Maximizing Professional-Led Sexual Well-being Support in Cancer Care: Findings From a Qualitative Process Evaluation Following Healthcare Professionals' Engagement With an eLearning Resource.

BACKGROUND: Provision of healthcare professional (HP)-led sexual support in cancer care is lacking, perpetuated by barriers including a lack of HP awareness of sexual concerns and strategies to help patients and partners cope. In response, the Maximizing Sexual Wellbeing|Cancer Care eLearning resource (MSW|CC) was developed and demonstrated efficacy in reducing HPs' attitudinal barriers to the provision of sexual support. However, the mechanisms for such change are not yet known. OBJECTIVE: A qualitative process evaluation was used to explore mechanisms that influence HP engagement with MSW|CC and its adoption into practice. METHODS: Semistructured interviews were conducted with HPs providing cancer care in Northern Ireland upon MSW|CC completion. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. RESULTS: Seventeen participants were interviewed, and 4 key themes were identified: (1) MSW|CC raises HPs' awareness of the need for holistic sexual support as part of routine clinical care; (2) MSW|CC prepares and equips HPs to provide sexual support in cancer care; (3) MSW|CC is coherent, engaging, and acceptable; and (4) MSW|CC: moving forward. CONCLUSION: Participants derived benefits from MSW|CC, deeming it an acceptable resource. Insights into MSW|CC mechanisms of success were identified, including language to address sexual concerns, alongside patient referral resources. Perceived MSW|CC shortcomings from an earlier study were confirmed as a software issue.Implications for Practice:Healthcare professionals require training and resources to enhance sexual support provision in cancer care. Proactive implementation strategies used to maximize HP engagement with MSW|CC could equip HPs with tools to improve patient sexual outcomes after cancer.

A qualitative evaluation of a multi-modal cancer prehabilitation programme for colorectal, head and neck and lung cancers patients.

BACKGROUND: Growing evidence indicates patients' survivorship outcomes can be enhanced through active engagement in a multi-modal cancer prehabilitation programme (MCPP), although this intervention is not uniformly embedded as a standard of care. MCPP aims to optimise patients physiologically and psychologically for cancer treatments, shorten recovery time, reduce complications, promote healthier lifestyles and improve quality of life. South Eastern Health and Social Care Trust (SET) developed and evaluated a system-wide collaborative approach to MMCP across three tumour groups (colorectal, lung, head and neck cancer). Addressing the lack of qualitative evaluation of MCPPs, this novel paper explores mechanisms promoting feasibility and acceptability of MCPP from patients' and interdisciplinary professionals' perspectives. METHODS: Semi-structured virtual one-to-one interviews were conducted with 24 interdisciplinary professionals and nine patients. Transcripts were recorded, transcribed verbatim and themes developed using Framework Analysis. RESULTS: Analysis of findings identified three themes providing an in-depth understanding of key elements required to develop and promote system-wide delivery of a MCPP: 1) Equipping the team: Capability and capacity, 2) Timing of intervention and delivery timeframe and 3) Systems and processes. CONCLUSION: The system-wide collaborative approach to developing a MCPP was deemed both feasible and acceptable. Success was attributed to visionary leadership, alongside a diverse group of interdisciplinary professionals being engaged, motivated and committed to intervention delivery in an effort to improve patient outcomes. Iterative, responsive troubleshooting during initial delivery is required to facilitate successful implementation. Further training is required for greater adherence to provision of prescriptive high intensity exercise within the programme, which may further promote enhanced patient outcomes. To enable sustainability of MCPP, ongoing training for professionals and funding is required.

Enhancing healthcare professional-led sexual support in cancer care: Acceptability and usability of an eLearning resource and its impact on attitudes towards providing sexual support.

OBJECTIVE: Barriers to healthcare professional (HP) (HP)-led sexual support in cancer care include lack of knowledge, skills and evidence-based educational interventions, to equip HPs to address sexual challenges faced by patients and partners. Consequently, sexual support is often avoided. This study examined HPs' acceptability and usability of the Maximising Sexual Wellbeing: Cancer Care (MSW|CC) eLearning resource for HPs and evaluated its impact on HPs' sexual attitudes and beliefs to providing sexual support in cancer care. METHODS: HPs (n = 87) completed pre and post-test surveys using the modified 12-item Sexual Attitudes and Beliefs Scale (SABS). Post-test, participants rated acceptability and usability of the MSW|CC, with optional free-text comments. A repeated measures t-test assessed changes in HPs' scores on the SABS. Descriptive statistics and reporting of free text comments were used to explore HPs' perspectives of the MSW|CC. RESULTS: SABS scores increased significantly from Time 1 (M = 35.1, SD = 4.8) to Time 2 (M = 40.1, SD = 4.3), t (86) = -10.2, p < 0.001 (two-tailed) with a medium effect size (d = 0.55); indicating a decrease in HPs' attitudinal barriers to providing sexual support. The MSW|CC was deemed acceptable, user-friendly and easy to navigate. Healthcare professionals would recommend the use of this eLearning resource to others (3.78/4, SD = 0.5), considered it a good informational resource (3.78/4, SD = 0.5) and straightforward to use (3.8/4, SD 0.42). DISCUSSION/CONCLUSION: The MSW|CC reduced HPs' attitudinal barriers towards the provision of HP-led sexual support in cancer care, whilst being acceptable and useable. The MSW|CC could support implementation of global clinical guidelines advocating for HP-led sexual support across the treatment trajectory.

Adapting and usability testing of an eLearning resource to enhance healthcare professional provision of sexual support across cancer care.

OBJECTIVES: To adapt the theory-driven and positively evaluated Maximising Sexual Wellbeing| Prostate Cancer (MSW|PC) eLearning resource to an eLearning resource suitable for health professionals (HPs) working with mixed cancer populations, followed by usability and acceptability testing. METHODS: Guided by Person-Based Approach (PBA) and Biopsychosocial Model, the MSW|PC was adapted by combining evidence from the literature, an expert group (n = 27: patients, partners, and HPs working in cancer care) and the research team. New content was developed relevant for a mixed cancer population. The Maximising Sexual Wellbeing| Cancer Care (MSW|CC) eLearning prototype was usability tested and modified with HPs using "think aloud" interviews (n = 18). RESULTS: Many identified sexual challenges were common across cancer populations, with additional information required for breast, colorectal, gynaecological, head and neck, and prostate cancers. During the testing phase, navigational difficulties were identified and resolved. HPs reported the MSW|CC as engaging, informative, and relevant with helpful communication and signposting tools to support practice. CONCLUSION: This systematic and iterative PBA yielded important insights to enhance the content and usability of MSW|CC. This novel resource provides HPs working across cancer care with tools to potentially address the gap in knowledge and skills and positively impact future sexual healthcare provision across cancer care.