Implementation Challenges of a Multi-Center Financial Navigation Intervention: A Qualitative Analysis of Operational...

Area of Science:

• Implementation Science
• Health Services Research
• Oncology Patient Support

Background:

• The Lessening the Impact of Financial Toxicity (LIFT) intervention, a financial navigation program, showed initial promise.
• Scaling LIFT to an eight-site trial introduced implementation complexities not seen in its pilot phase.

Purpose of the Study:

• To analyze factors influencing the implementation of the LIFT financial navigation intervention across multiple oncology sites.
• To identify challenges and effective strategies for deploying financial navigation services in diverse clinical settings.

Main Methods:

• A deductive-inductive hybrid qualitative approach was used.
• Analysis of 55 technical assistance and 23 peer support calls with financial navigators.
• Utilized the Consolidated Framework for Implementation Research (CFIR) to categorize findings.

Main Results:

• 18 themes and 91 sub-themes emerged across CFIR domains, including workforce issues, resource limitations, and navigator workload.
• Key challenges identified in the outer and inner settings related to institutional factors and clinical infrastructure.
• Common implementation strategies involved adapting content pacing, reframing the study, and modifying delivery methods like phone visits.

Conclusions:

• Implementing financial navigation across multiple oncology sites presents significant workforce and administrative challenges.
• Technical assistance and peer support calls provide valuable data for guiding the implementation of financial navigation interventions.