A main takeaway from a methodological perspective for me is the power of triangulating qualitative (interviews & field notes) and quantitative methods to account for context when appraising effect. Many other key considerations and takeaways can be found in the paper/ my thesis.

What did we learn from the process evaluation? Participants found small incremental physical activity goals motivating and enjoyed meeting relatable, but did not feel confident to organise this themselves in the early stages, and so deficits in their social health persisted during the intervention.

Given this is a feasibility trial, we cannot ascertain any intervention effects. However, we did see that physical activity levels increased when measured by accelerometry, yet quality of life was seen to decrease when using the EORTC QOLO-C30 and depression and anxiety improved when using HADS. ⁉️

Only 3 group walks took place over the course of the 12-week intervention, and these were highly enjoyable and beneficial. Compliance with group walking was affected by Covid-19 but in addition, participants would have preferred research team led organisation of this aspect rather than peer led.

However, plot twist: Covid pandemic stayed around for implementation. Despite this, there was an acceptable retention rate of 77%. The Fitbit was perceived to be the most enjoyable aspect followed by the health coaching:

Each participant received education on physical activity, a Fitbit to monitor their activity, daily diaries and fortnightly health coaching to reflect on and redefine goals and were allocated to groups with other survivors and encouraged to walk together.

ACCEPTANCE was designed as a technology and community based behaviour change intervention to increase physical activity (mainly walking) in line with WHO guidance during the cervical cancer survivorship period.

Really proud to share this paper which is an accumulation of 3.5 years of work to plan, implement and evaluate this trial, and even more time (post PhD) of writing. Here is a brief thread on what we happened:

Ah yes true! Indeed it’s useful to proactively think then about the practicalities of dealing with a dataset where some data can be analysed by AI and some cannot. Thanks!

Thanks for sharing- the worked examples are really insightful! I wonder whether the choice to analyse data using AI should also consider participant’s feelings and attitudes around its use (e.g., via informed consent) or in your experience is it primarily driven by considerations of the research?

Hi Michael, this is a really accessible paper and the practical tips on balancing continuity and flexibility are great for the stage we are at. Thanks for sharing!

Interested in the EPSA method? Please take a read and feel free to reach out. Since we are in the preprint stage I would be interested to hear if you have any thoughts on the study or on the topic in general!

This is why we wanted to write a paper which transparently details our co-creation process, the aim of which was to update and refine a conceptual model for the Affirm Relationships project, using the EPSA method.

Balancing the prioritisation of co-created and other forms of knowledge is common during scientific conceptualization stages of research. However, a lack of transparency around this process can lead to disempowerment of Lived Experienced Experts and perpetuate processes of extractive research.

We know that the practice of co-creation can be empowering as Lived Experienced Experts can create knowledge and influence research processes. But, what happens to this co-created knowledge? How is it used and prioritized when other knowledge on a topic (e.g, derived from theory) already exists?

Within AFFIRM Relationships, I lead the qualitative and participatory research. So, I am looking forward to connecting with other qualitative and participatory health researchers working in LGBTQ+ health, intervention implementation and/ or physical activity promotion. Feel free to reach out!😀

I am now working within a multidisciplinary team on an exciting project called AFFIRM Relationships in NL. This project is advancing the field of transgender health by triangulating different methods to explore the effect of gender affirming hormone therapy on social well-being and relationships.