Adopting a systems-thinking approach to optimise dietary and exercise referral practices for cancer survivors
Publication Details
Joseph, R.,
Hart, N.,
Bradford, N.,
Crawford-Williams, F.,
Wallen, M.,
Milch, V.,
Han, C.,
Holland, J.,
&
Chan, R.
(2024).
Adopting a systems-thinking approach to optimise dietary and exercise referral practices for cancer survivors.
Supportive Care in Cancer, 32 (8).
Abstract
Purpose: Service referrals are required for cancer survivors to access specialist dietary and exercise support. Many systemlevel factors infuence referral practices within the healthcare system. Hence, the aim of this study was to identify system-level factors and their interconnectedness, as well as strategies for optimising dietary and exercise referral practices in Australia.
Methods: A full-day workshop involving national multidisciplinary key stakeholders explored system-level factors impacting dietary and exercise referral practices. Facilitated group discussions using the nominal group technique identifed barriers and facilitators to referral practices based on the six World Health Organisation (WHO) building blocks. The systems-thinking approach generated six cognitive maps, each representing a building block. A causal loop diagram was developed to visualize factors that influence referral practices. Additionally, each group identified their top five strategies by leveraging facilitators and addressing barriers relevant to their WHO building block.
Results: Twenty-seven stakeholders participated in the workshop, including consumers (n=2), cancer specialists (n=4), nursing (n=6) and allied health professionals (n=10), and researchers, representatives of peak bodies, not-for-profit organisations, and government agencies (n=5). Common system-level factors impacting on referral practices included funding, accessibility, knowledge and education, workforce capacity, and infrastructure. Fifteen system-level strategies were identified to improve referral practices.
Conclusion: This study identified system-level factors and strategies that can be applied to policy planning and practice in Australia.
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