251 Optimising engagement and addressing inequalities for patients using a Digital Behaviour Change Intervention in lung cancer prehabilitation: A mixed-methods study

Abstract

Introduction Surgery has the best proven cure rates for early stage lung cancer, but is only offered to patients with sufficient cardiorespiratory fitness. Prehabilitation helps patients optimise fitness before treatment to improve outcomes. Barts Health introduced a mobile prehabilitation App 'Living with Lung Cancer' in 2023. Digital Behaviour Change Interventions (DBCI) such as this can be used to support prehabilitation provision, however success depends on patient uptake and engagement. Patients from the diverse East London population may face greater inequalities in healthcare and digital access limiting prehabilitation success. Methods We are conducting a convergent-parallel mixed-methods study to identify the barriers and facilitators to uptake and engagement with the prehabilitation App and inform the development of an intervention addressing inequalities in use. Qualitative interviews with patients and healthcare professionals will explore barriers and facilitators to uptake and engagement with the prehabilitation App. Thematic analysis guided by theoretical underpinnings (e.g. COM-B Model) will generate insights to guide the design of an intervention to optimise uptake and engagement. Quantitative analysis of usage data will explore uptake and engagement with the prehabilitation App. Analysis will identify inequalities in use by demographic groups and provide a measure of success during intervention development. Results Interventions may include; in-App assessments, educational modules, a standardised on-boarding process, or identification of patients who may require additional support. Findings will be reviewed in a mixed stakeholder co-design workshop, informed by 'The Person-Based Approach'. Guidelines for development and implementation of the prehabilitation App and future DBCIs will be produced. Conclusion DBCIs should be tailored to optimally and equitably support prehabilitation in lung cancer care to address inequalities in healthcare access and outcomes. By improving patient fitness through prehabilitation, previously borderline patients may safely undergo curative treatments and face fewer post-operative complications, in turn improving survival rates and reducing healthcare costs. Disclosure No significant relationships.