Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

Implementation of the culturally adapted online interactive Malnutrition Screening Tool into three cancer services  (#473)

Isabel Bailey 1 , Jenelle Loeliger 1 2 , Karla Gough 3 4 5 , Hollie Bevans 6 , June Savva 7 , Tanya McKenzie 8 , Sarah Sanelli 1 , Courtney Pocock 9 , Shu-Yi Soong 10 , Michael Barton 11 , Jane Stewart 1
  1. Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  2. School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
  3. Health Services Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  4. Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, VIC, Australia
  5. Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia
  6. Dietetics and Nutrition Department, Western Health, Melbourne, VIC, Australia
  7. Nutrition and Dietetics, Monash Health, Melbourne, VIC, Australia
  8. Health Literacy and Diversity Manager, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  9. Department of Speech Pathology and Audiology, Western Health, Melbourne, VIC, Australia
  10. Nutrition and Speech Pathology Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
  11. Western and Central Melbourne Integrated Cancer Services, Melbourne, VIC, Australia

Aims: The Malnutrition Screening Tool (MST) is commonly used within Australian cancer services to identify malnutrition risk. In 2019, the MST was culturally adapted, translated into 10 languages and converted into an interactive online tool. This tool was deemed acceptable and feasible for use but remained untested within usual clinical care. This project’s aim was to support three Victorian cancer services to embed the interactive online MST into usual care. The Consolidated Framework for Implementation Research (CFIR) was used to guide and assess the implementation strategy and success of implementation was evaluated according to Proctor’s outcomes of acceptability, adoption, appropriateness, feasibility, and fidelity. 

Methods: The Knowledge-to-Action Model guided implementation of the online MST. Three pre-implementation focus groups identified barriers and enablers to implementation, and strategies were tailored to site-specific workflows. Following an 8-month implementation phase, evaluation was conducted through three focus groups with implementation team members and interviews with nursing managers. Results were thematically analysed using CFIR domains and constructs, and themes were assessed against Proctors implementation outcomes.   

Results: The online MST was considered acceptable, appropriate, and feasible for use in a range of cancer settings with planning and tailored implementation strategies. Both adoption and fidelity were impacted by barriers in the individual and inner settings, however demonstrated improvement with targeted strategies. Challenges to implementation included reduced staff engagement due to insufficient understanding of the tool’s benefits as well as staff turnover and timeline delays due to COVID-19. Enablers included clinical champions, ease of access and a staff education package. The important role of staff education and reinforcement opportunities to ensuring the tool’s sustainability were highlighted. 

Conclusion: The culturally adapted and translated online MST can be successfully implemented within a range of cancer settings by utilising tailored strategies. A suite of resources to support implementation are available at www.petermac.org/MST.