{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T10:31:18Z","timestamp":1787308278285,"version":"build-2736575974"},"reference-count":46,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"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":["Health Planning &amp;amp; Management"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Patient Navigation Programs (PNPs) address fragmentation and socioeconomic barriers in breast cancer care, but sustainable implementation is complex and context dependent. This scoping review systematically maps and synthesises multilevel determinants of breast cancer PNPs to inform strategic planning and health system management for sustainable service delivery across diverse public health contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Guided by the Arksey and O'Malley methodology framework and reported in accordance with PRISMA\u2010ScR, we conducted a comprehensive search across five databases, covering studies published between January 2000 and December 2025. Implementation determinants were retrospectively mapped using the Consolidated Framework for Implementation Research (CFIR v1.0) as an analytic lens. Dual independent screening and multi\u2010reviewer construct coding were performed, with discrepancies resolved through consensus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010six studies met the inclusion criteria. Determinants were identified across all five CFIR domains. Outer\u2010setting pressures (e.g.,\u00a0financial and transportation barriers) frequently intersect with inner\u2010setting constraints (e.g.,\u00a0workforce shortages, fragmented service structures). Process\u2010related strategies, particularly stakeholder engagement and\u00a0structured navigator training, were consistently described as enabling mechanisms that buffered contextual strain\u2014intervention characteristics, including cost, complexity, and adaptability, moderated integration trajectories. Sustainability improved when navigation functions were embedded within routine service structures rather than maintained as externally funded add\u2010ons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The implementation of breast cancer PNPs appears to be shaped by dynamic cross\u2010domain interactions. This synthesis suggests that sustainability may be strengthened through alignment of financing arrangements, workforce configuration, service integration mechanisms, and deliberate implementation strategies. A proposed phased implementation pathway offers a practical planning guide for resource\u2010constrained systems.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hpm.70129","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T10:14:59Z","timestamp":1787307299000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Planning and Sustaining Breast Cancer Patient Navigation Programs: A CFIR\u2010Informed Scoping Review of Implementation Determinants"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-4710-8932","authenticated-orcid":false,"given":"Siti Nurhafizah","family":"Saharudin","sequence":"first","affiliation":[{"name":"Department of Community Medicine School of Medical Sciences Universiti Sains Malaysia  Kota Bharu Kelantan Malaysia"},{"name":"Selangor State Health Department Malaysia Ministry of Health Wisma Sunway  Shah Alam Selangor Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-8017-0158","authenticated-orcid":false,"given":"Nazirul Munir Abu","family":"Hassan","sequence":"additional","affiliation":[{"name":"Department of Community Medicine School of Medical Sciences Universiti Sains Malaysia  Kota Bharu Kelantan Malaysia"},{"name":"Kelantan State Health Department Malaysia Ministry of Health  Kota Bharu Kelantan Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-9850-1978","authenticated-orcid":false,"given":"Mohd Fittri Fahmi","family":"Fauzi","sequence":"additional","affiliation":[{"name":"Department of Community Medicine School of Medical Sciences Universiti Sains Malaysia  Kota Bharu Kelantan Malaysia"},{"name":"Kelantan State Health Department Malaysia Ministry of Health  Kota Bharu Kelantan Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-8839-3581","authenticated-orcid":false,"given":"Ahmad Zulfahmi","family":"Sha'ari","sequence":"additional","affiliation":[{"name":"Department of Community Medicine School of Medical Sciences Universiti Sains Malaysia  Kota Bharu Kelantan Malaysia"},{"name":"Kelantan State Health Department Malaysia Ministry of Health  Kota Bharu Kelantan Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0120-8609","authenticated-orcid":false,"given":"Mohd Faiz Mohd","family":"Ghazali","sequence":"additional","affiliation":[{"name":"Department of Community Medicine School of Medical Sciences Universiti Sains Malaysia  Kota Bharu Kelantan Malaysia"},{"name":"Kelantan State Health Department Malaysia Ministry of Health  Kota Bharu Kelantan Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0917-2728","authenticated-orcid":false,"given":"Afiq Izzudin A.","family":"Rahim","sequence":"additional","affiliation":[{"name":"Department of Community Medicine School of Medical Sciences Universiti Sains Malaysia  Kota Bharu Kelantan Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010022\u201008927\u2010x"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12905\u2010022\u201001793\u2010z"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1200\/jgo.17.00229"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.19.00526"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010013\u20102491\u20104"},{"key":"e_1_2_13_8_1","volume-title":"Patient Navigation for Early Detection","author":"WHO","year":"2024"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102407\u201010\u2010551"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2014.01.002"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201021\u20100191"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacr.2024.03.006"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ncc.0b013e3181c40401"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0223537"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/10732748211038734"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.evalprogplan.2021.101999"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.2196\/42683"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.6050"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/1364557032000119616"},{"key":"e_1_2_13_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20104\u201050"},{"key":"e_1_2_13_21_1","doi-asserted-by":"publisher","DOI":"10.7326\/M18\u20100850"},{"key":"e_1_2_13_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010022\u201001245\u20100"},{"key":"e_1_2_13_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010025\u201001450\u20107"},{"key":"e_1_2_13_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/IGC.0000000000001256"},{"key":"e_1_2_13_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.conctc.2019.100411"},{"key":"e_1_2_13_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13187\u2010024\u201002429\u20106"},{"key":"e_1_2_13_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23547"},{"key":"e_1_2_13_28_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313481007601003"},{"issue":"7","key":"e_1_2_13_29_1","first-page":"106","article-title":"An Evaluation of a Community\u2010Based Breast Education and Navigation Program: Highlights and Lessons Learned From the Pitt County Breast Wellness Initiative","volume":"27","author":"Torres E.","year":"2018","journal-title":"Cancer Epidemiology, Biomarkers & Prevention"},{"key":"e_1_2_13_30_1","doi-asserted-by":"publisher","DOI":"10.1188\/12.ONF.379\u2010385"},{"key":"e_1_2_13_31_1","doi-asserted-by":"publisher","DOI":"10.4102\/sajo.v1i0.30"},{"key":"e_1_2_13_32_1","doi-asserted-by":"publisher","DOI":"10.1200\/jgo.19.00054"},{"key":"e_1_2_13_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/fmch\u20102023\u2010002397"},{"key":"e_1_2_13_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010021\u201006675\u2010y"},{"key":"e_1_2_13_35_1","doi-asserted-by":"publisher","DOI":"10.1200\/jgo.18.59500"},{"key":"e_1_2_13_36_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201012\u20100537"},{"key":"e_1_2_13_37_1","doi-asserted-by":"publisher","DOI":"10.1177\/1524839916628865"},{"key":"e_1_2_13_38_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10549\u2010017\u20104498\u20108"},{"key":"e_1_2_13_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010008\u20100416\u20102"},{"key":"e_1_2_13_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13187\u2010017\u20101298\u20100"},{"key":"e_1_2_13_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13187\u2010015\u20100904\u20102"},{"key":"e_1_2_13_42_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35671"},{"key":"e_1_2_13_43_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13187\u2010019\u201001492\u20108"},{"key":"e_1_2_13_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2025.11.032"},{"issue":"10","key":"e_1_2_13_45_1","first-page":"e616","article-title":"Documenting Coordination of Cancer Care Between Primary Care Providers and Oncology Specialists in Canada","volume":"62","author":"Brouwers M. C.","year":"2016","journal-title":"Canadian Family Physician"},{"key":"e_1_2_13_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2023.06.001"},{"key":"e_1_2_13_47_1","volume-title":"Global Breast Cancer Initiative Implementation Framework: Assessing, Strengthening and Scaling\u2010up of Services for the Early Detection and Management of Breast Cancer","author":"World Health Organization","year":"2023"}],"container-title":["The International Journal of Health Planning and Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hpm.70129","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hpm.70129","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hpm.70129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T10:15:02Z","timestamp":1787307302000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hpm.70129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":46,"alternative-id":["10.1002\/hpm.70129"],"URL":"https:\/\/doi.org\/10.1002\/hpm.70129","archive":["Portico"],"relation":{},"ISSN":["0749-6753","1099-1751"],"issn-type":[{"value":"0749-6753","type":"print"},{"value":"1099-1751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"assertion":[{"value":"2026-03-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-16","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"hpm.70129"}}