Enablers and barriers to accessing self‐management support services for those living with and beyond cancer: A qualitative study using the theoretical domains framework

Abstract

BackgroundSupporting those living with and beyond cancer to self‐manage their health can optimise health‐related quality of life and reduce symptom burden. Self‐management support (SMS) programmes have been shown to be effective, but uptake is often low. This qualitative study aimed to identify experienced and perceived enablers and barriers to accessing SMS services among those who had completed primary cancer treatment and were living with and beyond cancer.MethodsParticipants were recruited through social media and cancer advocacy groups. Semi‐structured telephone and online interviews were conducted. Transcripts were coded inductively based on participants' reported experiences. Statements related to factors that enable or inhibit access to SMS were then mapped to the Theoretical Domains Framework (TDF).ResultsTwenty‐six people participated. Six themes explain the factors that act as barriers and enablers which mapped to 11 TDF domains. Lack of knowledge of available SMS was a prominent barrier, as well as inaccessible services due to timing and place of delivery. Lack of confidence and emotional factors including fear were barriers to seeking SMS. Social influences shaped knowledge, attitudes and readiness to access SMS. Perceptions of SMS service goals and if in alignment with self‐identity, intentions and goals also shaped decisions around accessing support.ConclusionsWhile lack of knowledge and provider signposting were common barriers, findings suggest that other psychosocial and emotional factors may be barriers, even if SMS services are accessible. Findings are relevant for oncology healthcare services developing strategies to increase reach of SMS for those living with and beyond cancer.

Implementation science and psycho‐oncology: Advancing the translation of evidence into practice

“…4 Understanding the context-specific barriers is critical for the selection of strategies that may improve implementation success. 3 In this issue, three papers explore barriers and facilitators across the topics of self-management support programs, 5 colorectal cancer survivors' experiences of shared care and telehealth models 6 and implementation of a national guideline for palliative care. 7 Interestingly, while these studies have been conducted in different contexts-Ireland, Australia and Denmark-there are notable similarities across barriers.…”