Strategies to Optimise Intervention Fidelity in a Randomised Controlled Trial

This scientific poster presents the strategies developed and implemented to optimise intervention fidelity within the INSPIRE project (Integrated Short-Term Palliative Rehabilitation in Incurable Cancer), a multinational randomised controlled trial investigating a complex rehabilitation intervention for people with incurable cancer. The work aims to describe the strategies used to support consistent intervention delivery and transparent reporting, ensuring that trial outcomes can be interpreted in relation to the intervention delivered. Three implementation strategies were developed: Development of an Intervention Manual: A theoretically informed and feasibility-tested manual was refined for the effectiveness trial. It includes guidance for delivering the intervention, supporting documentation and resources for rehabilitation practitioners. The manual was translated into French, Italian, Danish, Norwegian and Czech. Training for rehabilitation practitioners: A combination of asynchronous learning resources and in-person training was developed to support intervention delivery. A total of 26 rehabilitation practitioners across six countries accessed the manual and 12 asynchronous presentations before attending in-person training between February and November 2024. Establishment of a Community of Practice: Monthly online meetings were introduced in September 2024 to support rehabilitation practitioners, promote knowledge exchange and minimise intervention drift. Attendance rates exceeded 80%, with discussions covering intervention components, patient needs, inclusive practices and practical delivery challenges. The poster reports how these strategies were implemented across participating study sites and discusses their potential contribution to intervention fidelity and accurate reporting of the INSPIRE rehabilitation intervention. The findings highlight the importance of structured training, standardised intervention guidance and ongoing professional support when delivering complex rehabilitation interventions across multiple healthcare settings. Project: INSPIRE – Integrated Short-Term Palliative Rehabilitation in Incurable Cancer. Poster number: 787.