Implementing evidence-based psychological treatments for cancer patients.
Williams KC, Brothers BM, Ryba MM, Andersen BL
Psychooncology 24 1618-25 12/01/2015
OBJECTIVE: New regulations and guidelines require implementation of screening and evidence based psychological treatment (EBT) for cancer patients, but little research exists to assist psychosocial care providers with implementation. This study aimed to develop a conceptual framework for community providers to consider as they embark on implementation of EBTs.
METHODS: Full-time psychosocial care providers received dissemination training in delivery of a cancer-specific EBT and then received implementation support. Qualitative data were collected in two phases. In Phase I, after training, trainees (N = 52) participated in six monthly group conference calls with six to eight trainees and EBT trainers. Qualitative data from the calls were analyzed using a grounded theory paradigm. In Phase II, the resultant framework was piloted with additional trainees (N = 73) during EBT training to prompt early planning for implementation at their home institutions.
RESULTS: In Phase I, themes of 'person' (i.e. attitudes, vocalizations, and behaviors of others) and 'environment' factors (i.e. material, monetary, and time resources of organizations) affecting implementation emerged. It appeared that both factors influenced how easily barriers could be addressed, although positive person factors also appeared to positively influence environment factors. In Phase II, trainees found the framework acceptable and considered it when generating solutions for implementation challenges.
CONCLUSIONS: The framework suggests tailoring implementation efforts to consider person and environment factors. As person support is developed, resource limitations of the environment may be more easily addressed.