Participants described SHAReClinic as a much-needed resource for prostate cancer survivors' sexual health, but limited funding, lack of institutional support, and workflow integration challenges emerged as primary barriers to implementation.
Key Findings
Background
Sexual dysfunction is a prevalent and often under-addressed concern among prostate cancer survivors that significantly affects quality of life for patients and their partners.
The study identifies sexual dysfunction as a key survivorship issue in prostate cancer care
The concern extends beyond patients to include their partners
The study was motivated by the absence of standardized sexual health pathways in oncology care
Nine Canadian health care centres were involved in the assessment
Background
The True North Sexual Health and Rehabilitation eClinic (SHAReClinic) is a virtual, biopsychosocial intervention designed to improve access to sexual health support for prostate cancer survivors and their partners.
SHAReClinic uses a biopsychosocial framework, addressing biological, psychological, and social dimensions of sexual health
The intervention is delivered virtually
It is designed for both prostate cancer survivors and their partners
The study examined its pre-implementation context across nine Canadian health care centres
Methods
A qualitative descriptive design using semi-structured interviews with 17 knowledge users was employed to assess barriers and facilitators to SHAReClinic implementation.
17 knowledge users were interviewed, including health care providers and institutional leaders
Interviews were semi-structured in format
The study spanned nine Canadian health care centres
Data were analyzed using a hybrid deductive-inductive thematic approach
The Consolidated Framework for Implementation Research (CFIR) 2.0 guided the analysis
Results
Participants identified SHAReClinic as a much-needed resource, particularly given the absence of standardized sexual health pathways in oncology care.
All 17 participants were knowledge users including health care providers and institutional leaders
The perceived need was linked specifically to gaps in standardized sexual health support in oncology
Participants viewed the program as filling an important unmet need in cancer survivorship care
Results
The virtual format of SHAReClinic was perceived as accessible and well suited to addressing sensitive topics related to sexual health.
Virtual delivery was identified as a facilitator to implementation
Participants noted that the format was appropriate for discussing sensitive sexual health topics
Accessibility was highlighted as a key advantage of the virtual approach
Results
Limited funding, lack of institutional support, and workflow integration challenges emerged as primary barriers to SHAReClinic implementation.
Three primary barrier categories were identified: limited funding, lack of institutional support, and workflow integration challenges
These barriers were identified across nine health care centres
Findings were organized using the CFIR 2.0 framework
These barriers have implications for the scalability and sustainability of the program
Conclusions
The study findings offer practical, theory-informed guidance for integrating SHAReClinic into oncology care and highlight key considerations for developing sustainable and scalable survivorship care models.
Guidance is described as both practical and theory-informed
The CFIR 2.0 framework provided the theoretical basis for the findings
The authors frame findings in the context of broader survivorship care model development
Scalability and sustainability are identified as central considerations for future implementation
What This Means
This research suggests that sexual health problems are a common but poorly addressed issue for prostate cancer survivors and their partners in Canada, and that there are currently no standardized ways to help these patients within the existing oncology care system. To address this gap, researchers developed a virtual program called SHAReClinic that takes a whole-person approach — addressing physical, emotional, and relationship aspects of sexual health. Before rolling it out more widely, the research team interviewed 17 healthcare providers and hospital leaders across nine Canadian cancer centres to understand what would help or hinder the program's adoption.
The interviews revealed that healthcare professionals genuinely saw SHAReClinic as a valuable and needed resource. They appreciated that it was delivered virtually, which made it easier for patients to access and also felt like a more comfortable format for discussing sensitive topics around sexuality and cancer. However, three major obstacles were identified: not enough funding to sustain the program, insufficient support from healthcare institutions, and difficulties fitting the program into existing clinical workflows without disrupting how care is currently delivered.
This research suggests that while there is clear enthusiasm among healthcare providers for better sexual health support in cancer survivorship care, structural and financial barriers must be addressed before programs like SHAReClinic can be successfully and consistently offered to patients. The findings provide a practical roadmap — grounded in an established implementation science framework — for how cancer centres might work to overcome these obstacles and build long-term, scalable models of sexual health care for cancer survivors.
Incze T, Peres D, Guirguis S, Neil-Sztramko S, Bender J, Elterman D, et al.. (2025). Pre-Implementation Assessment of a Sexual Health eClinic in Canadian Oncology Care.. Current oncology (Toronto, Ont.). https://doi.org/10.3390/curroncol32070395