Table 5.

Reported barriers to Bright IDEAS adoption, implementation and maintenance in pediatric oncology practice.

Measures of implementation barriers	No. (%) Reporting “Yes, this measure is a barrier.”
	6-months post training *				12-months post training **
	Pre-adaptation	Post-adaptation	Overall	P -value	Pre-adaptation	Post-adaptation	Overall	P -value
	(N = 159)	(N = 50)	(N = 209)		(N = 159)	(N = 50)	(N = 209)
I lack time (to assess/counsel clients)	83 (59.7%)	23 (57.5%)	106 (59.2%)	0.80	77 (63.1%)	11 (40.7%)	88 (59.1%)	0.03
Incorporating Bright IDEAS into routine care (clinical work flow)	68 (48.9%)	17 (42.5%)	85 (47.5%)	0.47	72 (59.0%)	16 (59.3%)	88 (59.1%)	0.98
Client compliance issues	53 (38.1%)	15 (37.5%)	68 (38.0%)	0.94	56 (45.9%)	13 (48.1%)	69 (46.3%)	0.83
Bright Ideas takes too much time	31 (22.3%)	6 (15.0%)	37 (20.7%)	0.31	28 (23.0%)	7 (25.9%)	35 (23.5%)	0.74
Lack of opportunity (clients)	30 (21.6%)	10 (25.0%)	40 (22.3%)	0.65	30 (24.6%)	6 (22.2%)	36 (24.2%)	0.79
Lack of administrative support	11 (7.9%)	3 (7.5%)	14 (7.8%)	0.93	13 (10.7%)	2 (7.4%)	15 (10.1%)	0.61
Lack of experience	10 (7.2%)	3 (7.5%)	13 (7.3%)	0.95	4 (3.3%)	4 (14.8%)	8 (5.4%)	0.02
Reimbursement and/or insurance issues	10 (7.2%)	1 (2.5%)	11 (6.1%)	0.28	7 (5.7%)	1 (3.7%)	8 (5.4%)	0.67
Lack of consensus of professional guidelines	2 (1.4%)	0 (0.0%)	2 (1.1%)	0.45	1 (0.8%)	0 (0.0%)	1 (0.7%)	0.64

Source: Online surveys administered 6 and 12 months after the initial in-person training session.

^*N missing was 14.4% (N = 30).

^**N missing was 28.7% (N = 60).