Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

Support group leaders’ perspectives on factors affecting implementation of professionally-led groups for metastatic breast cancer: a qualitative study using Consolidated Framework for Implementation Research (CFIR-2.0)   (#397)

Zhicheng Li 1 , Melanie Hamilton 1 , Frances Boyle 2 3 , Michele Daly 4 , Pia Hirsch 5 , Fiona Dinner 6 , Kim Hobbs 7 , Laura Kirsten 8 , Sophie Lewis 3 , Carolyn Mazariego 9 , Ros McAuley 10 , Mary O'Brien 11 , Amanda O’Reilly 12 , Natalie Taylor 9 , Lisa Tobin 13 , Andrea Smith 1
  1. The Daffodil Centre, University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
  2. Mater Hospital, Sydney, NSW, Australia
  3. Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
  4. Consumer Advisory Panel, Cancer Institute, Sydney, NSW, Australia
  5. Advanced Breast Cancer Group, Brisbane, QLD, Australia
  6. Consumer representative, Melbourne, VIC, Australia
  7. Westmead Centre for Gynaecological Cancers, Sydney, NSW, Australia
  8. Nepean Cancer Care Centre, Sydney, NSW, Australia
  9. Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
  10. Think Pink, Melbourne, VIC, Australia
  11. Advanced Breast Cancer Group, Brisbane, Qld, Australia
  12. Support group facilitator , Sydney, NSW, Australia
  13. Breast Cancer Network Australia, Camberwell, VIC, Australia

Aim: To understand factors critical to successful implementation of professionally-led metastatic breast cancer (MBC) support groups in Australia.   

Method: In-depth interviews with leaders of professionally-led MBC support groups (n=20) about experiences of running MBC groups, views on ideal group structure, and perceptions of factors affecting implementation of groups. Recruitment ceased once thematic saturation was reached. Transcripts were analysed thematically, and implementation factors mapped to Proctor’s Implementation Framework1 and CFIR-2.0.2

Results: Interview data relating to implementation determinants were mapped to 13 constructs across four CFIR-2.0 domains: (1) Innovation (innovation complexity and adaptability); (2) Inner Setting (available resources, culture, compatibility, access to knowledge and information); (3) Individuals (needs, capability, and motivation of the innovation deliverers; needs and opportunity of the innovation recipients); and (4) Outer Setting (critical incidents and local attitudes). The identified implementation determinants affected the acceptability, feasibility, and sustainability of the support groups. Examples of key implementation determinants included: having suitably skilled and experienced support group leaders capable of managing and supporting a high-needs and potentially vulnerable population; access to sustainable funding and resources; an organisation’s ‘patient-centredness’ and appreciation of the value and importance of MBC groups to patients; and leader’s ability to adapt the group to an evolving membership base and changing needs over time. Implementation strategies identified included: collecting regular feedback to better understand members’ needs; improving access to clinical supervision; providing training tailored specifically for leaders of metastatic cancer support groups; improving public awareness of metastatic cancer; and shifting negative perceptions about metastatic cancer groups among patients and health professionals.   

Conclusion: No ‘one-size-fits-all’ model of MBC support group exists. The format and structure of successful groups depended on multiple factors relating to the setting, the individuals leading the group, and those participating in the group. The study identified key factors and strategies critical to implementing professionally-led MBC support group feasibly and sustainably in an Australian context. 

  1. Proctor, E. et al. Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda. Administration and Policy in Mental Health and Mental Health Services Research 38, 65–76 (2011).
  2. Damschroder, L. J., Reardon, C. M., Widerquist, M. A. O. & Lowery, J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci 17, 75 (2022).