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      Acceptability and Feasibility of a Return-to-Work Intervention for Posttreatment Breast Cancer Survivors: Protocol for a Co-design and Development Study

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          Abstract

          Background

          The mortality rate from breast cancer has been declining for many years, and the population size of working-age survivors is steadily increasing. However, the recurrent side effects of cancer and its treatment can result in multiple disabilities and disruptions to day-to-day life, including work disruptions. Despite the existing knowledge of best practices regarding return to work (RTW) for breast cancer survivors, only a few interdisciplinary interventions have been developed to address the individualized needs and multiple challenges of breast cancer survivors, health care professionals, and employer and insurer representatives. Thus, it seems appropriate to develop RTW interventions collaboratively by using a co-design approach with these specific stakeholders.

          Objective

          This paper presents a protocol for developing and testing an innovative, interdisciplinary pilot intervention based on a co-design approach to better support RTW and job retention after breast cancer treatment.

          Methods

          First, a participatory research approach will be used to develop the intervention in a co-design workshop with 12 to 20 participants, including people affected by cancer, employer and insurer representatives, and health care professionals. Next, a pilot intervention will be tested in a primary care setting with 6 to 8 women affected by breast cancer. The acceptability and feasibility of the pilot intervention will be pretested through semistructured interviews with participants, health care professionals, and involved patient partners. The transcribed data will undergo an iterative content analysis.

          Results

          The first phase of the project—the co-design workshop—was completed in June 2021. The pilot test of the intervention will begin in spring 2022. The results from the test will be available in late 2022.

          Conclusions

          The project will offer novel data regarding the use of the co-design approach for the development of innovative, co-designed interventions. In addition, it will be possible to document the acceptability and feasibility of the pilot intervention with a primary care team. Depending on the results obtained, the intervention could be implemented on a larger scale.

          International Registered Report Identifier (IRRID)

          DERR1-10.2196/37009

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          Most cited references76

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          How Many Interviews Are Enough?: An Experiment with Data Saturation and Variability

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            Developing and evaluating complex interventions: the new Medical Research Council guidance

            Evaluating complex interventions is complicated. The Medical Research Council's evaluation framework (2000) brought welcome clarity to the task. Now the council has updated its guidance
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              Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010.

              Measuring disease and injury burden in populations requires a composite metric that captures both premature mortality and the prevalence and severity of ill-health. The 1990 Global Burden of Disease study proposed disability-adjusted life years (DALYs) to measure disease burden. No comprehensive update of disease burden worldwide incorporating a systematic reassessment of disease and injury-specific epidemiology has been done since the 1990 study. We aimed to calculate disease burden worldwide and for 21 regions for 1990, 2005, and 2010 with methods to enable meaningful comparisons over time. We calculated DALYs as the sum of years of life lost (YLLs) and years lived with disability (YLDs). DALYs were calculated for 291 causes, 20 age groups, both sexes, and for 187 countries, and aggregated to regional and global estimates of disease burden for three points in time with strictly comparable definitions and methods. YLLs were calculated from age-sex-country-time-specific estimates of mortality by cause, with death by standardised lost life expectancy at each age. YLDs were calculated as prevalence of 1160 disabling sequelae, by age, sex, and cause, and weighted by new disability weights for each health state. Neither YLLs nor YLDs were age-weighted or discounted. Uncertainty around cause-specific DALYs was calculated incorporating uncertainty in levels of all-cause mortality, cause-specific mortality, prevalence, and disability weights. Global DALYs remained stable from 1990 (2·503 billion) to 2010 (2·490 billion). Crude DALYs per 1000 decreased by 23% (472 per 1000 to 361 per 1000). An important shift has occurred in DALY composition with the contribution of deaths and disability among children (younger than 5 years of age) declining from 41% of global DALYs in 1990 to 25% in 2010. YLLs typically account for about half of disease burden in more developed regions (high-income Asia Pacific, western Europe, high-income North America, and Australasia), rising to over 80% of DALYs in sub-Saharan Africa. In 1990, 47% of DALYs worldwide were from communicable, maternal, neonatal, and nutritional disorders, 43% from non-communicable diseases, and 10% from injuries. By 2010, this had shifted to 35%, 54%, and 11%, respectively. Ischaemic heart disease was the leading cause of DALYs worldwide in 2010 (up from fourth rank in 1990, increasing by 29%), followed by lower respiratory infections (top rank in 1990; 44% decline in DALYs), stroke (fifth in 1990; 19% increase), diarrhoeal diseases (second in 1990; 51% decrease), and HIV/AIDS (33rd in 1990; 351% increase). Major depressive disorder increased from 15th to 11th rank (37% increase) and road injury from 12th to 10th rank (34% increase). Substantial heterogeneity exists in rankings of leading causes of disease burden among regions. Global disease burden has continued to shift away from communicable to non-communicable diseases and from premature death to years lived with disability. In sub-Saharan Africa, however, many communicable, maternal, neonatal, and nutritional disorders remain the dominant causes of disease burden. The rising burden from mental and behavioural disorders, musculoskeletal disorders, and diabetes will impose new challenges on health systems. Regional heterogeneity highlights the importance of understanding local burden of disease and setting goals and targets for the post-2015 agenda taking such patterns into account. Because of improved definitions, methods, and data, these results for 1990 and 2010 supersede all previously published Global Burden of Disease results. Bill & Melinda Gates Foundation. Copyright © 2012 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                JMIR Res Protoc
                JMIR Res Protoc
                ResProt
                JMIR Research Protocols
                JMIR Publications (Toronto, Canada )
                1929-0748
                April 2022
                22 April 2022
                : 11
                : 4
                : e37009
                Affiliations
                [1 ] Faculty of Nursing University of Montreal Montreal, QC Canada
                [2 ] Centre de recherche Hopital Maisonneuve Rosemont Montreal, QC Canada
                [3 ] Faculté de médecine et des sciences de la santé University of Sherbrooke Longueuil, QC Canada
                [4 ] Département de relations industrielles Université du Québec à Trois-Rivières Trois-Rivières, QC Canada
                [5 ] Département de relations industrielles Université du Québec en Outaouais Gatineau, QC Canada
                [6 ] Ingram School of Nursing Mcgill University Montreal, QC Canada
                [7 ] Centre intégré universitaire de santé et de services sociaux de l'Est de l'île de Montréal Montréal, QC Canada
                [8 ] Faculté de l'aménagement École de Design Université de Montréal Montreal, QC Canada
                Author notes
                Corresponding Author: Karine Bilodeau karine.bilodeau.2@ 123456umontreal.ca
                Author information
                https://orcid.org/0000-0002-0705-3426
                https://orcid.org/0000-0002-6534-4897
                https://orcid.org/0000-0002-4485-7829
                https://orcid.org/0000-0002-1841-1380
                https://orcid.org/0000-0002-4443-9387
                https://orcid.org/0000-0003-2137-6560
                https://orcid.org/0000-0002-6489-9276
                https://orcid.org/0000-0001-8078-5722
                https://orcid.org/0000-0002-3312-9770
                Article
                v11i4e37009
                10.2196/37009
                9077508
                35451972
                8691c3bd-3876-48c3-a1f8-be1c4df38f95
                ©Karine Bilodeau, Marie-Michelle Gouin, Alexandra Lecours, Valérie Lederer, Marie-José Durand, Kelley Kilpatrick, David Lepage, Lauriane Ladouceur-Deslauriers, Tomas Dorta. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 22.04.2022.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Research Protocols, is properly cited. The complete bibliographic information, a link to the original publication on https://www.researchprotocols.org, as well as this copyright and license information must be included.

                History
                : 25 February 2022
                : 10 March 2022
                : 24 March 2022
                : 29 March 2022
                Categories
                Protocol
                Protocol
                Custom metadata
                This paper was externally peer-reviewed by the Quebec Rehabilitation Research Network (Réseau Provincial de Recherche en Adaptation-Réadaptation, REPAR) - Réseau thématique soutenu par le FRQS - Programme 1.1 Recherche clinique 2020-2021 (Montréal, Canada). See the Multimedia Appendix for the peer-review report;

                co-design,breast cancer,intervention,return-to-work,primary care,qualitative

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