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

Barriers and enablers to implementing a digital health intervention into a community-based cancer organisation: an evaluation using the Consolidated Framework for Implementation Research (126533)

Eleanor G Wilson 1 , Sarah Dwyer 2 , Amanda Winiata 2 , Ben Smith 1 , Rebecca Raeside 3 , Stephanie R Partridge 3 4 , Siobhan Dunne 2 , Nehmat Houssami 1 5 , Elisabeth Elder 5 6 , Julie Redfern 3 7 , Anna C Singleton 1
  1. The Daffodil Centre, University of Sydney, Camperdown, NSW, Australia
  2. Breast Cancer Network Australia, Melbourne, VIC, Australia
  3. Susan Wakil School of Nursing and Midwifery, University of Sydney, Camperdown, NSW, Australia
  4. Charles Perkins Centre, University of Sydney, Camperdown, NSW, Australia
  5. School of Public Health, University of Sydney, Camperdown, NSW, Australia
  6. Sydney Medical School, University of Sydney, Camperdown, NSW, Australia
  7. Institute for Evidence-Based Healthcare, Bond University, Gold Coast, QLD, Australia

Objectives/purpose: In the past decade, >100,000 Australians finished initial breast cancer treatment; ~67% experience unmet support needs. Digital health interventions, including text messaging, are effective for improving perceived support and psychosocial outcomes (e.g., distress, depression), but are rarely implemented in hospital-care (barriers: limited staff time, infrastructure-interoperability). IPOS and international health organisations identified that community-based organisations are underutilised in delivering psychosocial care. This mixed-methods study evaluated barriers and enablers to implementing EMPOWER-SMS, a text message intervention for early-stage breast cancer survivors, within Breast Cancer Network Australia (BCNA).

Sample and setting: Eligibility: current BCNA staff or trained consumer representatives involved in implementing EMPOWER-SMS. BCNA is Australia’s peak consumer-led breast cancer support organisation.

Procedures: Participants were recruited via internal email and provided verbal consent. Data sources: team meetings, focus groups (recorded and transcribed); standard operating procedures and project documentation. Transcripts were parallel coded by two researchers using deductive thematic analysis mapped to the updated Consolidated Framework for Implementation Research across 5 domains (example sub-domains); Outer-setting (policies, community need), Inner-setting (IT infrastructure, communications), Innovation/intervention (evidence-based, adaptability), Individual (skills, capacity), Implementation process (planning, assessing need).

Preliminary results: Participants: 13 staff from 4 teams and 2 consumer representatives. Key barriers included grant deadlines (Outer-setting), competing priorities (Inner-setting); adapting content to BCNA’s ‘voice/brand’ (Innovation); new SMS infrastructure requirements, limited system interoperability, role adjustments and experts’ limited availability (Individual), and mapping internal approvals (Process). Enablers included alignment with BCNA’s member priorities (Outer-setting); high organisational readiness and willingness to adapt (Inner-setting); strong staff support (junior-senior), relevant skills, and creative problem-solving (Individuals); and use of existing meetings to engage core teams (Process).

Conclusion/clinical implications: New organisational systems and processes will be evaluated in a pilot-implementation to rural/remote members before national roll-out and adaptation to other priority population (e.g., metastatic). Results will also form implementation strategies for other community-based cancer organisations.