The Teleprehabilitaiton intervention (also known as Surgery School) is a one-off group based education session delivered online. Video presentations of 7 key prehabilitation education areas will be facilitated by a live clinician facilitator who will introduce the educational content and answer any questions. All standardised video presentations during the session will be made available to participants through an online password-protected video repository hosted on a video platform after the session and will be available until their surgery.

An individualised inspiratory muscle training and walking program delivered by a Physiotherapist using telehealth.

Usual care alone. Usual care will be reviewed every four months during the trial and site leads will be asked to provide information about any changes to usual hospital and medical care at their site.

DAoH-30, DAoH-180, DAoH-365 (days alive and out of hospital 30, 180, 365 days post operatively): a patient centric metric and composite outcome that integrates several clinically important outcomes: hospital length of stay, re-admission or discharge to a destination other than origin (usually home) as well as survival. Higher numbers indicate a greater time alive and out of hospital post operatively.

Maximal Inspiratory Pressure (cm H2O) will be assessed using a small handheld device using 3 tests of inspiratory muscle strength recording the highest value. Undertaken at centres participating in the sub study.

Physical activity levels will be documented subjectively using the International Physical Activity Questionnaire - Short Form (IPAQ-SF). The IPAQ-SF is a questionnaire used internationally to obtain comparable estimates of physical activity. The questionnaire comprises seven questions related to physical activity at different levels of intensity and sitting time. Results will be reported in categories (low activity levels, moderate activity levels or high activity levels) and a continuous variable (MET minutes a week). Higher METs or categories indicate higher levels of physical activity.

Physical activity levels will be collected objectively using wearable monitors, such as fitbits for three days at baseline, three days after the intervention and at 30 days postoperatively. Physical activity variables will include the total number of daily steps, daily minutes of moderate to vigorous physical activity (MVPA), peak 1-minute cadence (the highest single minute of steps recorded), and peak 30-minute cadence (the average steps/min for the highest non-consecutive 30 minutes in a day). A minimum of 8 hours over 3 days is considered valid wear time for physical activity data. Values are described using mean +/- standard deviation and mean difference (MD) with 95% confidence intervals (95% CI).

Attendance at Surgery School session, length of time attended the Surgery School session and number of questions asked during Surgery School session.

The number of times the videos are accessed outside of the Surgery School session, site, day of week, time of day will be collected. Number of questions asked during Surgery School session.

The electronic Edmonton Symptom Assessment System-revised ((e)ESAS-r) is a 10-item assessment tool for self-reporting symptom intensity via electronic platforms for digital use. The (e)ESAS-r allows participants to rate the severity of common symptoms as well as the opportunity to rate 'other problems' as nominated by the participant on a scale from 0 to 10 with higher score indicating higher severity of symptoms

Behaviour change will be measured using a bespoke questionnaire: STTARRS behaviour change questionnaire (SBCQ) developed to assess patient action related to information (a) contained within the videos and surgery school session (intervention group) and (b) for usual care participants information provided to them through educational materials. This patient reported experience measure will measure responses to questions on a 5-point Likert scale (strongly disagree to strongly agree). Results will be presented descriptively. Higher responses on the likert scales indicates a higher agreement.

Patient Activation Measure (PAM) is a questionnaire assessing three key domains: knowledge, skills, confidence to understand self-management ability. The PAM is a 13-item survey scored on a 100 point scale, with 4 activation levels validated for across time measures and used world-wide. PAM Levels 1 and 2 indicate lower patient activation, while PAM levels 3 and 4 indicate higher patient activation.

Multimorbidity Treatment Burden Questionnaire (MTBQ) is a 13 item questionnaire that assesses the perception of the effort required to self-manage their medical conditions and the impact that this has on their wellbeing. The MTBQ has demonstrated good content and construct validity, reliability and responsiveness. The MTBQ is scored from 0-100 with higher scores indicating higher treatment burden which fall into four categories: no burden (score 0), low burden (score <10), medium burden (10-22) and high burden (>=22).

Viewer perceptions of the intervention including perceived personal relevance will be assessed using a previously published questionnaire. The questionnaire includes questions on four domains: helpfulness, believability, novelty, and relevance of information. A total of 7 questions all rate on 0-6 Likert scales from strongly disagree to strongly agree, with higher score indicating stronger agreement and an additional yes/no question asked regarding whether participants intend to change any behaviours.

Portion of eligible patients participating will be collected and reported as a percentage of all patients eligible for the trial.

Representativeness relative to a wider group of eligible patients presented descriptively

Actual teleprehabilitation referral rates as a % of total eligible to be referred

Reasons for declining will be reported descriptively.

Participants will be asked to complete a survey regarding trial acceptability. The survey questions will be based upon the Theoretical Framework of Acceptability. The framework comprises seven domains designed to assess acceptability elements: perceived effectiveness, self-efficacy, affective attitude, ethicality burden, intervention coherence and opportunity costs.

Treatment delivery: using duration of education session provided (minutes).

Treatment delivery: total number of videos accessed, presented descriptively and also by video title.

Treatment delivery: using number of videos viewed, results presented descriptively .

Treatment delivery (centre level): using process concordance with implementation protocol.

Treatment delivery: using the time of participant viewing (minutes).

Treatment receipt: % of participants who attend a session once booked in

Treatment receipt: the number of questions per session will be recorded.

Treatment receipt: the number of participants attending follow up will be recorded (% of total participants).

The Australian Hospital Patient Experience Question Set (AHPEQS) is a 12-item questionnaire (ten core items and two sub-items) used to measure patient satisfaction with recent treatment. Questions are measured on responses from always to never or didn't apply. Results will be reported descriptively with positive responses indicating greater satisfaction with recent treatment.

European Organisation for the Research and Treatment of Cancer (EORTC QLQ- C30) core questionnaire is a measure composed of five multi-item domains (physical, role, emotional, cognitive function and social functioning). All of the scales and single-item measures range in score from 0 to 100. A high scale score represents a higher response level. A high score for a functional scale represents a high/healthy level of functioning. A high score for the global health status / quality of life represents a high quality of life but a high score for a symptom scale / item represents a high level of symptomatology / problems. The EORTC QLQ-C30 Summary score will also be reported and is calculated from the mean of 13 of the 15 QLQ-C30 scale, with higher score indicating a higher quality of life. This tool has established validity and reliability in cancer.

The Postoperative Quality of Recovery Score (PostopQRS) is a multidimensional recovery assessment tool that is a verbal questionnaire. It has proven patient user acceptance and has been validated to be performed either face to face or over the telephone. The core domains include physiologic, nociceptive, functional, cognitive and emotional recovery and satisfaction with care, that is designed for use over multiple timepoints. The PostopQRS provides objective assessment of post-operative recovery, analysing the core domains of recovery, namely physiologic, nociceptive, functional, cognitive and emotional recovery compared to a unique individual preoperative baseline score. Recovery is then scored for each domain, and patients must recover in all tests within the domain to be scored as recovered. "All domains" recovery implies recovery in all of the five recovery domains.

Length of hospital stay will be documented from the medical records by a blinded assessor at each centre.

Captured in following ways:

(i) hospital services and the use of health care services outside of hospital. (ii) Patients will be surveyed on their use of health services outside the hospital at 6 and 12 months postop follow-up using a questionnaire. (iii) Cost of program delivery

Teleprehabilitation is an intervention suitable for patients of low to moderately high perioperative risk levels, however subgroup analyses based on risk provide the opportunity to explore if teleprehabilitation offers additional benefits to patients of increasing risk level. Surgical procedure: Differences in PPC rates between the two surgical groups (abdominal and lung) and between those receiving or not receiving neo-adjuvant therapy before abdominal cancer surgery will be explored.

After consent, participants' demographic data will be extracted from their medical record, including height (cm).

After consent, participants' demographic data will be extracted from their medical record, including weight (kg).

After consent, participants' demographic data will be extracted from their medical record, including primary language spoken (name of).

After consent, participants' clinical data will be extracted from their medical record, including proposed surgery (category of abdominal cancer or lung cancer surgery) and description of surgery.

After consent, participants' clinical data will be extracted from their medical record, including medical conditions.

After consent, participants' social data will be extracted from their medical record, including living situation, living alone (yes/no).

After consent, participants' social data will be extracted from their medical record, including living situation, if they have a partner (yes/no).

After consent, participants' demographic data will be extracted from their medical record, including work status.

After consent, participants' demographic data will be extracted from their medical record, including postcode (zip code).

The American Society of Anaesthesiologists (ASA) score is a longstanding score that includes a subjective assessment of a patient's overall health according to five classes; (i) Patient is a completely healthy fit patient, (ii) Patient has mild systemic disease, (iii) Patient has severe systematic disease that is not incapacitating, (iii) Patient has severe systemic disease that is not incapacitating, (iv) Patient has incapacitating disease that is a constant threat to life or (v) A moribund patient who is not expected to live 24 hours with or without surgery. A higher category indicates higher risk.

The Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score is a valid tool for determining a patient's risk score for developing postoperative pulmonary complications. A higher score indicates higher risk of postoperative pulmonary complications and is classified as: low risk <26, intermediate risk: 26-44, and high risk : >=45.

Frailty is a multidimensional geriatric syndrome characterised by a decline of physical and cognitive reserves that leads to increased vulnerability. It will be measured using the modified Reported Edmonton Frail Scale. The scale is a questionnaire with 13 items with a total score of 0 to 18. Scores are converted into the following categories: (0-5) not frail, (6-7) apparently vulnerable, (8-9) mild frailty, (10-11) moderate frailty and (12-18) severe frailty.

Patients will be followed to assess if they are alive at 12 months post operatively.

Intraoperative details of surgical procedure, type of anaesthesia and reversal agent