Administrator, Provider, and Staff Perspectives on Implementing Acupuncture in Medically Underserved Breast Cancer Survivors.

Abstract

Background: Breast cancer survivors on endocrine therapy frequently experience multiple symptoms that significantly impact their quality of life. Acupuncture has shown potential in managing these symptoms but remains less accessible for medically underserved populations.

Objective: This study aimed to explore the acceptability, challenges, and facilitators of acupuncture integration from the perspective of health system partners.

Interventions/methods: Using a convergent mixed-methods approach and the Consolidated Framework for Implementation Research, we conducted interviews (n = 14) and surveys (n = 13) with administrators, providers, and staff from a federally qualified health center and oncology clinic between September 2023 and May 2024. Interviews were analyzed through directed content analysis, and descriptive statistics assessed demographics and acupuncture experience, as well as 6 key Consolidated Framework for Implementation Research constructs.

Results: Five key themes emerged: acceptability and willingness to use acupuncture, limited experience and awareness of its effectiveness, and perceived challenges and facilitators to implementation. Survey results highlighted a positive organizational culture, strong leadership engagement, and a supportive learning environment, although clinic stress was noted as a concern. High receptivity to acupuncture was evident, with challenges (eg, limited insurance coverage) and facilitators (eg, leadership support and collaboration with community partners) identified for its integration.

Conclusions: There is strong support among administrators, providers, and staff for integrating acupuncture into care for underserved breast cancer survivors. Addressing challenges while leveraging facilitators will aid successful implementation.

Implications for practice: Enhancing patient/provider education, establishing acupuncture spaces, fostering supportive clinic environments, securing funding, and addressing insurance coverage issues are vital steps to advancing equitable access to acupuncture.