Archived
This content is available here strictly for research, reference, and/or recordkeeping and as such it may not be fully accessible. If you work or study at University of Kentucky and would like to request an accessible version, please use the SensusAccess Document Converter.
Abstract
Background
Integration of comprehensive oncology financial and legal navigation (OFLN) programs within health systems are needed to address cancer-related financial toxicity, however, implementation challenges exist.
Objectives
The aim of this study was to assess contextual factors that may influence implementation of a virtual OFLN intervention within a pediatric and adolescent and young adult oncology clinic and to inform necessary modifications to the proposed implementation strategies, pathways, and workflows.
Methods
We conducted 18 key informant interviews with healthcare team members, patients and caregivers. Data collection and analysis were guided by the Consolidated Framework for Implementation Research (CFIR) to provide a structured evaluation and framework to tailor the implementation of the proposed virtual OFLN intervention. Interviews were recorded, transcribed, and analyzed by two independent coders and organized as facilitators and barriers to implementation within each CFIR domain.
Results
We identified ten potential implementation facilitators related to high demand and need for OFLN services, adaptability of virtual resources, and nurse-led navigation. Six potential implementation barriers related to limited confidence among nurses in facilitating cost of care conversations and conflicts between existing workflows and the intervention were identified.
Conclusions
Guided by CFIR, we were able to identify contextual factors that may influence the implementation of the proposed virtual OFLN intervention. These findings will be used to further adapt our proposed OFLN intervention and implementation processes to facilitate seamless integration into health systems.
Document Type
Article
Publication Date
2025
Digital Object Identifier (DOI)
https://doi.org/10.1186/s43058-025-00827-5
Funding Information
This study was funded by the Kentucky Pediatric Cancer Trust Fund, Kentucky Cabinet for Health and Family Services.
Repository Citation
Edward, Jean; Fariduddin, Haafsah; Caldwell, Mackenzie; Eisele, Lori P; Doran, Joanna; Bryant, Monica; D'Orazio, John A.; Ray, Anne E.; and Northrip, Kimberly D., "Evaluating potential determinants of health system implementation of a virtual oncology financial and legal navigation intervention to address cancer-related financial toxicity" (2025). Nursing Faculty Publications. 80.
https://uknowledge.uky.edu/nursing_facpub/80
Notes/Citation Information
© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.