Contextual assessment of perceived health system alignment with National Standards for Cancer Survivorship Care in the American Southeast
5 affiliations
- 1Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, USA
- 2Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, USA
- 3Department of Implementation Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, USA
- 4Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, USA
- 5Vanderbilt-Ingram Cancer Center, Nashville, USA
Abstract
Purpose: We assessed perceived alignment of a large health system in the American Southeast with the National Standards for Cancer Survivorship Care (National Standards).
Methods: We engaged key partners and distributed an electronic survey to oncology practices within the system. In parallel, in four representative clinics we collected qualitative data including four clinic observations and 12 semi structured interviews informed by the Consolidated Framework for Implementation Research (CFIR).
Results: Of the 51 informants at practices who received the survey, 16 consented, and 10 completed at least one item. On average, informants reported meeting 55% of the survivorship care National Standards at least some of the time. Facilitators and barriers for National Standards implementation were identified in these CFIR Domains: Characteristics of the Individuals (e.g., believed to be beneficial for improving and standardizing care), Outer Setting (e.g., need to be linked to an incentive), Inner Setting (e.g., need for more provider training on what is available), Intervention Characteristics (e.g., difficult to understand), and Process (e.g., important decision-makers).
Conclusions: While most informants reported meeting at least half of the National Standards, there was variability in how consistently National Standards were perceived as applied across practices. Further, there was likely bias, with more favorable responses from those who chose to complete the survey than those who did not.
Implications for Cancer Survivors: These data demonstrate a systematic approach for assessing alignment with National Standards and identifying opportunities for improving survivorship care. A model that combines standardized survivorship services with flexibility to meet local population needs may help reduce gaps in care, promote equitable access to supportive resources, and enhance outcomes for cancer survivors across diverse settings.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02123-0.
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BibTeX
@article{bluethmann2026contextual,
title = {{Contextual assessment of perceived health system alignment with National Standards for Cancer Survivorship Care in the American Southeast}},
author = {Shirley M. Bluethmann and Stephanie Bunch and Chandylen Nightingale and Alana R. Willis and Beth York and Beth Fisher and Sarah A. Birken and Rachel Zimmer and Carla Strom and Ashley Strahley and Sarah Zakrzewski and Stephanie J. Sohl},
journal = {Journal of Cancer Survivorship},
year = {2026},
month = sep,
doi = {10.1007/s11764-026-02123-0},
url = {https://doi.org/10.1007/s11764-026-02123-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Contextual assessment of perceived health system alignment with National Standards for Cancer Survivorship Care in the American Southeast
AU - Shirley M. Bluethmann
AU - Stephanie Bunch
AU - Chandylen Nightingale
AU - Alana R. Willis
AU - Beth York
AU - Beth Fisher
AU - Sarah A. Birken
AU - Rachel Zimmer
AU - Carla Strom
AU - Ashley Strahley
AU - Sarah Zakrzewski
AU - Stephanie J. Sohl
PY - 2026
DA - 2026/09/15
JO - Journal of Cancer Survivorship
DO - 10.1007/s11764-026-02123-0
UR - https://doi.org/10.1007/s11764-026-02123-0
AB - Purpose: We assessed perceived alignment of a large health system in the American Southeast with the National Standards for Cancer Survivorship Care (National Standards). Methods: We engaged key partners and distributed an electronic survey to oncology practices within the system. In parallel, in four representative clinics we collected qualitative data including four clinic observations and 12 semi structured interviews informed by the Consolidated Framework for Implementation Research (CFIR). Results: Of the 51 informants at practices who received the survey, 16 consented, and 10 completed at least one item. On average, informants reported meeting 55% of the survivorship care National Standards at least some of the time. Facilitators and barriers for National Standards implementation were identified in these CFIR Domains: Characteristics of the Individuals (e.g., believed to be beneficial for improving and standardizing care), Outer Setting (e.g., need to be linked to an incentive), Inner Setting (e.g., need for more provider training on what is available), Intervention Characteristics (e.g., difficult to understand), and Process (e.g., important decision-makers). Conclusions: While most informants reported meeting at least half of the National Standards, there was variability in how consistently National Standards were perceived as applied across practices. Further, there was likely bias, with more favorable responses from those who chose to complete the survey than those who did not. Implications for Cancer Survivors: These data demonstrate a systematic approach for assessing alignment with National Standards and identifying opportunities for improving survivorship care. A model that combines standardized survivorship services with flexibility to meet local population needs may help reduce gaps in care, promote equitable access to supportive resources, and enhance outcomes for cancer survivors across diverse settings. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02123-0.
SN - 1932-2259
SN - 1932-2267
ER -