{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T03:49:36Z","timestamp":1789876176284,"version":"4.0.1"},"reference-count":45,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007602","name":"Programme Grants for Applied Research","doi-asserted-by":"publisher","award":["NIHR200861"],"award-info":[{"award-number":["NIHR200861"]}],"id":[{"id":"10.13039\/501100007602","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,1,28]]},"published-print":{"date-parts":[[2026,2]]},"abstract":"\n Objectives<\/jats:title>\n Due to increasing incidence of head and neck cancer (HNC) and overwhelming clinical demand on follow-up services, a new risk-stratified pathway, patient-initiated follow-up (PIFU) with a patient support package is being evaluated (PETNECK2 study). We aimed to (a) explore acceptability to both HNC patients and health professionals and the impact on self-management behaviours including self-surveillance and fear of cancer recurrence and (b) conduct intervention optimisation.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Qualitative interviews conducted 1\u20132 months after receiving the PIFU support package.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Eight hospital trusts across the UK.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n 25 patients around 1-year post-HNC treatment receiving the PETNECK2 intervention, and 7 health professionals from NHS Trusts involved in recruitment and\/or intervention delivery.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n All patients received the intervention (PIFU) following a clear PET-CT scan, which included a face-to-face education session with a health professional and a digital app and\/or booklet, that aimed to support engagement in PIFU self-care behaviours (including regularly checking for symptom changes; prompt help-seeking; self-management of fear of recurrence). Patients had open access to their hospital team if concerns arose.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The PIFU intervention with a patient support package was largely acceptable to health professionals and most patients. Engagement in new habitual self-care behaviours was evident in most, influenced by having increased knowledge and confidence regarding these behaviours, provided by key elements of the PIFU support package (eg, demonstration of self-examination). Acceptability appeared lower in a few patients reporting low self-efficacy for self-examination, ongoing challenges with fear of recurrence and concerns over no scheduled appointments.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Our intervention support package was largely acceptable and promoted patient engagement with PIFU and key self-management behaviours. Findings can usefully inform the design of future PIFU support packages and highlight important considerations for future evaluations of patient acceptability of PIFU pathways. Following intervention optimisation, a UK-wide trial is now underway.<\/jats:p>\n <\/jats:sec>\n \n Trial registration number<\/jats:title>\n \n ISRCTN13709798<\/jats:ext-link>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-099993","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T14:40:23Z","timestamp":1772203223000},"page":"e099993","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Promoting engagement in patient-initiated follow-up and self-care behaviours: acceptability of the \u2018ACT now & check-it-out\u2019 intervention for head and neck cancer (PETNECK2 study)"],"prefix":"10.1136","volume":"16","clinical-trial-number":[{"clinical-trial-number":"isrctn13709798","registry":"10.18810\/isrctn"},{"clinical-trial-number":"isrctn13709798","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2828-7528","authenticated-orcid":false,"given":"Lauren","family":"Matheson","sequence":"first","affiliation":[{"name":"Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3592-1315","authenticated-orcid":false,"given":"Eila","family":"Watson","sequence":"additional","affiliation":[{"name":"Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9857-1834","authenticated-orcid":false,"given":"Tessa","family":"Fulton-Lieuw","sequence":"additional","affiliation":[{"name":"Department of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9315-0361","authenticated-orcid":false,"given":"Saloni","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8665-300X","authenticated-orcid":false,"given":"Piers","family":"Gaunt","sequence":"additional","affiliation":[{"name":"Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Sissons","sequence":"additional","affiliation":[{"name":"Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evaggelia","family":"Liaskou","sequence":"additional","affiliation":[{"name":"Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6000-9093","authenticated-orcid":false,"given":"Claire","family":"Gaunt","sequence":"additional","affiliation":[{"name":"Cancer Research UK Clinical Trials Unit, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4664-6117","authenticated-orcid":false,"given":"Paul","family":"Nankivell","sequence":"additional","affiliation":[{"name":"Department of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5544-6224","authenticated-orcid":false,"given":"Hisham","family":"Mehanna","sequence":"additional","affiliation":[{"name":"Department of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5116-4238","authenticated-orcid":false,"given":"Jo","family":"Brett","sequence":"additional","affiliation":[{"name":"Oxford School of Nursing and Midwifery, Oxford Brookes University, Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"2026022706401728000_16.2.e099993.1","unstructured":"Cancer Research UK . 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