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A nested interview study explores the patient preferences and the multi-perspective view of patients, relatives and health professionals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In total, 42 surgical patients with \u22651 SNAP factor are allocated to individually tailored STRONG programme or usual care during adjuvant chemotherapy prior to radical bladder cancer surgery. The STRONG programme has \u22656 weekly sessions with patient education, motivational and pharmaceutical support. It is based on intensive smoking and alcohol cessation interventions reporting perioperative quit rates &gt;\u200950%.<\/jats:p><jats:p>Surgical risk reduction is measured as \u22651 step for 1 or more risky lifestyles on the ASA-score, secondly as having no risky SNAP factors, and as any SNAP improvement. The outcomes are validated by measurements and biomarkers. Postoperative complications are categorised according to the Clavien-Dindo classification. Health-related quality of life is measured by EQ-5D.<\/jats:p><jats:p>The patients are followed up after 6\u2009weeks at surgery and 6\u2009weeks and 6\u2009months postoperatively.<\/jats:p><jats:p>A representative sample of the participants, their relatives and the clinical staff are interviewed until data saturation. Transcription, triangulated analyses and data management are conducted using NVivo computer software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The surgical agenda is characterised by fixed dates for surgery focusing on clear risk reduction within a short time. This requires a clinical useful lifestyle intervention programme with a high effect and coverage as well as containing all SNAP factors and tailored to individual needs.<\/jats:p><jats:p>The STRONG programme seems to meet these requirements. After development in multi-professional collaboration, STRONG is delivered by a specially trained nurse as part of the surgical patient journey.<\/jats:p><jats:p>Overall, this study will bring important new knowledge about risk reduction in a frail patient group undergoing major cancer surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration<\/jats:title><jats:p>Registration at<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clintrials.gov\">www.clintrials.gov<\/jats:ext-link>(<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/register.clinicaltrials.gov\">NCT04088968<\/jats:ext-link>)<\/jats:p><jats:p>The manuscript form from<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/trialsjournal.biomedcentral.com\/bmc\/journal\">https:\/\/trialsjournal.biomedcentral.com\/bmc\/journal<\/jats:ext-link>and the SPIRIT guidelines are followed.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s13063-022-06272-2","type":"journal-article","created":{"date-parts":[[2022,4,21]],"date-time":"2022-04-21T12:04:41Z","timestamp":1650542681000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["STRONG for Surgery &amp; Strong for Life \u2014 against all odds: intensive prehabilitation including smoking, nutrition, alcohol and physical activity for risk reduction in cancer surgery \u2014 a protocol for an RCT with nested interview study (STRONG-Cancer)"],"prefix":"10.1186","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7161-3416","authenticated-orcid":false,"given":"Hanne","family":"T\u00f8nnesen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Line Noes","family":"Lydom","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulla Nordstr\u00f6m","family":"Joensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingrid","family":"Egerod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helle","family":"Pappot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne Vahr","family":"Lauridsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,4,21]]},"reference":[{"issue":"1","key":"6272_CR1","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/j.eururo.2017.07.036","volume":"73","author":"M Roupret","year":"2018","unstructured":"Roupret M, Babjuk M, Comperat E, Zigeuner R, Sylvester RJ, Burger M, et al. 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