A complex intervention to improve life experience during and after acute treatment for breast cancer: Preliminary results from intervention development for the Continuum PAROLE-Onco 360 program.

introductionIn Quebec, 87% of women diagnosed with breast cancer report lingering after-effects, such as fatigue, chronic pain, and difficulty returning to work after treatment. The Continuum PAROLE-Onco (CPO) 360 program addresses these complex and various unmet needs through a comprehensive and patient partnership intervention.

objectivesThe objectives of this study are to (1) explore the development process of the CPO 360 program during its inaugural year, with particular focus on the co-construction approach involving patient co-investigators (PCIs) and accompanying patients (APs), and (2) identify key insights to inform subsequent phases of feasibility and pilot testing, evaluation, and implementation, in alignment with a framework on complex interventions. METHODOLOGY: A qualitative multiple-case study was conducted across three Quebec university hospitals to evaluate the first year of the CPO 360 program's implementation. The study focuses on how key components of this complex intervention were developed and adapted within real-world settings. Data sources included program documents, semi-structured interviews with accompanying patients, and a focus group with patient co-investigators. Thematic analysis was used to interpret the data, and the findings were reported in accordance with the COREQ checklist for qualitative research.

resultsThe findings highlight several key developments: the creation of training programs for accompanying patients (APs), the design of tools to support patients during care transitions, challenges related to data access and the implementation of needs-based stratification, the development of strategies to educate and engage healthcare professionals, and efforts to raise awareness among primary care teams regarding patient follow-up.

conclusionThis first phase in the development of the CPO 360 intervention is part of a dynamic, iterative, creative process that is open to change and forward-looking in its implementation. The co-construction process involving patients, professionals, and the community from the outset enables the development of a shared vision of how to improve the transition process in three different environments. Adjustments to its implementation will need to take account of intersectoral coordination and access to clinical resources.