Aims
Australians in rural and remote areas may experience delays in cancer diagnosis and treatment commencement of up to 53 days, compared to their metropolitan counterparts, contributing to poorer survival. To reduce this inequity, the Equitable Cancer Outcomes across Rural and Remote Australia (ECORRA) Project was launched in 2024 to co-design and embed an implementation package to support rural and remote cancer services to align with the Optimal Care Pathways (OCPs), as recommended in the Australian Cancer Plan.
Methods
The ECORRA Project, funded by the Medical Research Future Fund, uses best practice recommendations to co-design a sustainable and scalable, evidence-informed, implementation package for rural and remote health services. Commencing 2024, Phase 1 uses the Theoretical Domains Framework to guide interviews with professional and consumer stakeholders to identify the key determinants influencing the implementation of the diagnosis- and treatment-related components of the OCPs. Relevant determinants will then be mapped to implementation strategies. Commencing 2025 and drawing upon Phase 1 results and realist reviews, Phase 2 will conduct a series of workshops with diverse and representative stakeholders from rural and remote Australia to co-design and refine an implementation package prototype. From 2026-2029, a pragmatic stepped-wedge cluster randomised trial will embed and evaluate the implementation package in 14 rural and remote cancer care services across South Australia, Victoria, and Queensland.
Results
The ECORRA implementation package is hypothesised to improve adherence to the diagnosis- and treatment-related components of the OCPs in rural and remote cancer services, to be acceptable and feasible, and lead to reduced healthcare costs. Partnerships with stakeholder organisations and representatives have been formalised via the ECORRA Charter and will facilitate nationwide scaling from 2029 onwards.
Conclusions
The ECORRA Project represents a substantial investment and commitment to reduce inequity in cancer diagnosis and treatment services for rural and remote Australians nationally.