Understanding the Multilevel Factors Influencing the Implementation of Mindfulness-based Mobile Applications in Adolescents and Young Adult (AYA) Cancer Survivorship Care

Abstract Background A growing body of evidence supports the efficacy of a range of mind-body therapies in alleviating psychosocial stress and other symptoms in cancer patients and survivors. Healthcare providers can leverage the convenience and appeal of technology to deliver psychosocial interventions for AYA cancer survivors. The goal of this study was to identify key patient-, provider-, and organization-level barriers and facilitators to implementing evidence-based mindfulness mobile applications for AYAs with cancer. Methods Twenty semi-structured interviews were conducted with stakeholders including AYA survivors (n = 10) and clinical providers and administrators (n = 10). Interviews were transcribed and deductively mapped using the CFIR and TDF complementary frameworks. Results Results indicated that factors like cost and patients’ needs and resources were prevalent among both survivors and providers. There were key differences between providers and AYA survivors. Providers’ adoption and promotion of mindfulness mobile applications were influenced most strongly by contextual factors. That is, providers described available resources (Inner Setting), culture (Outer Setting), and networks and communications (Outer Setting) as important factors in their adoption. On the other hand, survivors emphasized individual and intervention-related factors; they reported that social influence and knowledge influenced their adoption of meditation apps. Conclusions These results identified barriers and facilitators to the adoption of mindfulness mobile interventions from multiple stakeholders. Results can be used to guide the development of implementation strategies to improve the uptake of evidence-based mindfulness interventions in care, ultimately improving the psychosocial well-being of AYA cancer survivors.