{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:21:50Z","timestamp":1783113710522,"version":"3.54.6"},"reference-count":45,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp;amp; Cancer"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Adolescents and young adults (AYAs) with advanced cancer navigate complex medical decisions amid evolving autonomy and family involvement. MyPref, a digital values\u2010clarification tool using adaptive conjoint analysis, helps AYAs articulate care preferences and supports clinicians in initiating preference\u2010based conversations. This study explored pediatric oncology clinicians\u2019 experiences with MyPref to identify barriers, facilitators, and strategies for clinical integration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>\n                      We conducted a qualitative study using semi\u2010structured interviews with attending physicians and nurse practitioners (\n                      <jats:italic>N<\/jats:italic>\n                      = 10) at a single academic pediatric center. Participants had received MyPref summary reports for at least one AYA enrolled in the MyPref Adapt Study. Interviews were audio\u2010recorded and analyzed using conventional content analysis to identify themes related to clinical utility and implementation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Clinicians emphasized MyPref's potential to reveal patient priorities, strengthen communication, and normalize values\u2010based dialogue. Implementation was limited by time constraints, uncertain actionability, and emotional discomfort\u2014particularly during periods of prognostic ambiguity. Barriers reflected structural (workflow integration, competing demands) and relational factors (patient readiness, family involvement, clinician tolerance for uncertainty). Recommended strategies to enhance uptake included leadership endorsement, communication training, psychosocial collaboration, and iterative refinement of MyPref's design and delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Clinician insights underscore MyPref's potential to deepen connection and elevate AYAs\u2019 voices in advanced cancer care when thoughtfully integrated into practice. Addressing implementation challenges will require flexible timing, reflective spaces for clinicians to navigate uncertainty, and systems\u2010level support to embed preference\u2010based discussions into routine care. Broader success depends on a cultural shift that normalizes anticipatory dialogue and centers AYAs\u2019 personhood when navigating serious illness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70345","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T12:39:49Z","timestamp":1776256789000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Preferences to Practice: Clinician\u2010Informed Strategies to Integrate the MyPref Values\u2010Clarification Tool Into Adolescent and Young Adult Oncology Care"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9194-424X","authenticated-orcid":false,"given":"Simran","family":"Bansal","sequence":"first","affiliation":[{"name":"Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace S.","family":"Chandler","sequence":"additional","affiliation":[{"name":"Division of Hematology\u2010Oncology Ann &amp; Robert H. Lurie Children's Hospital  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-8994","authenticated-orcid":false,"given":"Jennifer M.","family":"Snaman","sequence":"additional","affiliation":[{"name":"Department of Supportive Oncology Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"},{"name":"Division of Hematology\/Oncology, Boston Children's Hospital Department of Pediatric Oncology, Dana\u2010Farber Cancer Institute Harvard Medical School  Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.2196\/10463"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.30554"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/COAYA.S60916"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27713"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2018\u20102800"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010016\u20103561\u2010z"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/jayao.2013.0011"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2025.07.036"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers14030710"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5109"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2005.04.015"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.04.068"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.2196\/17673"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/23814683251344624"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/wvn.12522"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1369\u20107625.2010.00595.x"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010020\u201005806\u20101"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28755"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1037\/cpp0000486"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989x16671933"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.31624"},{"key":"e_1_2_10_23_1","volume-title":"Qualitative Research & Evaluation Methods: Integrating Theory and Practice","author":"Patton M. 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