Beyond the Document: A Single-Center Qualitative Study of Survivorship Care Plan Barriers and Opportunities Across Pediatric Oncology Stakeholders.

BACKGROUND

Survivorship care plans (SCPs) summarize cancer treatment and guide risk-based follow-up for cancer survivors, yet remain difficult to create, share, and use. Stakeholder perspectives are needed to inform usable approaches.

OBJECTIVE

To characterize how SCPs are created, shared, and used in pediatric oncology and identify stakeholder priorities for improving workflows and SCP design.

METHODS

We conducted semi-structured interviews with childhood cancer survivors and family members, primary care providers (PCPs), and oncology clinicians at a single academic center. Interviews explored SCP receipt or creation, usefulness, barriers, and communication across care settings. Transcripts were analyzed using inductive thematic analysis, with interpretation informed by a sociotechnical work-system perspective.

RESULTS

Twenty-one participants were interviewed: seven survivor/family participants (one survivor, six caregivers), nine PCPs, and five oncology clinicians. Four higher order themes were identified: (i) Survivorship care remained oncology-centered, reflecting relational continuity developed during treatment and uncertainty about shared-care roles. (ii) SCPs were valued but poorly integrated into clinical workflows. (iii) SCP content reflected standardized documentation more than tailored user needs: families needed understandable information, PCPs needed concise action items and role clarity, and oncology clinicians needed detailed treatment and guideline information. (iv) Stakeholders viewed digital and AI-assisted tools as potentially helpful for reducing manual work and improving access, but emphasized accuracy, transparency, and oversight.

CONCLUSION

SCP challenges extend beyond the document to surrounding systems of communication, responsibility, and workflow. Future SCPs should be embedded in clinical processes and designed as role-specific, user-centered tools, with technology supporting rather than replacing clinician judgment and relational continuity.