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Front. Public Health | doi: 10.3389/fpubh.2018.00035

Developing a return to work intervention for breast cancer survivors with the Intervention Mapping protocol: challenges and opportunities of the needs assessment

 Jean-Baptiste Fassier1, 2*,  Marion Lamort-Bouché1, 3,  Guillaume Broc1,  Laure Guittard4, 5,  Julien Peron6, 7, Sabrina ROUAT8, Julien Carretier4, 9,  Béatrice Fervers9, 10, Laurent Letrilliart3, 4 and Philippe Sarnin8
  • 1UMRESTTE UMR_T9405, Claude Bernard University Lyon 1, France
  • 2Occupational Health and Medicine, Hospices Civils de Lyon, France
  • 3Collège universitaire de médecine générale, Claude Bernard University Lyon 1, France
  • 4HESPER EA7425, Claude Bernard University Lyon 1, France
  • 5Pôle IMER, Hospices Civils de Lyon, France
  • 6LBBE, UMR 5558, Claude Bernard University Lyon 1, France
  • 7Service d’oncologie médicale, Institut de Cancérologie (IC-HCL), Hospices Civils de Lyon, France
  • 8GRePS, EA 4163 (Groupe de Recherche en Psychologie Sociale), Lumière University Lyon 2, France
  • 9Département Cancer et Environnement, Centre Léon Bérard, France
  • 10Faculté de Médecine Lyon Est, Claude Bernard University Lyon 1, France

Return to work (RTW) is an important step for breast cancer survivors (BCS). However, they face many barriers which affect particularly women with low socioeconomic status. Healthcare, workplace and insurance actors lack of knowledge and collaborate poorly. No intervention to date has proven effective to reduce social disparities in employment after breast cancer. The Intervention Mapping protocol is being used in France to develop, implement and evaluate an intervention to facilitate and sustain return to work after breast cancer (FASTRACS project). The research question of this study was to elicit the needs for RTW after breast cancer from the various stakeholders’ point of view. The aim of this study was to describe the process and the preliminary results of the needs assessment of the FASTRACS project. Different methods were followed to a) establish and work with a planning group, b) conduct a needs assessment to create a logic model of the problem. A planning group was organized to gather the stakeholders with the research team. A review of the literature and indicators was conducted to identify the magnitude of the problem and the factors influencing RTW. A qualitative inquiry was conducted with 12 focus groups and 48 individual semi-structured interviews to explore the needs and experience of the stakeholders. The results of these tasks were the proposition of a charter of partnership to structure the participative process, a review of the scientific evidence and indicators, and the description by the stakeholders of their needs and experience. Many stakeholders disagreed with the concept of ‘early intervention’. They advocated for a better support of breast cancer survivors during their RTW, emphasized as a process. Anticipation, intersectoral collaboration, and workplace accommodation were mentioned to fit the needs of the BCS and their environment. A logic model of the problem was elaborated from these data. The ability of the model to consider specific characteristics of women with low socioeconomic status is discussed, with a view to developing the FASTRACS intervention through the next steps of the IM protocol.

Keywords: Intervention mapping, breast cancer, Needs Assessment, Return-to-work, Work rehabilitation, Program Development, Participative research, Social health disparities

Received: 09 Oct 2017; Accepted: 31 Jan 2018.

Edited by:

Gerjo Kok, Maastricht University, Netherlands

Reviewed by:

Frederieke Schaafsma, VU University Medical Center, Netherlands
Angelique D. Rijk, Maastricht University, Netherlands  

Copyright: © 2018 Fassier, Lamort-Bouché, Broc, Guittard, Peron, ROUAT, Carretier, Fervers, Letrilliart and Sarnin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: MD, PhD. Jean-Baptiste Fassier, Claude Bernard University Lyon 1, UMRESTTE UMR_T9405, 8, avenue Rockefeller, Lyon, F-69373, France,