Trial reportBMC health services research2021
Barriers to symptom management care pathway implementation in pediatric Cancer.
Trial report in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Factors Associated With Symptom Burden Among Pediatric Patients With Cancer.JCO oncology practice · 2026Trial
- Factors associated with unplanned healthcare encounters in pediatric cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Trial
- Team-Based Versus Technology-Based Supportive Cancer Care: A Mixed Methods Study of Multi-Site Implementation.Journal of the National Comprehensive Cancer Network : JNCCN · 2025Trial
- Symptom management care pathway adaptation process and specific adaptation decisions.BMC cancer · 2023Trial
- Care Pathway- and Guideline-Consistent Care in Pediatric Cancer Symptom Management.JCO oncology practice · 2026Article
- Management of fatigue in children with cancer: a survey of pediatric hematology-oncology professionals' knowledge, attitudes, and practices in the United States and Canada.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Healthcare professional perspectives following implementation of an infection management care pathway for pediatric patients with cancer: a qualitative study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Promise and Perils of Large Language Models for Cancer Survivorship and Supportive Care.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2024Article
- Identification of an oncological clinical pathway through questionnaires to health professionals.BMC health services research · 2023Article
- Patient-Reported Outcomes in Pediatric Patients With Cancer.American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting · 2023Article
- Healthcare Providers and Parents Highlight Challenges of Pediatric Hand Fracture Care.Plastic and reconstructive surgery. Global open · 2023Article
- Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
Abstract
backgroundObjectives were to describe barriers to pediatric cancer symptom management care pathway implementation and the impact of the COVID-19 pandemic on clinical research evaluating their implementation.
methodsWe included 25 pediatric oncology hospitals in the United States that supported a grant submission to perform a cluster randomized trial in which the intervention encompassed care pathways for symptom management. A survey was distributed to site principal investigators prior to randomization to measure contextual elements related to care pathway implementation. Questions included the inner setting measures of the Consolidated Framework for Implementation Research (CFIR), study-specific potential barriers and the impact of the COVID-19 pandemic on clinical research. The Wilcoxon rank sum test was used to compare characteristics of institutions that agreed that their department supported the implementation of symptom management care pathways vs. institutions that did not agree.
resultsOf the 25 sites, one withdrew because of resource constraints and one did not respond, leaving 23 institutions. Among the seven CFIR constructs, the least supported was implementation climate; 57% agreed there was support, 39% agreed there was recognition and 39% agreed there was prioritization for symptom management care pathway implementation at their institution. Most common barriers were lack of person-time to create care pathways and champion their use (35%), lack of interest from physicians (30%) and lack of information technology resources (26%). Most sites reported no negative impact of the COVID-19 pandemic across research activities. Sites with fewer pediatric cancer patients were more likely to agree that staff are supported to implement symptom management care pathways (P = 0.003).
conclusionsThe most commonly reported barriers to implementation were lack of support, recognition and prioritization. The COVID-19 pandemic may not be a major barrier to clinical research activities in pediatric oncology.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.