Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Integrating nutritional interventions into cancer care: a systematic review informed by implementation science (126155)

Shuang Liang 1 , Niamh Fanning 2 , Amanda Landers 2 , Helen Brown 3 , Catriona Rother 4 , Fong Fu 2 , Guillaume Fontaine 5 6 7 8 , April Morrow 1 , Natalie Taylor 1
  1. School of Population Health, Faculty of Medicine and Health, UNSW, Sydney, NSW, Australia
  2. Department of Medicine, University of Otago, Christchurch, New Zealand
  3. Nurse Maude Hospice Palliative Care Service, Nurse Maude Association, Christchurch, New Zealand
  4. Wellington Blood and Cancer Centre, Te Whatu Ora Capital, Wellington, New Zealand
  5. Methodological and Implementation Research, Ottawa Hospital Research Institute, Ottawa, Canada
  6. Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
  7. Centre for Clinical Epidemiology, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis Jewish General Hospital, Montréal, Canada
  8. Kirby Institute, University of New South Wales, Sydney, Australia

Objectives/purpose: Nutritional care is a critical component of oncology treatment, yet its integration into clinical practice remains limited. Implementation science offers valuable frameworks to identify factors influencing the delivery of care, map key intervention components, and describe implementation outcomes. This systematic review aimed to identify and synthesise the barriers, strategies, and outcomes in relation to implementation efforts related to evidence-based nutrition in cancer care.

Sample and setting: A comprehensive search was conducted across 10 electronic databases up to December 2024. Search terms were designed to capture key concepts related to nutrition, cancer, and implementation. Studies were included if they described implementation efforts within healthcare setting.

Procedures: Data extraction encompassed study characteristics, intervention details, implementation-related information, including barriers, strategies, and outcomes. Implementation data were coded using the updated Consolidated Framework for Implementation Research (CFIR 2.0), Expert Recommendations for Implementing Change (ERIC), Theoretical Domains Framework (TDF), Behavior Change Techniques (BCT), and Proctor’s outcomes framework. The CFIR-ERIC matching tool and TDF-BCT linkage tool were used to assess alignment between current practice and existing evidence.

Results: From 5,168 records identified, 4,055 abstracts and 165 full texts were screened, resulting in 38 articles from 31 unique studies meeting inclusion criteria. Nutrition interventions fell into four main categories: risk screening/assessment (n = 5), care planning/pathways (n = 17), nutritional monitoring (n = 3), and support guidelines (n = 6). The most frequently reported barriers were limited clinician awareness of nutritional care guidelines, along with resource constraints. A range of implementation strategies and BCTs were identified, with a core group consistently applied across studies.

Conclusion and clinical implications: Successful implementation appears to hinge on practical guidance, trusted communication, and contextual understanding. Implementation science should guide future efforts, with further research warranted to determine the active ingredients that drive effective and sustainable implementation of nutritional care in oncology.