Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Feb;30(2):202-211.
doi: 10.1002/pon.5550. Epub 2020 Oct 20.

Using formative evaluation to plan for electronic psychosocial screening in pediatric oncology

Jordan Gilleland Marchak  1   2 , Sean N Halpin  3 , Cam Escoffery  3 , Shadé Owolabi  3 , Ann C Mertens  1   2 , Karen Wasilewski-Masker  1   2
Affiliations

Using formative evaluation to plan for electronic psychosocial screening in pediatric oncology

Jordan Gilleland Marchak et al. Psychooncology. 2021 Feb.

Abstract

Objective: To demonstrate how formative research methods can be used to plan for implementation of evidence-based psychosocial screening in pediatric oncology.

Methods: Multidisciplinary pediatric oncology professionals participated in focus groups to adapt the distress thermometer for electronic administration and develop health systems processes to promote psychosocial screening in the pediatric oncology outpatient clinic setting. Seven 1-hour focus groups were conducted using a structured guide based on the reach, efficacy, adoption, implementation, and maintenance framework and transcribed verbatim. Two independent raters coded transcripts using a quasi-deductive approach with high inter-coder reliability (Cohen kappa >0.80).

Results: Participants' (N = 44) responses were used to identify overarching topics related to the adoption, implementation, and maintenance of electronic screening (e-screening) including: barriers to meeting families' psychosocial needs, identification of champions, suggestions to adapt the proposed e-screening program, perceived barriers to e-screening, and potential impact of carrying out e-screening. Following review of qualitative data, we employed specific implementation strategies to promote adoption, implementation, and maintenance of an e-screening program.

Conclusions: Perceived barriers to the implementation of psychosocial screening remain substantial, yet enthusiasm for using electronic health records (EHRs) technology to help meet patient needs through regular assessment was evident among pediatric oncology professionals. Electronic administration of screening and integration of results into the EHR in real time were identified as critical needs to overcome barriers to e-screening. Formative research including qualitative data from stakeholders can be used to tailor implementation strategies to successfully support the adoption, implementation, and maintenance of e-screening programs in pediatric oncology.

Keywords: electronic health records; health care; pediatrics; process assessment; psycho-oncology; screening.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Statement: Authors have no conflicts of interest to disclose.

Figures

Figure 2.
Figure 2.
Clinical algorithm for e-screening process in outpatient pediatric oncology Notes: ROS= Review of Systems. EHR= Electronic Health Record
See this image and copyright information in PMC

References

    1. Kazak AE, Barakat LP, Ditaranto S, Biros D, Hwang WT, Beele D, et al. Screening for Psychosocial Risk at Pediatric Cancer Diagnosis: The Psychosocial Assessment Tool. J Pediatr Hematol Oncol. 2011;33(4):289. - PubMed
    1. Kazak AE, Rourke MT, Alderfer MA, Pai A, Reilly AF, Meadows AT. Evidence-based assessment, intervention and psychosocial care in pediatric oncology: A blueprint for comprehensive services across treatment. J Pediatr Psychol. 2007;32(9):1099–110. - PubMed
    1. Kazak AE, Abrams AN, Banks J, Christofferson J, DiDonato S, Grootenhuis MA, et al. Psychosocial Assessment as a Standard of Care in Pediatric Cancer. Pediatr Blood Cancer. 2015;62(S5):S426–S59. - PubMed
    1. Wakefield CE, McLoone J, Goodenough B, Lenthen K, Cairns DR, Cohn RJ. The psychosocial impact of completing childhood cancer treatment: a systematic review of the literature. J Pediatr Psychol. 2010;35(3):262‐274. - PubMed
    1. Kahalley LS, Wilson SJ, Tyc VL, et al. Are the psychological needs of adolescent survivors of pediatric cancer adequately identified and treated? Psychooncology. 2013;22(2):447‐458. - PMC - PubMed

Publication types