Barriers and Facilitators to the Implementation of Family Cancer History Collection Tools in Oncology Clinical Practices

Introduction: This study aimed to identify barriers and facilitators to the implementation of family cancer history (FCH) collection tools in clinical practices and community settings by assessing clinicians’ perceptions of implementing a chatbot interface to collect FCH information and provide personalized results to patients and providers. By identifying design and implementation features that facilitate tool adoption and integration into clinical workflows, this study can inform future FCH tool development and adoption in healthcare settings. Methods: Quantitative data was collected using implementation science measure surveys to evaluate the acceptability, adoption, appropriateness, feasibility, and sustainability of the chatbot tool for collecting FCH, and semi-structured interviews were conducted to gather qualitative data on respondents' experiences using the tool and recommendations for enhancements. Results: We completed 19 interviews with providers (n = 9, 47%), clinical staff (n = 5, 26%), administrators (n = 4, 21%) and other staff (n = 1, 5%) affiliated with the NCI Community Oncology Research Program. FCH was systematically collected using a wide range of tools at sites, with information being inserted into the patient’s medical record. Participants found the chatbot tool to be highly acceptable, with the tool aligning with existing workflows, and were open to adopting the tool into their practice. Conclusions: The varying clinical workflows across clinic sites necessitates that future FCH tool development accommodates customizable implementation strategies. A one-size-fits-all approach to implementation of FCH collection tools in clinical workflows is not feasible and options for implementation should be considered during tool development to enhance the uptake of FCH in clinical practices and community settings.