Evidence map›Paper›PMID 42853432›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2026

Designing for delivery: a Delphi study of feasibility-informed implementation strategies for a fear of cancer recurrence clinical pathway.

Ben Smith, Verena Shuwen Wu, Alison Pearce, Jia Liu, Heather L Shepherd, Joanne Shaw, Afaf Girgis, Gail Garvey, Laura Kirsten, Iman Zakhary and 7 more

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

17 authors.

Ben SmithThe Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, Australia. ben.a.smith@sydney.edu.au.
Verena Shuwen WuThe Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, Australia.
Alison PearceThe Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, Australia.
Jia LiuThe Kinghorn Cancer Centre, St Vincent's Hospital, Sydney, NSW, Australia.
Heather L ShepherdSusan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Joanne ShawPsycho-Oncology Cooperative Research Group, The University of Sydney, Camperdown, NSW, Australia.
Afaf GirgisSouth West Sydney Clinical Campuses, UNSW Medicine & Health, UNSW Sydney, Sydney, Australia.
Gail GarveySchool of Public Health, The University of Queensland, Brisbane, Australia.
Laura KirstenPsycho-Oncology Cooperative Research Group, The University of Sydney, Camperdown, NSW, Australia.
Iman ZakharyMulticultural Services, Liverpool Hospital, South Western Sydney Local Health District, Sydney, Australia.
Carolyn EeFlinders LiveWell Cancer Research Centre, Caring Futures Institute, Flinders University, Adelaide, Australia.
Dan EwaldSydney University Medical School, Northern Rivers University Centre for Rural Health, Lismore, NSW, Australia.
Annie MillerPsycho-Oncology Cooperative Research Group, The University of Sydney, Camperdown, NSW, Australia.
Andrea SmithThe Daffodil Centre, The University of Sydney, and Cancer Council NSW, Sydney, Australia.
Agamjot Kaur VirkSydney School of Public Health, The University of Sydney, Camperdown, Australia.
Joy GaoSydney School of Public Health, The University of Sydney, Camperdown, Australia.
Natalie TaylorImplementation to Impact (i2i), School of Population Health, UNSW Sydney, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFear of cancer recurrence (FCR) is pervasive among cancer survivors, yet evidence-based care is rarely implemented. Clinical pathways offer a structured approach to translating evidence into practice. This study identified key implementation barriers, enablers, and strategies for feasibly integrating an FCR clinical pathway comprising screening, assessment, and triage to stepped care into practice.

methodsA three-round Delphi study was conducted with Australian health professionals and FCR researchers. Participants rated and provided qualitative feedback on the feasibility of FCR clinical pathway elements. Qualitative responses were content analysed using the updated Consolidated Framework for Implementation Research. Recommended strategies were mapped using the Expert Recommendations for Implementing Change taxonomy.

resultsEighty-nine participants completed Round 1, 69 Round 2, and 73 Round 3. Feasibility ratings varied across pathway elements (49-90%). Stepped care elements were widely endorsed as feasible (71-83% agreement), while resource-intensive recommendations (e.g., training all staff for screening) were perceived as least feasible. Key implementation enablers included Adaptability, Access to Knowledge and Information, and strong Innovation Recipient Need. Major barriers were Available Resources, Work Infrastructure and limited Innovation Deliverer Opportunity. Recommended strategies included tailoring delivery to local contexts and patient needs supported by modular training and local champions.

conclusionImplementing the FCR clinical pathway requires pragmatic adaptation and system-level support. Prioritising high-impact elements, providing training, integration into existing workflows, and shared decision-making to meet patient needs are critical. Future research should evaluate these strategies using hybrid effectiveness-implementation designs to ensure sustainable implementation and improved patient outcomes.

Indexed as

Cancer SurvivorsCritical PathwaysFearNeoplasm Recurrence, LocalNeoplasmsAdultAustraliaDelphi TechniqueFeasibility StudiesFemaleHumansMaleMiddle AgedCancer survivorshipClinical pathwayDelphi studyFear of cancer recurrenceImplementationSupportive care

Identifiers

PMID42853432

What OpenQuestion holds

Textmetadata
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Registered trials

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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.