Developing a Return to Work Intervention for Breast Cancer Survivors with the Intervention Mapping Protocol: Challenges and Opportunities of the Needs Assessment

Abstract

Return to work (RTW) is an important step for breast cancer survivors (BCSs). However, they face many barriers that affect particularly women with low socioeconomic status (SES). Health care, workplace, and insurance actors lack knowledge and collaborate poorly. No intervention to date has proven effective to reduce social disparities in employment after breast cancer. The intervention mapping (IM) protocol is being used in France to develop, implement, and evaluate an intervention to facilitate and sustain RTW after breast cancer [FAciliter et Soutenir le retour au TRAvail après un Cancer du Sein (FASTRACS) project]. The research question of this study was to elicit the needs for RTW after breast cancer from various stakeholders’ point of view. The aim of this study was to describe the process and the preliminary results of the needs assessment of the FASTRACS project. Different methods were followed to (a) establish and work with a planning group and (b) conduct a needs assessment to create a logic model of the problem. A planning group was organized to gather the stakeholders with the research team. A review of the literature and indicators was conducted to identify the magnitude of the problem and the factors influencing RTW. A qualitative inquiry was conducted with 12 focus groups and 48 individual semi-structured interviews to explore the needs and experience of the stakeholders. The results of these tasks were the proposition of a charter of partnership to structure the participative process, a review of the scientific evidence and indicators, and the description by the stakeholders of their needs and experience. Many stakeholders disagreed with the concept of “early intervention.” They advocated for a better support of BCSs during their RTW, emphasized as a process. Anticipation, intersectoral collaboration, and workplace accommodation were mentioned to fit the needs of the BCS and their environment. A logic model of the problem was elaborated from these data. The ability of the model to consider specific characteristics of women with low SES is discussed, with a view to developing the FASTRACS intervention through the next steps of the IM protocol.

Returning to work after cancer: Survivors', caregivers', and employers' perspectives

“…Many cancer survivors and caregivers are struggling to find the best pathways to return to their jobs. While efforts to design interventions to support cancer survivors in returning to work are underway, these may not be entirely successful if they are directed only to survivors and not caregivers or workplace stakeholders …”

Intervention Mapping: Theory- and Evidence-Based Health Promotion Program Planning: Perspective and Examples

“…Fassier et al (44) describe the use of IM in the development of an intervention to help breast cancer survivors in France successfully return to work after treatment. The authors emphasize the importance of taking an ecological perspective to planning and note that IM can help identify and document interpersonal, organizational, community, and societal influences.…”

Managing employment among pre-retirement aged cancer survivors

“…Participants in this study were not “returning” to work (de Boer et al., 2011; Tamminga et al., 2010). This common view has infused both the clinical and research worlds with the notion of “return to work.” A logic model related to work and breast cancer visually illustrated the idea that return to work happened after treatment (Fassier et al., 2018). In contrast, we found that managing to continue to work during treatment was one of the most commonly discussed topics.…”