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Process of diffusing cancer survivorship care into oncology practice

  • Original Research
  • Published:
Translational Behavioral Medicine

ABSTRACT

The LIVESTRONG Centers of Excellence were funded to increase the effectiveness of survivorship care in oncology practice. This study describes the ongoing process of adopting and implementing survivorship care using the framework of the diffusion of innovation theory of change. Primary data collection included telephone interviews with 39 members from the eight centers and site visits. Organizational characteristics, overall progress, and challenges for implementation were collected from proposals and annual reports. Creating an awareness of cancer survivorship care was a major accomplishment (relative advantage). Adoption depended on the fit within the cancer center (compatibility), and changed over time based on trial and error (trialability). Implementing survivorship care within the existing culture of oncology and breaking down resistance to change was a lengthy process (complexity). Survivorship care became sustainable as it became reimbursed, and more new patients were seen (observability). Innovators and early adopters were crucial to success. Diffusion of innovation theory can provide a strategy to evaluate adoption and implementation of cancer survivorship programs into clinical practice.

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Acknowledgments

This research was supported by funding from the LIVESTRONG Foundation.

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Authors and Affiliations

  1. 2009 Pershing Street, Durham, NC, 27705, USA

    Irene Tessaro DrPH

  2. Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, 27599, USA

    Marci K Campbell PhD, Mindy Gellin RN, BSN & Donald L Rosenstein MD

  3. Goldsmith Research Group, Winston-Salem, NC, USA

    Shannon Golden MA

  4. Memorial Sloan-Kettering Cancer Center, New York, NY, 10021, USA

    Mary McCabe RN, MA

  5. Fred Hutchinson Cancer Research Center, Seattle, WA, 98109, USA

    Karen Syrjala PhD & Scott Baker MD

  6. Jonsson Comprehensive Cancer Center, Los Angeles, CA, 90095-6900, USA

    Patricia A Ganz MD

  7. Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Linda Jacobs RN, PhD

  8. Sinai Hospital Medical Oncology, Baltimore, MD, 21215, USA

    Kenneth D Miller MD

Authors
  1. Irene Tessaro DrPH
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  2. Marci K Campbell PhD
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  3. Shannon Golden MA
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  4. Mindy Gellin RN, BSN
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  5. Mary McCabe RN, MA
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  6. Karen Syrjala PhD
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  7. Patricia A Ganz MD
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  8. Linda Jacobs RN, PhD
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  9. Scott Baker MD
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  10. Kenneth D Miller MD
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  11. Donald L Rosenstein MD
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Corresponding author

Correspondence to Irene Tessaro DrPH.

Additional information

Marci K Campbell is deceased.

Implications

Practice:Recognizing barriers and facilitators for change when introducing a new practice (cancer survivorship) into oncology services is essential for program success.

Policy:

Adequate and continuing resources along with organizational commitment and support are essential for adoption and implementation of cancer survivorship care into clinical care.

Research:

Research to identify what does and does not work in the process of adopting and implementing survivorship programs in a clinical setting should occur from the beginning to make sure programs continue.

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Tessaro, I., Campbell, M.K., Golden, S. et al. Process of diffusing cancer survivorship care into oncology practice. Behav. Med. Pract. Policy Res. 3, 142–148 (2013). https://doi.org/10.1007/s13142-012-0145-4

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  • DOI: https://doi.org/10.1007/s13142-012-0145-4

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