Realist Collaborative Evaluation of a Work Disability Prevention Program for Breast Cancer Survivors: Protocol for a RECOVA-FASTRACS Realist Evaluation.

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Background: Women with breast cancer face many barriers to returning to work (RTW) after their treatment. The Facilitating and Sustaining the Return to Work After Breast Cancer (FASTRACS) intervention aims to facilitate and sustain functional RTW. Objective: The main objective of the RECOVA-FASTRACS (Realist Collaborative Evaluation of a Work Disability Prevention Program for Breast Cancer Survivors) study is to evaluate the processes using a realist approach that analyzes what works, how, for whom, and under what circumstances. Methods: The RECOVA-FASTRACS study uses a mixed methods design to assess the implementation, context, and impact mechanisms of the FASTRACS intervention. The qualitative analysis will include 2 main components: a trajectory analysis and a focus group assessment. The trajectory analysis will examine the experiences of women who participated in the intervention and key individuals involved in their RTW process. We will use semistructured interviews according to the multiple-case study method. Additionally, to explore organizational and professional practices, focus groups will be conducted with professionals who deliver the intervention. To analyze the trajectories, embedded and iterative integration will combine the qualitative findings with relevant quantitative data from the FASTRACS randomized controlled trial for 5 domains: personal situation, professional situation, RTW, care pathway, intervention tool use, and perceived usefulness. Results: The RECOVA-FASTRACS study received funding in 2022. Recruitment and qualitative data collection began in month 6. Final analyses are expected to be completed by the end of 2026, with dissemination of the main findings anticipated in late 2027. Conclusions: Our mixed methods realist evaluation will provide a detailed analysis of the intervention processes, helping to identify impact mechanisms within specific contexts. This approach is meant to ensure a more informed and realist deployment of the intervention by professionals following the study.

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