Specifying pathway requirements for mobile outreach cancer testing before rollout: an implementation-aware Target Product Profile method
File(s)
Published version (in press)
Author(s)
Kierkegaard, Patrick
Su, Bowen
Moghul, Masood
Cahill, Declan
James, Nicholas David
Type
Journal Article
Abstract
Background: Mobile cancer-testing services can widen access by taking testing to community or workplace sites. But the test is only one part of the pathway: eligibility explanation, informed choice, privacy, documentation, result communication, referral, and follow-up move outside clinics. Unless specified before rollout, these tasks can make a service easier to attend but harder to govern. In diagnostic-test development, a Target Product Profile is an advance brief defining a test’s intended users, use setting, and minimum and preferred features. To create an equivalent brief for outreach services, we adapted that approach into an implementation-aware Target Product Profile (iTPP). The iTPP turns evidence on delivery and handover into a requirement register, separating what must be in place, what would improve quality, what depends on local set-up, and what needs further evidence.
Methods: We conducted a qualitative method-development study using the Man Van mobile prostate-specific antigen (PSA) testing pathway as an exemplar, not an effectiveness evaluation. We interviewed attenders (n = 23), planning and delivery stakeholders (n = 13), and prospective stakeholders (n = 11). Using the Framework Method and abductive analysis, we charted interview evidence, converted delivery and handover issues into requirement statements, judged consequences of absence, and placed unresolved quantitative or operational questions in an Evidence and Decision Agenda.
Results: The method produced a Man Van-derived register with 42 attributes across six clusters: outreach legitimacy; privacy and dignity; deliverability; test acceptability and performance uncertainty; counselling and next steps; and data integration with primary care. Handover requirements centred on result ownership, record integration, safety-netting, and loop closure: documented responsibility acceptance by a named receiving service when action was required. Diagnostic thresholds, referral ratios, staffing ratios, outreach pacing, unit costs, and equity effects were treated as questions for further evidence, not universal requirements.
Conclusions: The iTPP is a pre-rollout method for specifying mobile outreach cancer-testing pathways before local adaptation, implementation, or evaluation. It identifies what should be preserved, what can vary by context, and what should remain open until stronger evidence is available. This PSA exemplar demonstrates the method; it does not establish service effectiveness, validate iTPP as an independent instrument, or recommend population screening.
Methods: We conducted a qualitative method-development study using the Man Van mobile prostate-specific antigen (PSA) testing pathway as an exemplar, not an effectiveness evaluation. We interviewed attenders (n = 23), planning and delivery stakeholders (n = 13), and prospective stakeholders (n = 11). Using the Framework Method and abductive analysis, we charted interview evidence, converted delivery and handover issues into requirement statements, judged consequences of absence, and placed unresolved quantitative or operational questions in an Evidence and Decision Agenda.
Results: The method produced a Man Van-derived register with 42 attributes across six clusters: outreach legitimacy; privacy and dignity; deliverability; test acceptability and performance uncertainty; counselling and next steps; and data integration with primary care. Handover requirements centred on result ownership, record integration, safety-netting, and loop closure: documented responsibility acceptance by a named receiving service when action was required. Diagnostic thresholds, referral ratios, staffing ratios, outreach pacing, unit costs, and equity effects were treated as questions for further evidence, not universal requirements.
Conclusions: The iTPP is a pre-rollout method for specifying mobile outreach cancer-testing pathways before local adaptation, implementation, or evaluation. It identifies what should be preserved, what can vary by context, and what should remain open until stronger evidence is available. This PSA exemplar demonstrates the method; it does not establish service effectiveness, validate iTPP as an independent instrument, or recommend population screening.
Date Issued
2026-07-16
Date Acceptance
2026-07-10
Citation
Implementation Science Communications, 2026
ISSN
2662-2211
Publisher
BMC
Journal / Book Title
Implementation Science Communications
Copyright Statement
© The Author(s) 2026. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
License URL
Identifier
10.1186/s43058-026-01041-7
Subjects
Implementation Science
Mobile Health Units
Qualitative Research
Adaptation
Cancer testing
Implementation planning
Implementation-aware target product profile
Pathway specification
Target product profile
Publication Status
Published online
Date Publish Online
2026-07-16