JMIR Publications

ABSTRACT

Background:

Children with cancer or cancer-like disease risk treatment-related isolation that negatively impacts their peer relationships, social competencies and exacerbates their loneliness. The COVID-19 Pandemic triggered increased virtual social interaction, including classmate “ambassador” online visits for hospitalised children with cancer.

Objective:

The objective of this study is to identify facilitators and barriers to online classmate “ambassador” visits during hospitalisation through a qualitative process evaluation using the Consolidated Framework for Implementation Research.

Methods:

We conducted 39 individual semi-structured interviews with hospitalised children (n=16), classmates (n=16), teachers (n=3) and Study nurses (n=4) from January to April 2022. To identify the participants’ perceptions of any facilitators and barriers, a thematically abductive analysis was performed using qualitative descriptive research and the Consolidated Framework for Implementation Research.

Results:

We identified xix facilitators and three barriers to online ambassador visits from the participants’ descriptions. The facilitators included: 1) adaptability of context; 2) adaptability of content; 3) the role of Study nurses and teachers; 4) the role of ambassadors; 5) collaboration between hospitals and schools; and 6) a desire to stay socially connected. Barriers were: 1) poor internet connection; 2) the online setting; and 3) children’s ages. The facilitators and barriers emanated from the Innovation, Individuals, and Implementation Process domains.

Conclusions:

The study shows that while hospitalised children and their classmates want to interact online, specific facilitators and barriers and the organizational context determine the success of these visits. While a high degree of adult engagement is required, these visits can promote cross-institutional interaction between children. Clinical Trial: This study is a part of the RESPECT Study [file no.: H-20077439].