Table 3

Themes and dimensions

Theme

Dimension

Concepts


Building capacity

Science and research

Capacity for basic and clinical science; funding for clinical research; trained nurses/staff for clinical research.


Skilled nurses

Capacity to train nurses for patient care and patient education and to provide qualified nursing support.


Research infrastructure

Capacity for clinical research; need for research laboratories; need for research equipment.


National statistics

Capacity to investigate local incidence and characteristics of breast cancer; IT capacity to support national registries and research.


Public education

Capacity for national public education and awareness campaigns on breast cancer and screening.


Developing evidence

Study of local etiology

Evidence identifying differences between local patients and those in the UK/USA; younger women; more aggressive tumor morphology.


Personalized therapy

Evidence to promote personalized therapy; includes using genetic targets to tailor treatment.


Developing guidelines

Research in local populations and other evidence to inform local guidelines and policies; national treatment guidelines and coordination.


International networks

Connecting to evidence internationally; keeping up to date; global research programs, networking and education opportunities.


Local communication

Communicating evidence across stakeholders; improved communications between/within institutions and across institutions within areas or the country.


Removing barriers

Out-of-pocket costs

Barriers due to out-of-pocket expenses paid for by the patient.


Disparities in access

Barriers for underserved and rural populations.


High cost to payers

Barriers to reimbursing high-cost treatments.


Early detection

Barriers to accessing earlier detection.


Reimbursement

Barriers to accessing therapies that are not yet proven to be cost effective.


Promoting advocacy

Patient empowerment

Strategies to empower patients/patient groups and inform consumers.


Managing survivorship

Support increased focus on survivors; long-term side-effects and quality of life.


Quality of life

Support increased focus in research and practice on quality of life.


Metastatic disease

Support for the management of metastatic disease.


Organized advocacy

Support for leadership and staffing of advocacy groups; communication between advocacy groups.


Bridges et al. BMC Health Services Research 2011 11:227   doi:10.1186/1472-6963-11-227

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