Table 1.

Research Phases

Phase 1	Phase 2	Phase 3
Usual Care	Education Intervention	Support Intervention
	Patient Barriers	Patient Barriers
No intervention. Data collected to obtain baseline information.	Pain & fatigue patient education by research nurses Extensive written patient teaching materials Visibility of pain and fatigue through posters in all clinic rooms and on patient folder	Patient education delivered by clinic staff through simplified/brief teaching tools and “scripts” to guide teaching Visibility of pain and fatigue through posters in all clinic rooms and on patient folder Teaching materials in all exam rooms, clinic area, on website, and through Patient Education Department
	Follow-up phone calls every 2 weeks for 3 months
	Professional Barriers	Professional Barriers
	Pain and fatigue presentations by national experts to oncologists and NP’s Monthly newsletter to providers for ongoing communication and education Research results presentations at grand rounds	Professional education integrated into existing structures (e.g. Grand Rounds, monthly meetings) Meetings with various departments (medical oncology, pharmacy, nutrition, supportive care) to encourage and support them in efforts to focus on pain and fatigue Sharing study abstracts and publications with clinical staff
	System Barriers	System Barriers
	Internal Advisory Board (IAB) meets quarterly to gain clinician input for researchers Research nurses prompt earlier referrals to supportive services Meetings with Nurse Practitioners	Continued IAB meetings with emphasis on transfer of intervention from research team to institution Promote early referral as routine practice by clinicians Clinical mentoring of nurse practitioners by research nurses Integration of greater pain/fatigue data on routine clinical forms