2) to assess GPs’ confidence in promoting PA; and 3) to explore factors that influence PA promotion among GPs. Design & setting: Cross-sectional survey, using secondary analysis. Method: UK-based GPs were invited to take part in an online survey in January 2021. Demographic questions were followed by nine multiple choice questions. Categorical data were analysed using descriptive statistics, and open-ended data were analysed using content analysis and inductive coding. Results: In total, 839 GPs based in England completed the survey. Most GP responders (98.9%) believed that PA was important, yet only 35.7% reported being at least ‘somewhat familiar’ with current PA guidance. Despite this, 74.1% of GPs reported feeling confident raising the topic of PA with their patients. Barriers included lack of time, perceptions of patient attitude and risk, language issues, and COVID-19. Key facilitators were identified and ‘Couch to 5k’ and the ‘parkrun practice’ initiatives were the most widely used support tools. Conclusion: GPs value PA yet well-known barriers exist to embedding promotion into primary care. As primary care reconfigures, there is an opportunity to embed PA into systems, services, and processes.

Abstract Purpose The Active Together service provides multimodal rehabilitation support for people affected by cancer, embedded within clinical pathways at all stages of cancer treatment. The service aims to improve patient outcomes, such as physical fitness prior to surgery, tolerance to treatments, post-operative complications, and survival rates. Project description The design of the Active Together service was informed by extensive stakeholder engagement, involving consultations with patients and health professionals to determine the key elements of an impactful and sustainable rehabilitation service. Informal discussion groups and co-design workshops were held to understand ‘what mattered most’ to patients and to develop key features of the service. The Active Together service is delivered by a multi-disciplinary team at the Advanced Wellbeing Research Centre at Sheffield Hallam University, in partnership with Sheffield Teaching Hospitals and Yorkshire Cancer Research. Patients with a cancer diagnosis, over the age of 18 years and receiving treatment with curative intent are referred to the service, which provides exercise, nutritional and psychological support throughout their treatment. The evaluation aims to determine the impact of the service on patient outcomes and any economic benefits to the wider healthcare system. Outcome measures are captured throughout the patients’ treatment to assess the impact on their physical, nutritional, and psychological state. Economic evaluation will assess its effect on the costs of patients’ treatment, compared to patients that received treatment for cancer without rehabilitation. Initially, the Active Together service has provided support to patients in Sheffield, being treated for one of three specific forms of cancer: lung, colorectal and upper gastrointestinal. Over the next 2-3 years, the service will be scaled-up to provide support to patients receiving treatment for other forms of cancer at hospitals across Yorkshire. Findings will be disseminated to key stakeholders within the healthcare system and in academic journals. Conclusions Evidence to support the role of multi-modal rehabilitation for cancer patients is growing. The translation of that evidence into practice is less advanced. The results of this evaluation will provide valuable insight into service implementation and an understanding of the impact of cancer rehabilitation on both patient outcomes and the health economic landscape.

Background to the Active Hospital Pilot In 2017, Public Health England (PHE) and Sport England (SE) appointed Oxford University Hospital Foundation Trust (OUHFT) to deliver an Active Hospital pilot. The pilot focused on the integration of physical activity into care pathways within secondary care. Aims of the Active Hospital pilot The aim of the Active Hospital pilot was to create an 'Active Hospital' by embedding an SEM consultant led PA service within an NHS Trust to integrate PA into the care plans of patients. This was tested across five clinical pathways within OUHFT where PA has not previously been targeted as a treatment intervention. The evaluation of the Active Hospital pilot The National Centre for Sport and Exercise Medicine (NCSEM), in partnership with Sheffield Hallam University (SHU), were commissioned by PHE and SE to conduct an independent evaluation of the Active Hospital pilot. Primary and secondary aims of the Active Hospital pilot evaluation The primary aim of the evaluation was to explore the acceptability and feasibility of multi-disciplinary SEM teams delivering targeted and tailored support to integrate PA into the care plans of OUHFT patients. The secondary aims were to: i) Explore secondary care HCPs baseline perceptions of SEM clinical advice in the context of clinical patient care. ii) Determine clinical acceptability of SEM intervention with HCPs and with patients. iii) Identify what works and what doesn’t work in establishing this model of SEM PA provision in secondary care. iv) Understand the uptake of SEM PA provision in different clinical pathways and by different clinical teams within secondary care.

Abstract PurposeNEWDAY-ABC (North England Women’s Diet and ActivitY After Breast Cancer) trial is a bespoke weight management and behaviour change intervention for women treated for early-stage estrogen-receptor positive breast cancer (BC) with a body mass index (BMI) of ≥25 kg/m2. Many women are overweight or report further weight gain during and after BC-treatment. Due to the complex nature of weight management, NEWDAY-ABC was co-designed with BC-survivors and health care professionals (HCPs) prior to the COVID-19 outbreak. However, because of the COVID-19 pandemic, refinements had to be made to the intervention to enable remote (virtual) delivery options, allowing the trial to proceed while adhering to government social distancing and shielding guidance. MethodsPrior to the COVID-19 outbreak, initial focus groups (FG) were conducted with n=16 BC-survivors and n=21 HCPs. Framework analysis was used to categorise what BC-survivors want from a weight management intervention. Participants (n=9) subsequently attended a two-stage successive interactive co-design workshop. Workshop 1 explored: i) techniques to motivate change; ii) approaches to overcome challenges to intervention adherence; iii) core components of the intervention. Workshop 2 explored: i) language and graphics used for the support and educational materials; ii) delivery mechanisms; iii) refinement of workshop 1 ideas. Results / findingsCo-design revealed the intervention should address: i) self-confidence and self-esteem; ii) reassurance of safe physical activity (PA) and dietary guidance for BC-survivors; iii) knowledge about what happens to the body after treatment. In terms of intervention delivery: i) self-monitoring of weight should be optional; ii) content should be as visual as possible iii) emotional needs are as important to address as PA and dietary recommendations; iv) one-to-one facilitator support is as important as group peer-support. To integrate all these elements, the NEWDAY-ABC intervention included face-to-face group support sessions. However, due to the COVID-19 pandemic, remote delivery options had to be embedded into the intervention design to enable this support to be provided via means that are accessible to all eligible participants, whilst adhering to the guidance on social distancing and shielding of vulnerable populations. Key considerations include:•Participant and session leader’s ability to access and engage with remote delivery•Creating a peer supportive environment remotely•Remote platform security•Effectiveness of remote delivery in achieving clinically meaningful weight loss ConclusionsThe COVID-19 pandemic has forced cancer care to quickly adapt to ways of providing remote support to meet the needs of cancer patients and survivors. While this presents many challenges, including issues of accessibility, privacy and accessing peer support, use of virtual delivery platforms and new technologies means that BC-survivors can still access this bespoke weight management intervention during an extended period of post-pandemic social distancing. The effectiveness of the NEWDAY-ABC intervention in providing the required level of peer support, guidance and self-confidence needed for clinically meaningful weight loss with virtual delivery options will be tested in a randomised controlled trial. Citation Format: Katie Pickering, Sarah Wane, Helen Speake, Helen Crank, Annie Anderson, Henry Cain, Rob Copeland, Daniela Lee, Joanne Gray, Richard McNally, Jackie Hargreaves, Judith Cohen, Matthew Northgraves, Caroline Wilson, John Saxton. The new normal; adjusting to remote ways of providing bespoke weight management support to breast cancer survivors during the COVID-19 global pandemic [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS8-26.

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

BACKGROUND:Growing levels of both obesity and chronic disease in the general population pose a major public health problem. In the UK, an innovative 'health and weight' cohort trials facility, the 'South Yorkshire Cohort', is being built in order to provide robust evidence to inform policy, commissioning and clinical decisions in this field. This protocol reports the design of the facility and outlines the recruitment phase methods.METHOD/DESIGN:The South Yorkshire Cohort health and weight study uses the cohort multiple randomised controlled trial design. This design recruits a large observational cohort of patients with the condition(s) of interest which then provides a facility for multiple randomised controlled trials (with large representative samples of participants, long term outcomes as standard, increased comparability between each trial conducted within the cohort and increased efficiency particularly for trials of expensive interventions) as well as ongoing information as to the natural history of the condition and treatment as usual.This study aims to recruit 20,000 participants to the population based South Yorkshire Cohort health and weight research trials facility. Participants are recruited by invitation letters from their General Practitioners. Data is collected using postal and/or online patient self completed Health Questionnaires. NHS numbers will be used to facilitate record linkage and access to routine data. Participants are eligible if they are: aged 16 - 85 years, registered with one of 40 practices in South Yorkshire, provide consent for further contact from the researchers and to have their information used to look at the benefit of health treatments. The first wave of data is being collected during 2010/12 and further waves are planned at 2 - 5 year intervals for the planned 20 year duration of the facility.DISCUSSION:The South Yorkshire Cohort combines the strengths of the standard observational, longitudinal cohort study design with a population based cohort facility for multiple randomised controlled trials in a range of long term health and weight related conditions (including obesity). This infrastructure will allow the rapid and cheap identification and recruitment of patients, and facilitate the provision of robust evidence to inform the management and self-management of health and weight.