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Real-World Implementation of Best-Evidence Cancer Distress Management: Truly Comprehensive Cancer Care.

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Group-delivered cognitive behavioral therapy for cancer distress (CBT-C) was successfully adapted and implemented as a billable service. This approach improved patient access to evidence-based distress management, showing high acceptability and feasibility.

Keywords:
Policycancer distresscognitive-behavioral therapyimplementation sciencestakeholder engagement

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Area of Science:

  • Oncology
  • Psychosocial Oncology
  • Health Services Research

Background:

  • Cancer distress management is crucial for comprehensive care.
  • Group-delivered cognitive behavioral therapy for cancer distress (CBT-C) shows survival benefits but faces access barriers in clinical settings.
  • Adapting CBT-C for billable services is essential to improve patient access to evidence-based care.

Purpose of the Study:

  • To adapt and implement manualized CBT-C as a billable clinical service.
  • To evaluate the reach, acceptability, and feasibility of practice-adapted CBT-C from stakeholder perspectives.

Main Methods:

  • A stakeholder-engaged, mixed-methods, hybrid implementation study.
  • Phases included stakeholder engagement, user testing, and implementation evaluation.
  • Data collected on barriers, facilitators, reach, acceptability, and feasibility.

Main Results:

  • Stakeholders identified 7 barriers and 9 facilitators to CBT-C implementation.
  • Adaptations included expanding eligibility, reducing sessions to 5, and revising content.
  • 100 of 252 eligible patients (40%) enrolled, with 99% insurance coverage; geographic distance was a key barrier.
  • 98% of participants would recommend CBT-C.

Conclusions:

  • Implementation of CBT-C as a billable service was acceptable and feasible.
  • Future research should focus on diverse populations, clinical effectiveness, and remote delivery to reduce access barriers.