Using formative evaluation to plan for electronic psychosocial screening in pediatric oncology

Area of Science:

• Pediatric Oncology
• Health Services Research
• Implementation Science

Background:

• Psychosocial distress is a significant concern for pediatric oncology patients and families.
• Effective screening is crucial for addressing these needs, but implementation faces challenges.
• Evidence-based psychosocial screening requires tailored strategies for successful integration into clinical workflows.

Purpose of the Study:

• To demonstrate the utility of formative research methods for planning psychosocial screening implementation.
• To adapt existing screening tools for electronic administration in pediatric oncology settings.
• To develop health system processes supporting psychosocial screening within outpatient clinics.

Main Methods:

• Qualitative data were collected through seven focus groups with multidisciplinary pediatric oncology professionals (N=44).
• A structured guide based on the Reach, Efficacy, Adoption, Implementation, and Maintenance (RE-AIM) framework was used.
• Transcripts were analyzed using a quasi-deductive approach with high inter-coder reliability (>0.80).

Main Results:

• Key themes included barriers to meeting psychosocial needs, identifying champions, and adapting electronic screening (e-screening) programs.
• Perceived barriers to e-screening and its potential impact were identified.
• Qualitative findings informed the development of specific implementation strategies.

Conclusions:

• Substantial barriers to psychosocial screening implementation persist, but professionals show enthusiasm for electronic health record (EHR) integration.
• Real-time electronic administration and EHR integration are critical for overcoming implementation barriers.
• Formative research with stakeholders is essential for tailoring strategies to support e-screening adoption, implementation, and maintenance in pediatric oncology.