The pre-pilot phase sets out to iteratively develop the intervention, integrating support for physical activity and meaningful occupation, to produce therapist and patient materials ready for the pilot RCT, and to develop training to train those delivering the ACT+ intervention. It will also involve focus groups/interviews with patients and stakeholders, and delivery of the ACT+ intervention to a small number of patients, with interviews following.

The main aim is to answer the question: Can we recruit and retain sufficient participants, with outcome data, in an RCT?

We will run a pilot RCT to test the trial procedures in three centres – Barts, UCLH and Sheffield NHS Foundation Trusts, focusing on screening, recruitment, engagement with therapy, and retention with outcome data. We will recruit 45 participants in total, 15 from each centre.

Research question
Is ACT+ more effective and cost-effective than usual aftercare in improving QoL at one year follow up inpatients living with and beyond cancer, whilst remaining as safe as usual after care?

The design is a pragmatic, parallel two arm, randomised trial, comparing ACT+, added to usual aftercare, versus usual aftercare.

Participants (n=299) will be recruited from hospital clinics in three or more centres currently including: Barts Health and UCLH in London, and Sheffield NHS Trusts

We aim to conduct a qualitative study of experience of ACT+ amongst participants to understand contextual factors affecting trial participant including therapists

We will be trying to answer: what predicts response to any treatment? What moderates response to ACT+? What predicts costs and cost-effectiveness? What mediates the efficacy of ACT+?