Implementing a Psychosocial Screener in Pediatric Oncology: Perspectives of Multidisciplinary Clinicians

OBJECTIVE: Despite strong evidence supporting universal psychosocial risk screening in pediatric cancer implementation remains inconsistent. Factors at organizational, provider, and patient/family levels impact implementation. Potential differing perspectives regarding risk screening among multidisciplinary providers may influence uptake. This study describes perceived barriers and facilitators in implementing the Psychosocial Assessment Tool (PAT), a psychosocial risk screener and examines differences by discipline. METHODS: One hundred seventeen healthcare providers (HCPs) representing medical, social work, and psychology from 18 pediatric cancer programs completed two scales from PAT Implementation Questionnaire (PIQ). Item scores (1-4 scale) were ranked and differences tested by discipline. RESULTS: Barriers were perceived as "minor" and facilitators as "significant" and overall PIQ scale scores did not differ by discipline. PIQ-B had a significantly lower mean score (M = 2.03) than PIQ-F (M = 3.08), p < 0.001). Barriers and facilitators rated most impactful (highest mean scores) were: Barriers: "Language barriers/cultural considerations" (M = 2.37) and "Integrating results in EHR" (M = 2.26); and Facilitators: "Promotes psychosocial care for all families" (M = 3.31) and "Promotes positive psychosocial outcomes" (M = 3.25). Significant differences were found in the rank ordering of barriers and facilitators by discipline, between social workers and psychologists, with the former noting time constraints associated with screening. CONCLUSIONS: Multidisciplinary HCPs generally agree on the benefits and challenges in implementation of screening with the PAT. Subtle variations in perceived impact of barriers and facilitators between social workers and psychologists highlight the importance of interdisciplinary collaboration and communication to facilitate implementation.