{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:41:09Z","timestamp":1792489269461,"version":"4.5.0"},"reference-count":30,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T00:00:00Z","timestamp":1785024000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["MRFF, KAOH APP 1174028."],"award-info":[{"award-number":["MRFF, KAOH APP 1174028."]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>While evidence demonstrates benefits of early palliative care, translation into practice remains inconsistent. Effective implementation strategies are required to advance the field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To understand implementation strategies perceived as effective in delivering early palliative care for people with cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Multi-site stepped-wedge implementation trial of an early palliative care model for people with cancer, \u2018Care Plus\u2019, with qualitative outcome data focused upon perceptions of implementation strategies. Designed to target barriers to palliative care, Care Plus intervention involved: introduction of palliative care at designated cancer specific illness points; outpatient delivery of minimum three palliative care consultations alongside usual cancer care; and primary care case conferences. Interviews to understand perceptions of implementation strategies were audio-recorded, transcribed and analysed using a combined thematic inductive and theoretical deductive approach. This enabled identification of emerging ideas as well as categorisation based upon the RE-AIM implementation framework domains (Reach, Effectiveness, Adoption, Implementation and Maintenance).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Participants:<\/jats:title>\n                    <jats:p>Four Australian hospitals, involving patients, carers and healthcare providers purposively sampled across representative tumour streams.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Fifty-one interviews: patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200911), caregivers (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20092) and healthcare providers (physicians\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200919, nurse consultants\/practitioners\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200916, other\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20093), with, in total, 232 patients receiving Care Plus. Participants highlighted effective implementation strategies as: clinician-endorsed \u2018transition\u2019 points to prompt referral; systematic identification of patients; patient referral embedded into workflows; branding \u2018Care Plus\u2019, key phrases and mentored training to support referring clinicians; regular feedback to clinicians; and co-locating palliative care and cancer clinics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These effective strategies are available for the field to replicate supporting broader palliative care implementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration:<\/jats:title>\n                    <jats:p>\n                      ACTRN12619001703190, [\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.anzctr.org.au\/\">https:\/\/www.anzctr.org.au\/<\/jats:ext-link>\n                      ]\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163261465765","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T05:51:02Z","timestamp":1785131462000},"page":"1363-1374","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating early palliative care: Qualitative results from a multi-site implementation trial"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3312-0645","authenticated-orcid":false,"given":"Jennifer","family":"Philip","sequence":"first","affiliation":[{"name":"Department of Medicine, St Vincent\u2019s Hospital, University of Melbourne"},{"name":"Palliative Care Service, Royal Melbourne Hospital, Parkville, Australia"},{"name":"Peter MacCallum Cancer Centre, Parkville, Australia"},{"name":"Victorian Comprehensive Cancer Centre Alliance"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2139-0100","authenticated-orcid":false,"given":"Anna","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Medicine, St Vincent\u2019s Hospital, University of Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8296-4668","authenticated-orcid":false,"given":"Kylee","family":"Bellingham","sequence":"additional","affiliation":[{"name":"Department of Medicine, St Vincent\u2019s Hospital, University of Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0830-4864","authenticated-orcid":false,"given":"Brian","family":"Le","sequence":"additional","affiliation":[{"name":"Palliative Care Service, Royal Melbourne Hospital, Parkville, Australia"},{"name":"Peter MacCallum Cancer Centre, Parkville, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna K.","family":"Nowak","sequence":"additional","affiliation":[{"name":"Medical School, University of Western Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0715-1405","authenticated-orcid":false,"given":"Nicole M.","family":"Rankin","sequence":"additional","affiliation":[{"name":"Melbourne School of Population and Global Health, University of Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue-Anne","family":"McLachlan","sequence":"additional","affiliation":[{"name":"Cancer Services, St Vincent\u2019s Hospital, Melbourne"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijaya","family":"Sundararajan","sequence":"additional","affiliation":[{"name":"Department of Medicine, St Vincent\u2019s Hospital, University of Melbourne"},{"name":"Health Equity Research, St Vincent\u2019s Health Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7347-8855","authenticated-orcid":false,"given":"Gregory B.","family":"Crawford","sequence":"additional","affiliation":[{"name":"Adelaide Medical School, Faculty of Health &amp; 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