Evidence map›Paper›PMID 39529247›Full record

ArticlePediatric blood & cancer2025

Multilevel Facilitators and Barriers to Healthcare Organization and Delivery Among Childhood Cancer Survivors.

Brianna M Miller, Mary Rose Yockel, Burton E Appel, Chiranjeev Dash, Nicole Harris-Hollingsworth, Nina S Kadan Lottick, Arnold L Potosky, Julia Rowland, Tara Suntum, Katherine Chaillet and 3 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Pediatric blood & cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Brianna M MillerDepartment of Human Science, School of Health, Georgetown University, Washington, District of Columbia, USA.
Mary Rose YockelLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Burton E AppelHackensack Meridian Health, Hackensack, New Jersey, USA.
Chiranjeev DashLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Nicole Harris-HollingsworthHackensack Meridian Health, Hackensack, New Jersey, USA.
Nina S Kadan LottickLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Arnold L PotoskyLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Julia RowlandLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.ORCID https://orcid.org/0000-0003-4158-8050
Tara SuntumLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Katherine ChailletLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Marcelo M SleimanLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Muriel R StatmanLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.
Kenneth P TercyakLombardi Comprehensive Cancer Center, Georgetown University, Washington, District of Columbia, USA.

Funding

Tissue Culture Shared ResourceP30CA051008 · NCI · GEORGETOWN UNIVERSITY · PI MARCUS S NOEL · 1990 to 2026
$71.5M
National Cancer Institute at the National Institutes of Health CA051008NCI NIH HHS P30 CA051008
6 · The paper itself

Abstract

backgroundChildhood cancer survivors (CCS) are at risk for medical and psychosocial late effects of their disease and its treatment and are recommended to receive annual follow-ups. Yet, rates of follow-up adherence are suboptimal and may be influenced by the organization and delivery of their healthcare. This research aimed to examine experts' perceptions of facilitators and barriers to healthcare organization and delivery to CCS. PROCEDURE: Thirty-one clinicians and administrators in a comprehensive cancer center's research consortium were interviewed about system-level factors that may promote or deter annual follow-ups among CCS. Interview transcripts were coded and inductively analyzed using a study-specific scheme.

resultsThree main themes were identified: (1) healthcare system influences (59%); (2) social determinants of health (25%); and (3) intra/interpersonal factors (16%). Prominent subthemes included age-related changes in the transition of healthcare responsibility that disrupt ongoing CCS care (28.1%), the breadth and quality of psychosocial support available to navigate CCS to follow-up (13.5%), and transportation challenges (24.6%; especially in low-resource areas). In contrast, community trust facilitated follow-up (17.3%).

conclusionThe system of healthcare was prominent in receipt of follow-up by CCS, and further influenced by social determinants of health and intra/interpersonal factors. Easing transitions of responsibility (from parents to CCS, and acute care to survivorship teams) may be beneficial, especially when social determinants of health obstacles are present. Psychosocial wrap-around care is essential, along with promoting staff awareness of obstacles that CCS encounter in low-resource communities.

Indexed as

Cancer SurvivorsDelivery of Health CareNeoplasmsAdolescentAdultChildFemaleFollow-Up StudiesHealth Services AccessibilityHumansMaleSocial Determinants of Healthchildhood cancer survivorsfollow‐up adherenceguidelinessurvivorship care

Identifiers

PMID39529247
PMCPMC13006123

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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.