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Table 2 Intervention fidelity strategies (adapted)

From: Implementing a nurse-enabled, integrated, shared-care model involving specialists and general practitioners in breast cancer post-treatment follow-up: a study protocol for a phase II randomised controlled trial (the EMINENT trial)

Goal

Strategies

Training providers

Specialist Cancer Nurses will be trained to standardise the delivery of the intervention to study participants. Training includes provision of study manual containing

 • Generic study information: standard operating procedures, study overview, reporting and documentation guidelines, communication flowchart, rationale for the study treatment, completion of survivorship care plan, self-management goal setting, and health coaching

 • Specialist Cancer Nurse-specific information: job description, intervention protocol, quality assurance, and monitoring

An 8-h training program will be delivered by Experts in Cancer Survivorship and motivational interviewing. The program includes the National Cancer Nursing Education (EdCAN) learning module on survivorship, related literature, didactic presentations, and roleplay covering: basic concepts of quality cancer survivorship care, components of a high-quality treatment summary and survivorship care plan; provision of self-management support (including collaborative goal setting; motivational interviewing); and MBS item numbers that facilitate the proposed Model of Care.

Delivery of intervention

Intervention procedures are monitored through completion of intervention component checklists to ensure that the intervention is delivered as intended. Intervention checklists are completed during Clinics and GP Case Conferences to track protocol deviations across Specialist Cancer Nurses and study Arms. The intervention fidelity is closely monitored and discussed during the weekly 30-min meeting for the first 3 months of the trial between the Specialist cancer Nurses, research nurses, and investigators.

Minimising contamination between conditions by training interventionists to address participant questions about randomisation and their assigned condition using non-biased explanations.

Receipt of intervention

The SCP serves as a resource for a participant to understand and refer to whenever they are unsure of follow-up schedule and collaborative goal setting.

Enactment of treatment skills

Enactment of treatment skills includes processes to monitor and improve participant ability to perform treatment-related behavioural skills and cognitive strategies in relevant real-life settings as intended. This goal will be achieved by ensuring participants are aware of the follow-up schedules and responsibilities of all health professionals, ensuring participants will have a copy of the completed SCP including all care responsibilities and goals set for the individual, and checking in with participants once in the first week into the model, then monthly/bimonthly until the end of the trial period as resources allow.