Patients' and Providers' Perceptions of the Implementation of a Stepped Care Cognitive-Behavioral Therapy for Insomnia in Routine Cancer Care: A Qualitative Post-Implementation Study.
8 affiliations
- 1School of Psychology, University of Ottawa, 75 Laurier Ave E, Ottawa, ON K1N 6N5, Canada.
- 2Université Laval Cancer Research Center, 11 Côte du Palais, Québec, QC G1R 2J6, Canada.
- 3School of Psychology, Université Laval, 2325 Allée des Bibliothèques, Québec, QC G1V 0A6, Canada.
- 4CHU de Québec-Université Laval Research Center, 1401 18e Rue, Québec, QC G1J 1Z4, Canada.
- 5Centre des Maladies du Sein, CHU de Québec-Université Laval, 1050 ch Ste-Foy, Québec, QC G1S 4L8, Canada.
- 6School of Nursing, Université Laval, 1050 Avenue de la Médecine, Québec, QC G1V 0A6, Canada.
- 7CHU de Québec-Université Laval, 10 Rue de l'Espinay, Québec, QC G1L 3L5, Canada.
- 8CERVO Brain Research Center, 2301 Avenue d'Estimauville, Québec, QC G1E 1T2, Canada.
Abstract
Insomnia is one of the most commonly reported challenges among cancer patients and survivors. Cognitive-behavioral therapy for insomnia (CBT-I) is an effective treatment but remains underused in routine cancer care. A stepped-care CBT-I program was developed to address this gap. This study explores facilitators and barriers following the implementation of this program in four Québec cancer centers. Patients and providers participated in two individual interviews and seven focus groups. Interviews were guided by the Consolidated Framework for Implementation Research (CFIR). Data were transcribed and coded in NVivo using the CFIR codebook. A hybrid deductive-inductive thematic analysis was conducted. Codes were interpreted using Proctor's Implementation Outcomes Framework. A total of 14 patients and 18 providers were interviewed. Facilitators and barriers were divided into four key themes: (1) endorsement from trusted professionals; (2) fit with workflows and existing routines; (3) perceived burden for both patients and providers; and (4) readiness and motivation of both patients and providers. This analysis supports the acceptability, adoption, appropriateness, feasibility, and perceived sustainability of a stepped-care CBT-I in routine cancer care and suggests specific implementation strategies to optimize its implementation. Implementation of stepped-care CBT-I in routine cancer care has the potential to improve access to evidence-based treatments for insomnia and make it a standard component of survivorship care.
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BibTeX
@article{giguere2026patients,
title = {{Patients' and Providers' Perceptions of the Implementation of a Stepped Care Cognitive-Behavioral Therapy for Insomnia in Routine Cancer Care: A Qualitative Post-Implementation Study.}},
author = {Lauriane Giguère and Émilie Godin and Claudia Mc Brearty and Aude Caplette-Gingras and Marie-Pierre Gagnon and Lynda Bélanger and Charles M Morin and Josée Savard},
journal = {Current oncology (Toronto, Ont.)},
year = {2026},
month = sep,
doi = {10.3390/curroncol33100588},
url = {https://europepmc.org/article/MED/42930155},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patients' and Providers' Perceptions of the Implementation of a Stepped Care Cognitive-Behavioral Therapy for Insomnia in Routine Cancer Care: A Qualitative Post-Implementation Study.
AU - Lauriane Giguère
AU - Émilie Godin
AU - Claudia Mc Brearty
AU - Aude Caplette-Gingras
AU - Marie-Pierre Gagnon
AU - Lynda Bélanger
AU - Charles M Morin
AU - Josée Savard
PY - 2026
DA - 2026/09/01
JO - Current oncology (Toronto, Ont.)
DO - 10.3390/curroncol33100588
UR - https://europepmc.org/article/MED/42930155
AB - Insomnia is one of the most commonly reported challenges among cancer patients and survivors. Cognitive-behavioral therapy for insomnia (CBT-I) is an effective treatment but remains underused in routine cancer care. A stepped-care CBT-I program was developed to address this gap. This study explores facilitators and barriers following the implementation of this program in four Québec cancer centers. Patients and providers participated in two individual interviews and seven focus groups. Interviews were guided by the Consolidated Framework for Implementation Research (CFIR). Data were transcribed and coded in NVivo using the CFIR codebook. A hybrid deductive-inductive thematic analysis was conducted. Codes were interpreted using Proctor's Implementation Outcomes Framework. A total of 14 patients and 18 providers were interviewed. Facilitators and barriers were divided into four key themes: (1) endorsement from trusted professionals; (2) fit with workflows and existing routines; (3) perceived burden for both patients and providers; and (4) readiness and motivation of both patients and providers. This analysis supports the acceptability, adoption, appropriateness, feasibility, and perceived sustainability of a stepped-care CBT-I in routine cancer care and suggests specific implementation strategies to optimize its implementation. Implementation of stepped-care CBT-I in routine cancer care has the potential to improve access to evidence-based treatments for insomnia and make it a standard component of survivorship care.
SN - 1198-0052
SN - 1718-7729
ER -