{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T08:17:15Z","timestamp":1775204235293,"version":"3.50.1"},"reference-count":37,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,15]],"date-time":"2026-03-15T00:00:00Z","timestamp":1773532800000},"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; Cancer"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Inaccurate or imprecise diagnosis is a major contributor to treatment failure for children with cancer in low\u2010 and middle\u2010income countries (LMICs). Sequencing\u2010based diagnostic testing presents an opportunity to overcome diagnostic deficiencies. It is important to identify facilitators and barriers which are common to the implementation of sequencing\u2010based diagnostics in LMICs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Procedure<\/jats:title>\n                    <jats:p>Pediatric oncology research collaborators at six hospitals in LMICs were invited to participate in the study. Snowball sampling identified additional participants. Thirty\u2010nine virtual, semi\u2010structured interviews were conducted using interview guides informed by the Consolidated Framework for Implementation Research (CFIR) with suggested adaptations for LMICs. Rapid qualitative analysis was conducted to identify facilitators and barriers to the implementation of diagnostic sequencing for pediatric cancers. Barriers were then matched with expert recommendation for implementation change (ERIC) strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Implementation facilitators and barriers were organized by CFIR construct. Predominant facilitators were relative advantage, culture, collective efficacy, self\u2010efficacy, patient needs and resources, leadership engagement, knowledge and beliefs, tension for change, monitoring services for action, and implementation climate. Key barriers to implementation were cost, available resources, resource continuity, engaging participants, and resource source.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Participants communicated that the lack of diagnostic classification for pediatric cancer in LMICs is a common key limitation to current cancer care. They described considerable motivating strengths to leverage toward this goal of developing sequencing\u2010based diagnostic testing capacity. Resource availability, continuity, and sustainability are current barriers that must be addressed. Our data highlight the urgent need for creative global implementation partnerships as many centers in LMICs are poised to advance novel diagnostic solutions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1545-5017.70207","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T04:55:29Z","timestamp":1773636929000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Facilitators and Barriers for Implementing Diagnostic Sequencing Technology for Pediatric Oncology in Low\u2010 and Middle\u2010Income Countries"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1199-0081","authenticated-orcid":false,"given":"Kenneth M.","family":"Busby","sequence":"first","affiliation":[{"name":"Department of Pediatrics University of North Carolina  Chapel Hill North Carolina USA"},{"name":"Department of Pediatrics Emory University  Atlanta Georgia USA"}]},{"given":"Nathaniel","family":"Webb","sequence":"additional","affiliation":[{"name":"College of Arts and Science University of North Carolina  Chapel Hill North Carolina USA"}]},{"given":"Javeria","family":"Aijaz","sequence":"additional","affiliation":[{"name":"Indus Hospital  Karachi Pakistan"}]},{"given":"Federico","family":"Antillon\u2010Klussmann","sequence":"additional","affiliation":[{"name":"Unidad Nacional de Oncolog\u00eda Pedi\u00e1trica  Guatemala City Guatemala"},{"name":"School of Medicine Francisco Marroqu\u00edn University  Guatemala City Guatemala"}]},{"given":"Vaskar","family":"Saha","sequence":"additional","affiliation":[{"name":"Tata Translational Cancer Research Centre Tata Medical Center  Kolkata West Bengal India"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9639-7940","authenticated-orcid":false,"given":"Rui M.","family":"Reis","sequence":"additional","affiliation":[{"name":"Molecular Oncology Research Center Barretos Cancer Hospital  Barretos Brazil"}]},{"given":"Gevorg","family":"Tamamyan","sequence":"additional","affiliation":[{"name":"Pediatric Cancer and Blood Disorders Center of Armenia  Yerevan Armenia"}]},{"given":"Patricia","family":"Alcasabas","sequence":"additional","affiliation":[{"name":"Philippine General Hospital  Manila Philippines"}]},{"given":"Eva","family":"Cutiongdo\u2010de la Paz","sequence":"additional","affiliation":[{"name":"National Institutes of Health University of the Philippines  Manila Philippines"}]},{"given":"Jamie","family":"Zeal","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of North Carolina  Chapel Hill North Carolina USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4541-6910","authenticated-orcid":false,"given":"Dylan","family":"Graetz","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine St. Jude Children's Research Hospital  Memphis Tennessee USA"}]},{"given":"Nickhill","family":"Bhakta","sequence":"additional","affiliation":[{"name":"Department of Global Pediatric Medicine St. Jude Children's Research Hospital  Memphis Tennessee USA"}]},{"given":"Angelo","family":"Navas","sequence":"additional","affiliation":[{"name":"Eshelman School of Pharmacy University of North Carolina  Chapel Hill North Carolina USA"}]},{"given":"Samantha","family":"Rubio","sequence":"additional","affiliation":[{"name":"Eshelman School of Pharmacy University of North Carolina  Chapel Hill North Carolina USA"}]},{"given":"Stuart","family":"Rennie","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of North Carolina  Chapel Hill North Carolina USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0484-1574","authenticated-orcid":false,"given":"Thomas B.","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of North Carolina  Chapel Hill North Carolina USA"}]},{"given":"Megan C.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Eshelman School of Pharmacy University of North Carolina  Chapel Hill North Carolina USA"}]}],"member":"311","published-online":{"date-parts":[[2026,3,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(18)30909\u20104"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(13)70008\u20101"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(19)30273\u20106"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(18)30123\u20102"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2014.60.6376"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26709"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.5858\/arpa.2012\u20100571\u2010OA"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.aaw4892"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(20)30022\u2010X"},{"key":"e_1_2_8_11_1","volume-title":"CureAll Framework: WHO 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