JMIR Publications

ABSTRACT

Background:

Employment contributes to cancer survivors’ quality of life, but this population faces a variety of challenges when working both during and after treatment. We conducted this descriptive study as a preliminary step toward program development to meet the need among survivors at a rural comprehensive cancer center.

Objective:

(1) To identify supports and resources that stakeholders (cancer survivors, healthcare providers, and employers) suggest may help cancer survivors to maintain employment; and (2) To describe stakeholders’ views on the advantages and disadvantages of intervention delivery models that incorporate those supports and resources.

Methods:

We conducted a descriptive study collecting qualitative data from individual interviews and focus groups. Participants included adult cancer survivors, healthcare providers, and employers living and/or working in the Vermont–New Hampshire catchment area of the Dartmouth Cancer Center in Lebanon, NH, US. We grouped interview participants’ recommended supports and resources into four intervention categories, which ranged on a continuum from less to more intensive to deliver. We then asked focus group participants to discuss advantages and disadvantages of each of the four intervention categories.

Results:

Interview participants (n=45) included 23 cancer survivors, 17 healthcare providers, and 5 employers. Focus group participants (n=12) included 6 cancer survivors, 4 healthcare providers, and 2 employers. The four intervention categories were: (1) Educational materials; (2) Individual consultation with cancer survivors; (3) Joint consultation with both cancer survivors and their employers; and (4) Peer support or advisory groups. Each participant type acknowledged the value of providing educational materials, which could be crafted to improve accommodation-related interactions between survivors and employers. Participants saw utility in individual consultation but expressed concern about costs of program delivery and potential mismatches between consultant recommendations and the limits of what employers can provide. For joint consultation, employers liked being part of the solution and the possibility of enhanced communication. Potential drawbacks included additional logistical burden and its perceived generalizability to all types of workers and workplaces. Survivors and healthcare providers viewed the efficiency and potency of peer support as benefits of a peer advisory group but acknowledged the sensitivity of financial topics as a possible disadvantage of addressing work challenges in a group setting.

Conclusions:

The three participant groups identified both common and unique advantages and disadvantages of the four intervention types, reflecting varied barriers and facilitators to their potential implementation in practice. Theory-driven strategies to address these implementation barriers should play a central role in further intervention development.