Theory-Guided Development of Fertility Care Implementation Strategies for Adolescent and Young Adult Cancer Survivors.

Purpose: Oncofertility care at cancer diagnosis remains underimplemented across oncology and fertility care settings, with limited tools to scale up effective implementation strategies. Using implementation science theory, we systematically assessed factors that influence oncofertility care implemen...

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Publicado en:Journal of Adolescent & Young Adult Oncology Vol. 10; no. 5; pp. 512 - 521
Autores principales: Dornisch, Anna, Yang, Emily H., Gruspe, Jamie, Roesch, Erin R., Aristizabal, Paula, Aarons, Greg A., Helsten, Teresa, Takemoto, Michelle B., Romero, Sally A.D., Kaiser, Bonnie N., Su, Hui-Chun Irene
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. Oct2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2021
      vid: 10
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      pub: Mary Ann Liebert, Inc.
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        10.1089/jayao.2020.0156
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        atl: Theory-Guided Development of Fertility Care Implementation Strategies for Adolescent and Young Adult Cancer Survivors.
      aug:
        au:
          Dornisch, Anna
          Yang, Emily H.
          Gruspe, Jamie
          Roesch, Erin R.
          Aristizabal, Paula
          Aarons, Greg A.
          Helsten, Teresa
          Takemoto, Michelle B.
          Romero, Sally A.D.
          Kaiser, Bonnie N.
          Su, Hui-Chun Irene
        affil: Moores Cancer Center, University of California San Diego, La Jolla, California, USA.
      sug:
        subj:
          Cancer Survivors In Adulthood
          Fertility
          Fertility Preservation Methods
          Oncologic Care
          Cancer Survivors In Adolescence
          Adult
          Adolescence
          Female
          Purposive Sample
          Cancer Care Facilities
          Hospitals, Pediatric
          Semi-Structured Interview
          Focus Groups
          Thematic Analysis
          Health Services Accessibility
          Electronic Health Records
          Implementation Science
          Descriptive Statistics
          Confidence Intervals
          Odds Ratio
          Human
          Adult: 19-44 years
          Adolescent: 13-18 years
          Female
      ab: Purpose: Oncofertility care at cancer diagnosis remains underimplemented across oncology and fertility care settings, with limited tools to scale up effective implementation strategies. Using implementation science theory, we systematically assessed factors that influence oncofertility care implementation and mapped scalable strategies, particularly electronic health record (EHR)-enabled ones, that fit adult and pediatric oncology care contexts. Methods: Using purposeful sampling, we recruited health care providers and female, reproductive-aged survivors of adolescent and young adult (AYA) cancers (AYA survivors) from a comprehensive cancer center and a freestanding children's hospital to semistructured interviews and focus groups. Using thematic analysis combining inductive codes with deductive codes using the Consolidated Framework for Implementation Research (CFIR), we characterized barriers and facilitators to care and designed responsive strategies. Two coders independently coded each transcript. Results: We recruited 19 oncology and fertility providers and 9 cancer survivors. We identified barriers and facilitators to oncofertility care in the CFIR domains of individual, inner setting, outer setting, and process, allowing us to conceptualize oncofertility care to encompass three core components (screening, referral, and fertility preservation counseling) and map five strategies to these components that fit an adult and a children's context and bridge oncology and fertility practices. The strategies were screening using a best practice advisory, referral order, telehealth fertility counseling, provider audit and feedback, and provider education. All but provider education were EHR tools with embedded efficiencies. Conclusion: An implementation science approach systematically assessed oncofertility care and mapped strategies to provide a theory-based approach and scalable EHR tools to support wider dissemination.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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