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

Utilizing an implementation science framework to evaluate provider perspectives on inpatient physical therapy adherence in adolescents and young adults with hematological malignancies  (126433)

Jennifer A. Kelleher 1 , Jennifer L. Bernstein 2 , Katia M. Crisler 3 , Julia K. Herriott 1 , Kimberly L. Klages 1 4 5 , Robin E. Norris 3 5 , Mariann Strenk 2 , Meghan E. McGrady 1 4 5
  1. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  2. Division of Occupational and Physical Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  3. Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  4. Patient and Family Wellness Center, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
  5. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States

Objectives/purpose: Inpatient physical therapy (iPT) can minimize or reverse declines in physical functioning faced by adolescents and young adults (AYAs) with hematologic malignancies, but most AYAs do not receive the recommended dose of iPT during hospital admissions. This qualitative study explored healthcare providers’ perceptions of barriers and facilitators to iPT to inform efforts to promote AYA iPT engagement.

Sample and setting: Purposive sampling was used to recruit providers involved in facilitating iPT to AYAs with hematologic malignancies at a pediatric medical center in the United States. Four oncologists, three nurses, and two physical therapists participated (N=9; 56% female, 44% male; M[SD]=10.78[8.53] years in independent practice).

Procedures: Providers completed a semi-structured interview. A Consolidated Framework for Implementation Research (CFIR)-based deductive rapid qualitative analysis approach was used to derive information on iPT barriers and facilitators from interviews. We are using the CFIR-ERIC (Expert Recommendations for Implementing Change) matching tool to match barriers and facilitators to potential implementation strategies.

Results: Providers identified barriers and/or facilitators to iPT across 29 CFIR constructs with common constructs reported here (italicized). Barriers included communications (“I don't feel like we…discuss…[physical therapy] like as a whole crew...”, “ideally the nurse would communicate with us immediately”), work infrastructure (“I wish we had the ability to have physical therapists on the weekends…”), and the relative priority of iPT (“unfortunately, there are other, more acute, pressing concerns…”). Teaming or coordinating services (“…we [nursing] try to coordinate…a time that they [physical therapists] can see them [AYAs]”) facilitated iPT. CFIR-ERIC barriers/facilitators and their matched implementation strategies will be presented alongside relevant quotes.

Conclusions and clinical implications: Both organizational and provider-related factors affect iPT adherence in AYAs with hematological malignancies. The CFIR-ERIC matching tool offers actionable guidance for implementation teams in addressing barriers and enhancing AYA engagement in iPT, supporting AYA health.