Table 3.

Strategies for Establishing and Expanding Integrative Oncology (IO) Services.

Establishing an IO Center	Expanding an IO Center
Identify successful IO services to explore options for how to establish an IO service, sustainable business models, which TCIM services to provide, and recruiting and credentialing TCIM practitioners. Seek top-down support at the organizational and policy levels, and bottom-up support from the community and local champions	Find ways to make the work of nurses and oncologists easier. Collaborate with the health care team to demonstrate firsthand the benefits of IO. Take advantage of any opportunity to share evidence-based information about TCIM with hospital staff
Culture: patient groups, professions, and corporate
Focus on the importance of cultural competence and respect between health care professions and when responding to a patient’s values, preferences, and culture. Challenge negative attitudes (eg, IO is a nonessential service and not evidence based)	Proactively create a presence to negate “not being on the radar” of supportive cancer care services. Address any organizational policy that prevents IO service development. Challenge negative attitudes (eg, IO is a nonessential service and not evidence based)
Health literacy and practitioner education about benefits and risks
Engage stakeholders, listen and proactively address uncertainties about TCIM efficacy and safety. Identify reputable examples of user-friendly information (paper and electronic) for patients, practitioners, and providers about clinical indications and existing evidence	Ensure continuing education sessions for health professionals. Enable easy access to IO clinical resources for patients, practitioners, and providers about clinical indications and existing evidence
Research
Consider using an experience-based co-design, participatory action research model to engage relevant stakeholders. Establish a pilot program as a research initiative. Collaborate with other established IO research programs	Collect patient-reported outcomes on symptom burden and patient feedback about their experiences with IO and preferences. Improve translation by sharing the results of clinical research with hospital staff and management
Funding
Identify and advocate for funding opportunities within the overarching health system of the country or region (eg, public health funding, private health insurance funding, philanthropy) and ways to support patients with financial hardship. Make the case for value-based IO health care that places patients’ values at the center of service delivery and funding decisions

Abbreviations: TCIM, traditional complementary and integrative medicine.