Background: Canada represents half of the Children's Oncology Group (COG) sites that have opted to customize content for families within the COG KidsCare app. It was unclear how many sites proceeded with developing and inputting customized content and how well the app and customized content were implemented into practice. This raised concerns that Canadian families were unaware of this new digital resource and did not have equitable access to customized content. This qualitative study aimed to understand nursing site leads’ experiences including perspectives on facilitators and barriers to customization and implementation of the COG's KidsCare app. Method: Semi-structured interviews with clinicians who self-reported expertise in patient and family education local practices were conducted. Transcripts were independently coded by two team members using an iterative hybrid inductive/deductive approach, and analyzed using the Consolidated Framework for Implementation Research (CFIR), to summarize results. Results: The facilitators and barriers to implementing the COG KidsCare app with customization were categorized by five overarching CFIR-related themes: (a) features of the customized COG KidsCare app, (b) external environment, (c) institutional environment, (d) implementation team, and (e) the process of implementing and customizing the COG KidsCare app. Discussion: Nurses expressed feelings of tension between support and perceived value of the COG KidsCare app with customization, and their ability to successfully create, refine, implement content and disseminate to families. Using our RoadMap of recommended implementation strategies to integrate use of the app into practice may provide opportunity for successful implementation in a variety of contexts.
AburnG.GottM. (2011). Education given to parents of children newly diagnosed with acute lymphoblastic leukemia. Journal of Pediatric Oncology Nursing, 28(5), 300–305. https://doi.org/10.1177/1043454211409585
2.
BarwickM.BrownJ.PetriccaK.StevensB.PowellB. J.JaouichA.ShakespeareJ.SetoE. (2023). The implementation playbook: Study protocol for the development and feasibility evaluation of a digital tool for effective implementation of evidence-based innovations. Implementation Science Communications, 4(1), Article 21. https://doi.org/10.1186/s43058-023-00402-w
3.
BearmanM. (2019). Focus on methodology: Eliciting rich data: A practical approach to writing semi-structured interview schedules. Focus on Health Professional Education: A Multi-Professional Journal, 20(3), 1–11. https://doi.org/10.11157/fohpe.v20i3.387
4.
BoehmL. M.StolldorfD. P.JefferyA. D. (2020). Implementation science training and resources for nurses and nurse scientists. Journal of Nursing Scholarship, 52(1), 47–54. https://doi.org/10.1111/jnu.12510
CollinsC. S.StocktonC. M. (2018). The central role of theory in qualitative research. International Journal of Qualitative Methods, 17(1), Article 1609406918797475. https://doi.org/10.1177/1609406918797475
7.
DamschroderL. J.AronD. C.KeithR. E.KirshS. R.AlexanderJ. A.LoweryJ. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(1), Article 50. https://doi.org/10.1186/1748-5908-4-50
8.
DamschroderL. J.ReardonC. M.WiderquistM. A. O.LoweryJ. (2022a). Conceptualizing outcomes for use with the consolidated framework for implementation research (CFIR): The CFIR outcomes addendum. Implementation Science, 17(1), Article 7. https://doi.org/10.1186/s13012-021-01181-5
9.
DamschroderL. J.ReardonC. M.WiderquistM. A. O.LoweryJ. (2022b). The updated Consolidated Framework for Implementation Research based on user feedback. Implementation Science, 17(1), Article 75. https://doi.org/10.1186/s13012-022-01245-0
10.
FeredayJ.Muir-CochraneE. (2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International Journal of Qualitative Methods, 5(1), 80–92. https://doi.org/10.1177/160940690600500107
11.
HaugenM. S.LandierW.MandrellB. N.SullivanJ.SchwartzC.SkeensM. A.HockenberryM. (2016). Educating families of children newly diagnosed with cancer: Insights of a Delphi panel of expert clinicians from the Children’s Oncology Group. Journal of Pediatric Oncology Nursing, 33(6), 405–413. https://doi.org/10.1177/1043454216652856
12.
KeithR. E.CrossonJ. C.O’MalleyA. S.CrompD.TaylorE. F. (2017). Using the consolidated framework for implementation research (CFIR) to produce actionable findings: A rapid-cycle evaluation approach to improving implementation. Implementation Science, 12(1), Article 15. https://doi.org/10.1186/s13012-017-0550-7
13.
KellyK. P.PorockD. (2005). A survey of pediatric oncology nurses’ perceptions of parent educational needs. Journal of Pediatric Oncology Nursing, 22(1), 58–66. https://doi.org/10.1177/1043454204272537
14.
LandierW.AhernJ.BarakatL. P.BhatiaS.BingenK. M.BondurantP. G.CohnS. L.DobrozsiS. K.HaugenM.HerringR. A.HookeM. C.MartinM.MurphyK.NewmanA. R.RodgersC. C.RuccioneK. S.SullivanJ.WeissM.WithycombeJ.HockenberryM. (2016). Patient/family education for newly diagnosed pediatric oncology patients: Consensus recommendations from a Children’s Oncology Group expert panel. Journal of Pediatric Oncology Nursing, 33(6), 422–431. https://doi.org/10.1177/1043454216655983
15.
LandierW.GonzalezP. D. C.HennebergH.YorkJ. M.WadhwaA.AdamsK.Madan-SwainA.WolfsonJ. A.BentonB.SeidelC.SlaterV.SnuggsK.FolsomA.MillerJ.TomlinsonK.ZupanecS.BhatiaS. (2023). Children’s Oncology Group KidsCare smartphone application for parents of children with cancer. Pediatric Blood & Cancer, 70(6), Article e30288. https://doi.org/10.1002/pbc.30288
16.
O’BrienB. C.HarrisI. B.BeckmanT. J.ReedD. A.CookD. A. (2014). Standards for reporting qualitative research. Academic Medicine, 89(9), 1245–1251. https://doi.org/10.1097/acm.0000000000000388
17.
ProudfootK. (2023). Inductive/deductive hybrid thematic analysis in mixed methods research. Journal of Mixed Methods Research, 17(3), 308–326. https://doi.org/10.1177/15586898221126816
18.
RodgersC. C.LaingC. M.HerringR. A.TenaN.LeonardelliA.HockenberryM.Hendricks-FergusonV. (2016). Understanding effective delivery of patient and family education in pediatric oncology: A systematic review from the Children’s Oncology Group. Journal of Pediatric Oncology Nursing, 33(6), 432–446. https://doi.org/10.1177/1043454216659449
19.
SarkiesM. N.RobinsL. M.JepsonM.WilliamsC. M.TaylorN. F.O’BrienL.MartinJ.BardoelA.MorrisM. E.CareyL. M.HollandA. E.LongK. M.HainesT. P. (2021). Effectiveness of knowledge brokering and recommendation dissemination for influencing healthcare resource allocation decisions: A cluster randomised controlled implementation trial. PLoS Medicine, 18(10), Article e1003833. https://doi.org/10.1371/journal.pmed.1003833
WaltzT. J.PowellB. J.FernándezM. E.AbadieB.DamschroderL. J. (2019). Choosing implementation strategies to address contextual barriers: Diversity in recommendations and future directions. Implementation Science, 14(1), Article 42. https://doi.org/10.1186/s13012-019-0892-4
22.
WithycombeJ. S.Andam-MejiaR.DwyerA.SlavenA.WindtK.LandierW. (2016). A comprehensive survey of institutional patient/family educational practices for newly diagnosed pediatric oncology patients: A report from the Children’s Oncology Group. Journal of Pediatric Oncology Nursing, 33(6), 414–421. https://doi.org/10.1177/1043454216652857
