Depression is up to four times more common among individuals with cancer compared with the general population. Psychological therapies are effective in treating depression among patients in cancer care, but access is often delayed, which can exacerbate symptoms, increase dropout and reduce therapeutic effectiveness. This study evaluates the clinical and cost-effectiveness of a therapy preparation intervention (TPI) designed to enhance engagement and outcomes among patients awaiting psychological therapy in cancer care.

This study is a parallel-group, two-arm, multicentre, single-blind randomised controlled trial. A total of 150 adults (≥18 years) living with or beyond cancer and experiencing moderate-to-severe depression will be recruited from health services in the East Midlands region of England. Participants will be randomised (1:1) to receive either TPI plus treatment as usual (TAU) or TAU alone.

The primary outcome is depression severity measured using the Patient Health Questionnaire 9-items (PHQ-9) over a 24-week follow-up. Secondary outcomes include anxiety, functioning, mental well-being, patient activation, readiness for change, health-related quality of life and health economics, and therapy engagement including attendance and dropout. Hope and in-session patient activation, assessed using recorded treatment preparation sessions, will be explored as additional mechanistic variables. Health economic outcomes will be assessed at baseline and 24 weeks. Data will be collected via online or telephone surveys at baseline, and at 4, 8, 12 and 24 weeks post randomisation. Qualitative interviews with a subset of participants will explore intervention experiences, analysed using reflexive thematic analysis.

Ethical approval has been obtained from the Health Research Authority and National Health Service Research Ethics Committee (Bromley) (REC reference: 24/LO/0610). Findings will be disseminated through peer-reviewed journals, academic conferences and clinical and patient networks.

ISRCTN registry: ISRCTN13692666, registered on 18 October 2024.

To assess cardiovascular health (CVH) metrics using the American Heart Association’s Life’s Simple 7 (LS7) tool as a comprehensive measure of several metabolic and behavioural risk factors for cardiovascular diseases.

Cross-sectional study, nationally representative Iran STEPwise approach to non-communicable diseases risk factor surveillance (STEPS) survey 2021.

Iran, 2020–2021.

25 202 adult individuals aged 25 years and older participated in the STEPS survey.

Using the LS7 framework, seven factors were assessed: current smoking, body mass index (BMI), physical activity level, modified healthy diet score components, total cholesterol, blood pressure and fasting plasma glucose (FPG). Each factor was categorised into three levels of poor, intermediate and ideal, according to the LS7 methodology.

The study participants had a sex distribution of 55.5% females. The findings revealed a high prevalence of ideal levels of smoking (80.1%; 95% CI 79.3 to 81.0), total cholesterol (69.4%; 95% CI 68.5 to 70.4) and FPG (61.0%; 95% CI 60.0 to 62.1). BMI and blood pressure were ideal in about one-third of the population (33.0%; 95% CI 32.1 to 34.0, and 30.5%; 95% CI 29.6 to 31.4, respectively). However, only 13.3% (95% CI 12.6 to 14.0) of participants achieved ideal levels of physical activity, and a mere 0.4% (95% CI 0.3 to 0.6) adhered to an ideal healthy diet. Modest disparities in CVH metrics were observed across provinces and between two sexes. Ideal CVH status was significantly associated with lower risks of major diseases such as ischaemic heart disease, diabetes and chronic kidney disease.

Despite favourable scores in some CVH metrics, critical gaps in diet and physical activity highlight the need for intensive public health efforts to enhance CVH in Iran. The study emphasises the urgency of implementing region- and sex-specific public health policies.