# Feasibility and acceptability of a preoperative checklist health promotion in elective surgery in the UK: a mixed-methods study protocol

## TL;DR

This study tests a checklist to improve health promotion for patients with multiple long-term conditions before elective surgery in the UK.

## Contribution

A co-designed preoperative checklist is evaluated for feasibility and acceptability in identifying and managing long-term conditions.

## Key findings

- The checklist will be tested in a UK NHS trust with up to 50 patients.
- Mixed-methods data will assess recruitment, retention, and acceptability of the checklist.
- Findings will inform a future pilot trial on preoperative health promotion.

## Abstract

Multimorbidity or the presence of two or more long-term conditions is now common in people undergoing surgery. However, current care pathways often miss these healthcare encounters to support long-term health promotion. Therefore, there is a need for practical, scalable approaches that can be integrated into routine surgical care, for which limited solutions exist at present. We have co-designed a structured preoperative checklist to help identify and manage long-term conditions in patients listed for elective surgery. This study aims to evaluate the feasibility and acceptability of this preoperative checklist in patients undergoing elective surgery.

This is a mixed-methods feasibility study in one National Health Service trust in the UK. We will recruit up to 50 adults scheduled for elective surgery and use the checklist during initial surgical clinic appointments. Quantitative data will include recruitment and retention rates, completion of the checklist and baseline clinical characteristics, analysed using descriptive statistics. Qualitative data will be collected through semistructured interviews with up to 16 patients and clinicians. These interviews will be analysed thematically, guided by the Consolidated Framework for Implementation Research. Triangulation of quantitative and qualitative data will allow us to explore fidelity, acceptability, barriers and facilitators to implementation and refine the intervention ahead of a future pilot cluster randomised trial.

This study has received approval from the Yorkshire & The Humber - Sheffield Research Ethics Committee (approval number: 25/YH/0045). All participants will give written informed consent. Results will be published in peer-reviewed journals and shared with participants, the public and policy stakeholders.