Jayeoba Monisola, Scherr Courtney L, Carroll Allison J, Daly Elyse, Kerstiens Savanna, Phillips Siobhan M, Hitsman Brian, Garcia Sofia F, Spring Bonnie, Jacobs Maia
Department of Communication Studies, School of Communication, Northwestern University, Evanston, IL, United States.
Department of Computer Science, McCormick School of Engineering and Applied Science, Northwestern University, Evanston, IL, United States.
J Med Internet Res. 2025 May 30;27:e65975. doi: 10.2196/65975.
Digital health behavior change interventions play an important role in helping cancer survivors improve their quality of life and reduce the risk of cancer recurrence. Clinician-patient communication is central to promoting the uptake of and adherence to digital health behavior change interventions. However, oncologists face significant barriers, including time constraints, knowledge gaps, and conversational uneasiness that limit risk behavior and health behavior change conversations.
This qualitative study aims to explore oncologists' preferences for discussing and monitoring risk behaviors with cancer survivors, with a specific focus on conversations about digital health behavior change interventions. This study also aims to explore oncologists' informational and technological support requirements to facilitate these conversations.
We conducted semistructured interviews with 18 oncologists who provide cancer care in a large National Cancer Institute-designated comprehensive cancer center. The transcripts and interview notes were analyzed through an iterative thematic analysis to generate relevant themes and categories.
We identified 2 major themes with 7 subthemes. The first theme focused on oncologists' desired roles in promoting health behavior change, while the second theme addressed the support needs to facilitate conversations about risk and health promotion. Oncologists expressed a desire for 2 action-oriented communication mechanisms for promoting digital health behavior change with their patients: referring patients to interventions and reinforcing intervention goals longitudinally. To facilitate risk behavior and health behavior change conversations, their support needs included a preference for low-burden, electronic health record-integrated tools providing timely updates on patient enrollment and progress. The participating oncologists requested a tailored conversation aid for patient communication and parallel systems combining electronic health record messaging with print materials. They also emphasized the need for automated recommender systems to identify and refer eligible patients and reminder systems to prompt timely discussions with patients.
Oncologists are motivated and well-positioned to support patients' health behavior change but have unmet informational and technological requirements. On the basis of oncologists' perspectives, our findings provide actionable, user-centered, low-burden strategies for facilitating oncologist-patient conversations about digital health behavior change interventions. We make recommendations for integrating these strategies directly into the electronic medical record system, with the goal of amplifying oncologists' influential roles in motivating health behavior change among survivors. These scalable strategies may be applicable beyond oncology to clinical contexts where greater promotion of patients' health behavior change is desired.
数字健康行为改变干预措施在帮助癌症幸存者提高生活质量和降低癌症复发风险方面发挥着重要作用。医患沟通是促进数字健康行为改变干预措施的采用和坚持的核心。然而，肿瘤学家面临着重大障碍，包括时间限制、知识差距和对话不安，这些都限制了风险行为和健康行为改变方面的对话。
这项定性研究旨在探讨肿瘤学家在与癌症幸存者讨论和监测风险行为方面的偏好，特别关注关于数字健康行为改变干预措施的对话。本研究还旨在探讨肿瘤学家促进这些对话所需的信息和技术支持。
我们对在一家大型国立癌症研究所指定的综合癌症中心提供癌症护理的18名肿瘤学家进行了半结构化访谈。通过迭代主题分析对访谈记录和笔记进行分析，以生成相关主题和类别。
我们确定了2个主要主题和7个子主题。第一个主题关注肿瘤学家在促进健康行为改变方面期望发挥的作用，而第二个主题涉及促进风险和健康促进对话所需的支持。肿瘤学家表示希望有两种以行动为导向的沟通机制来促进与患者的数字健康行为改变：将患者转介至干预措施并纵向强化干预目标。为了促进风险行为和健康行为改变方面的对话，他们需要的支持包括倾向于低负担、与电子健康记录集成的工具，这些工具能及时提供患者登记和进展情况的最新信息。参与研究的肿瘤学家要求提供针对患者沟通的定制对话辅助工具，以及将电子健康记录信息与印刷材料相结合的并行系统。他们还强调需要自动化推荐系统来识别和转介符合条件的患者，以及提醒系统来促使及时与患者进行讨论。
肿瘤学家有动力且处于有利位置来支持患者的健康行为改变，但他们未得到满足的信息和技术需求。基于肿瘤学家的观点，我们的研究结果提供了可操作的、以用户为中心的、低负担的策略，以促进医患关于数字健康行为改变干预措施的对话。我们建议将这些策略直接整合到电子病历系统中，目的是增强肿瘤学家在激励幸存者改变健康行为方面的影响力。这些可扩展的策略可能适用于肿瘤学之外的临床环境，在这些环境中更希望促进患者的健康行为改变。
