Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Nov 10, 2025
Open Peer Review Period: Nov 11, 2025 - Jan 6, 2026
Date Accepted: Jan 14, 2026
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Facilitators and Barriers to Implementing Mobile Mental Health Interventions: A Qualitative Study of the Consolidated Framework for Implementation Research (CFIR) in Pediatric Oncology Providers
ABSTRACT
Background:
Adolescent and young adult (AYA) cancer survivors experience unique psychosocial needs during and after treatment. Mobile health (mHealth) interventions are an emerging area of research to help address unmet psychosocial needs. However, few studies have examined provider perspectives on the design-to-implementation pipeline.
Objective:
Guided by the Consolidated Framework for Implementation Research (CFIR), our study aimed to examine provider perspectives on facilitators and barriers to implementing mHealth apps in routine clinical care.
Methods:
AYA oncology providers participated in a semi-structured 1:1 interview on facilitators and barriers to incorporating mHealth apps as psychosocial standard of care. We conducted a directed content analysis of the interviews utilizing a standardized CFIR codebook and construct definitions, with codebook adaptations for mHealth innovations and the AYA cancer population.
Results:
A total of 20 providers (Mage = 39, SDage = 7.0; 80% female; 70% non-Hispanic White) representing various medical and psychosocial roles participated in the interviews. The data were analyzed with 16 CFIR constructs. We identified the following facilitators to mHealth implementation across 4 CFIR domains: (1) Innovation: alignment with patient needs, patient-centered co-design, strong research evidence, user-friendly design; (2) Outer Setting: shared commitment to addressing mental health needs, openness to mHealth use; (3) Inner Setting: openness to training on mHealth use; (4) Individuals: engaging key implementation partners such as bedside nurses and social workers, strong clinical team buy-in. We identified the following barriers to mHealth implementation across 3 CFIR domains: (1) Innovation: associated costs for patients; (2) Outer Setting: heavy clinical workloads; (3) Inner Setting: lack of cross-team collaboration and communication, clinical workflow integration.
Conclusions:
Our findings highlight key considerations for mHealth co-design, the adoption of mHealth apps into routine care, implementation strategies, and provider training opportunities in the context of AYA cancer care. Partnering with AYA patients, families, and providers will be crucial for developing and implementing mHealth apps with the ultimate goal of advancing universally accessible evidence-based digital health care.
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Copyright
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