Implementing an online-delivered exercise program for childhood cancer survivors: A hybrid effectiveness-implementation protocol for the MERRIER study

JSAMS plus Pub Date : 2025-03-12 DOI:10.1016/j.jsampl.2025.100095

David Mizrahi , Alexandra Martiniuk , Laurence Hibbert , Dinisha Govender , Tora Sibbald , Richard Mitchell , Natalia Millard , Lauren Ha , Damian Ragusa , Kylie Brown , Ben Smith

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Abstract

Background

Physical activity levels are low in childhood cancer survivors. Structured physical activity programs are not routinely provided, despite being safe and beneficial for improving physical and psychological health. Innovative health promotion programs delivered online may allow families to receive equitable health support, which may foster survivors to improve their health.

Aims

To determine implementation factors of an online exercise program recruited through a community organization, and effectiveness on physical activity levels and self-efficacy for childhood cancer survivors.

Methods and analysis

The MERRIER study is a type-1 hybrid effectiveness-implementation. Sixty children (5–18 years old) who have completed treatment for any cancer type will be enrolled between March 2025 and June 2026. Participants will be randomised (stratified by age, cancer type and sex) 1:1 to 3-months multimodal exercise or control group. The intervention group will receive five online consultations with an Accredited Exercise Physiologist to provide behaviour counselling, and prescribe an individualised aerobic, resistance and balance exercise program at low-moderate intensity. The RE-AIM framework will assess reach (e.g. recruitment rate), effectiveness (e.g. physical activity levels), adoption (e.g. qualitative interviews), implementation (e.g. exercise adherence), and maintenance (e.g. self-efficacy at follow-up). Physical function and patient-reported outcomes will be assessed at baseline (T0), post-intervention (T1; week 12) and follow-up (T2, week 24). An Axivity AX3 accelerometer will measure physical activity over five-days at T0/T1.