Challenges in implementing a multidisciplinary integrative oncology intervention for young women with localized breast cancer

Abstract

Objectives

This study examines the challenges and facilitators in implementing a lifestyle and integrative oncology intervention, which aims to provide education and personalized support related to oncology care, nutrition, rehabilitation, mindfulness, and psychological guidance. Breast cancer (BC) treatment is associated with disabilities among young women with BC, who experience side effects and psychosocial distress that impact their quality of life, physical functioning, and psychological well-being. There is an urgent need to implement multidisciplinary integrative oncology interventions to promote healthy lifestyles and improve the quality of life for women who are about to receive active treatment for BC. Integrative oncology is emerging as a discipline that combines complementary techniques with standard oncology, addressing the individual in all dimensions and encouraging a healthier lifestyle. However, it is essential to conduct studies on implementing and adopting new strategies, such as integrative oncology, in referral centers to evaluate opportunities for effective implementation.

Methods

A qualitative analysis was conducted to identify the challenges and facilitators perceived by patients and providers in implementing a hybrid (on-site and online) integrative oncology multidisciplinary intervention. Women aged 18 to 39 with a recent BC stage I-III diagnosis and providers participated in structured interviews based on the Consolidated Framework for Implementation Research (CFIR) and Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) tools. The data from this framework analysis provided insights for developing an effective intervention and helped identify potential barriers and facilitators.

Results

Patients and providers reported that implementing the intervention was challenging, primarily due to time constraints, follow-up requirements, and the need to sustain patient motivation. The hybrid modality enhances motivation and adherence while addressing limitations such as the distance necessary to attend in-person sessions. However, some patients encountered difficulties related to technology and scheduling virtual sessions. Despite these challenges, the intervention proved feasible in assisting patients in maintaining a healthy lifestyle since their diagnosis and throughout their active BC oncology treatment.

Conclusions

Integrative oncology interventions emerge as a strategy to maintain a healthy lifestyle, positively impacting quality of life during BC active treatment, and have gained widespread acceptance globally. However, their routine use and inclusion in BC standard treatment at oncology centers remain limited. This study underscores the importance of providing comprehensive care to YWBC from the outset of their treatment. Overcoming barriers such as patient ideologies, healthcare personnel, geographical distances, scheduling constraints, technological limitations, and institutional support is crucial for delivering this level of care.