Work

Implementing childhood cancer survivorship care plans: qualitative perspectives and experiences from Australian primary care physicians

Year: 2026

Type: conference-abstract

Abstract: Objective To explore primary care physicians’ (PCPs) perspectives and experiences with implementing cancer survivorship care plans developed through ‘Engage’—a multi-disciplinary intervention for survivors of childhood brain cancer.Design Qualitative interview study, guided by implementation science frameworks and a ‘think aloud’ exercise using a real-world survivorship care plan, conducted during a hybrid effectiveness-implementation trial of ‘Engage’.Participants 20 Australian PCPs participated in interviews, 3 of whom had direct experience referring a patient to participate in ‘Engage’, with the remainder recruited from the general workforce and invited to review the same sample survivorship care plan, based on a real childhood brain cancer survivor from ‘Engage’.Setting Most PCPs practised in a private (90%) metropolitan (75%) setting, with representation from seven of eight Australian states and territories.Analysis Deductive coding was guided by the constructs of the Consolidated Framework for Implementation Research V.2.0 (CFIR) and the Theoretical Domains Framework. An inductive approach was applied to develop themes reflecting participants lived experiences. Conventional content analysis was also undertaken to quantify participants’ responses regarding preferred formats, topics and dissemination pathways for educational materials for PCPs.Results PCPs’ suggestions to improve the content and structure of the ‘Engage’ care plan (3/20 ‘Engage’ PCPs and 17/20 general workforce PCPs) included offering a clearer rationale for follow-up recommendations, providing specialists contact information and using tables and visual cues to improve information salience (CFIR construct: Innovation Design). Key barriers to implementing the care recommended by the plan included lack of access to community care and medical specialists (Local Conditions), practice software constraints (Information-Technology Infrastructure), time pressures (Opportunity) and difficulties engaging survivors (Opportunity, Motivation). Facilitators included support from a specialist nurse at the ‘Engage’ survivorship clinic for referrals and education (Partnerships and Connections) and strategies to improve patient engagement in care (Engaging – Innovation Recipients). Most PCPs (18/20) expressed a desire for tailored survivorship care educational resources (Access to Knowledge and Information). While attitudes toward shared care approaches reported by a small subset of PCPs were positive (5/20, Implementation Process), operationalisation challenges were anticipated with its implementation.Conclusions We underscore the critical role of PCPs in the care trajectory of paediatric survivors and address a major gap in their inclusion in survivorship research and practice. Our findings offer practical recommendations for improving survivorship care plan design, alongside the broader system, practice and individual-level changes required for effective implementation.Trial registration number The Australian and New Zealand Clinical Trials Registry (ANZCTR), https://www.anzctr.org.au, (ACTRN12621000590864).

Source: Family Medicine and Community Health

DOI: 10.1136/fmch-2026-004002