title: Stakeholder perspectives on dissemination and implementation of a prospective surveillance model of rehabilitation for breast cancer treatment.
abstract: The prospective surveillance model proposes a paradigm shift in the delivery of care for patients with breast cancer. The model is based on clinical research and clinical practice experience that was reviewed and discussed at a multidisciplinary meeting. The model identifies critical physical sequelae of treatment as well as timeframes for identification of and surveillance for these issues. Although the model of ongoing assessment for physical impairment and early rehabilitative intervention creates a framework for care, broad support and active dissemination among a variety of stakeholders will be required to transform patient care. Translating research findings to transform practice often occurs on a protracted timeline. The authors sought participation from a variety of stakeholder representatives throughout the process of creating this model in an effort to ensure that it reflects the realities of the patient experience and care delivery, to incorporate their input regarding the construct and viability of the model, and to potentiate effective and efficient strategies for implementation. This article summarizes comments from stakeholder representatives concerning the prospective surveillance model for rehabilitation for women treated for breast cancer. Concerns addressed include the scope of impairments included in the model, the potential creation of barriers to exercise and participation in community exercise programs, and cost and feasibility issues. Stakeholder disseminations strategies are also presented. Overall, there is recognition by the stakeholder group that this model calls attention to important unmet needs and defines a crucial opportunity to improve care for breast cancer survivors.
authors.affiliation: Walter Reed National Military Medical Center, Bethesda, Maryland 20889, USA. nicole.stout@med.navy.mil
authors.forename: Nicole L
authors.initials: NL
authors.lastname: Stout
authors.forename: Kimberly
authors.initials: K
authors.lastname: Andrews
authors.forename: Jill M
authors.initials: JM
authors.lastname: Binkley
authors.forename: Kathryn H
authors.initials: KH
authors.lastname: Schmitz
authors.forename: Robert A
authors.initials: RA
authors.lastname: Smith
mesh_terms: D000328:Adult; D000368:Aged; D000570:American Cancer Society; D001943:Breast Neoplasms / Q000150:complications / Q000534:rehabilitation*; D003226:Congresses as Topic; D019317:Evidence-Based Medicine; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration*; D006801:Humans; D033181:Information Dissemination; D008137:Longitudinal Studies; D008875:Middle Aged; D017146:Models, Organizational; D010348:Patient Care Team / Q000458:organization & administration*; D011446:Prospective Studies; D011787:Quality of Health Care; D014481:United States