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

Primary care implementation of paediatric cancer survivorship care plans: A qualitative study of practitioner perspectives (126678)

Joseph Elias 1 2 , Jordana McLoone 2 3 , Christina Signorelli 2 3 , Shuang Liang 1 , Skye McKay 1 , Carolyn Mazariego 1 , Claire E Wakefield 3 4 , Richard J Cohn 2 3 , Joseph E Alchin 2 3 , Natalie Taylor 1
  1. Implementation to Impact, School of Population Health, UNSW Medicine & Health, Randwick, NSW, Australia
  2. Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
  3. Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Randwick, NSW, Australia
  4. Division of Quality of Life and Pediatric Palliative Care, Department of Pediatrics, Stanford University and Stanford Medicine Children’s Health, Palo Alto, California, USA

Objectives/Purpose: The responsibility for ongoing care of childhood cancer survivors (CCSs) has increasingly transitioned to community and primary settings. Though many Primary Care Practitioners (PCPs) report limited preparedness and knowledge in managing survivorship needs. Engage, a remote survivorship intervention for CCSs, delivered tailored survivorship care plans (SCPs) from oncology teams to PCPs to support their delivery of CCS care outside of hospital settings. Our qualitative study aimed to explore PCPs’ preferences on the design of personalised SCPs as well as implementation barriers and enablers to their routine integration in primary care.

Sample and Setting: Twenty PCPs from seven Australian states participated. Most were female (70%), trained in Australia (65%), and practicing in private (90%), metropolitan (75%) clinics. Participants were recruited via primary care networks and referrals linked to the Engage program.

Procedures: We conducted semi-structured interviews with PCPs, informed by implementation science and cognitive-interviewing principles. We performed a hybrid thematic analysis in NVivo-14. First, we deductively coded transcripts to the Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF). Inductive analysis was informed by phenomenological methods to reveal emerging themes.

Results: PCPs found Engage SCPs acceptable, appropriate, and mostly feasible to implement, considering them a valuable educational resource. PCPs preferred compact SCPs that clearly highlighted actions and priorities, used visual techniques to summarise dense information (e.g., tables), included specialist contact details, and explained the rationale for recommendations. PCPs identified implementation factors at a systems level including limited access to specialist or community services, provider level including limited clinic time and practice software constraints, and patient level including difficulties coordinating care for financially disadvantaged or rural survivors.

Conclusion and Clinical Implications: Our findings underscore the need for streamlined, user-friendly SCPs, enhanced PCP education, and stronger links with oncology teams to support sustainable, equitable survivorship care in primary settings.