What are the Facilitators and Barriers to Improving the Delivery of Survivorship Care Information to Rural Cancer Survivors? A Qualitative Study Using an Implementation Science Framework

Objective: To identify facilitators and barriers to improving communication of survivorship care information to rural cancer survivors from the perspective of healthcare professionals. Setting: Metropolitan and rural health services provide care to rural cancer survivors. Participants: Healthcare professionals (n = 31), including cancer specialists, general practitioners, nurses, care coordinators and allied health practitioners. Design: Qualitative descriptive study using semi-structured interviews to assess current practices for communicating survivorship care information, perspectives on how this information should be delivered and factors that may affect the implementation of a new method for delivering this information. Responses were categorised as a facilitator or barrier to improving information delivery. Barriers and facilitators were mapped to constructs of the Consolidated Framework for Implementation Research to identify the settings and contexts in which they occur. Results: Facilitators included the evidence base and relative advantage of improving survivorship care information delivery to rural cancer survivors, indicating that healthcare professionals perceive this initiative as important and valuable. Participants also reported a tension for change (i.e., current practices for information delivery are not sustainable) and mission alignment, meaning improving survivorship information to rural cancer survivors is within participants' organisations' goals. Barriers included local conditions, policies and laws and financing, including challenges accessing support services in rural settings and limited funding for post-treatment care. Conclusions: Guiding principles and suggested actions for improving survivorship care information delivery to rural cancer survivors are proposed, including strategies for minimising burden on healthcare teams, formalising transitional practices, streamlining referral pathways, partnering with community services and including family carers.