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The value of prostate cancer support groups: a pilot study of primary physicians’ perspectives Garrett, Bernard M; Oliffe, John L; Bottorff, Joan L; McKenzie, Michael; Han, Christina S; Ogrodniczuk, John S Mar 28, 2014

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RESEARCH ARTICLE Open AccessThe value of prostate cancer support groups:a pilot study of primary physicians’ perspectivesBernard M Garrett1*, John L Oliffe1, Joan L Bottorff2, Michael McKenzie3, Christina S Han1 and John S Ogrodniczuk4AbstractBackground: In Canada, prostate cancer (PCa) is the most common male cancer, and prostate cancer supportgroups (PCSGs) have prevailed for more than 20 years providing support to men with PCa and their families. Whilethe format, focus and benefits of attending PCSGs have been reported little is known about primary physicians’(PPs) perceptions of these groups. This article describes Canadian primary physicians’ views about face-to-face andweb-based PCSGs.Methods: Canadian based primary physicians (n = 140) attending a 2012 Continuing Medical Education Conferenceparticipated in a pilot survey questionnaire study. The 56-item questionnaire used in this study included six sets ofattitudinal items to measure primary physicians’ beliefs about positive and negative influences of PCSGs, reasons forattending PCSGs, the attributes of effective PCSGs, and the value of face-to-face and web-based PCSGs.Results: Results showed that PCSGs were positively valued, particularly for information sharing, education andpsychosocial support. Poor inclusivity, privacy, and accessibility were identified as potential barriers, andrecommendations were made for better marketing and web-based PCSGs to increase engagement with potentialattendees.Conclusions: Findings suggest PPs highly valued the role and potential benefits of PCSGs. Information provisionand an educational role were perceived as key benefits amid the need to improve local and provincial marketing ofPCSGs. The potential for web-based PCSGs to help in the support of PCa patients was also recognized.Keywords: Prostate cancer support groups, Primary healthcare providers, Clinician’s attitudesBackgroundIn Canada, prostate cancer (PCa) is the most commonmale cancer [1] with widespread availability of prostatespecific antigen (PSA) testing increasing PCa detection[2,3]. Men are also living longer with PCa and amid de-clining PCa mortality rates there are expectations thatthe PCa incidence will increase significantly in the future[1,4]. Today many men experience PCa as a chronic ill-ness [5], for which ongoing psychosocial supports areneeded. Among the support options available, volunteer-led, community-based face-to-face prostate cancer sup-port groups (PCSGs) have prevailed as a major source ofsuch support in Canada for more than 20 years, attract-ing men and their partners to monthly meetings atapproximately 100 Canadian groups. Another recenttrend is Web-based PCSGs [6].Research findings indicate that attending PCSGs pro-vides reassurance, reduces anxiety, improves positiveoutlook and the perception of being more involved intreatment decisions [7,8]. Other reported benefits in-clude mitigating the psychosocial impact of cancer byconveying information, empowering men with PCa, en-hancing and facilitating psychosocial adjustment, andhelping men and their partners cope with PCa [8-19]. A2005 review [20] concluded that PCSGs attendees mostvalued the information and education they received fromattending group meetings (e.g., information related totreatment, side effects, and the latest PCa research).Reported barriers to attending PCSGs included men’stendencies to avoid disclosure (due to a low perceivedneed for support), fear of stigmatization, denial of illness,practical access issues, the desire to avoid burdening* Correspondence: Bernie.garrett@nursing.ubc.ca1School of Nursing, University of British Columbia, T201, 2211 Wesbrook Mall,V6T 2B5 Vancouver, BC, CanadaFull list of author information is available at the end of the article© 2014 Garrett et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly credited.Garrett et al. BMC Family Practice 2014, 15:56http://www.biomedcentral.com/1471-2296/15/56others, [21-23] and misperceptions that PCSG meetingswere geared towards support of the terminally ill [24].While PCSG attendees and non-attendees perceptionshave been described, little is known about primary phy-sicians’ (PPs) perceptions of PCSGs (both face-to-faceand Web based). PPs’ views about PCSGs are especiallyimportant because there is evidence that health care pro-viders (HCPs) strongly influence men’s interest in atten-ding PCSGs [25-27]. Indeed research confirms that HCPs’endorsement is a leading influence of patients’ PCSG at-tendance [25,28,29]. Inversely, HCPs’ lack of awareness ofPCSGs can reduce the likelihood of men attending PCSGs[23,27,30]. In a novel study of 36 Australian clinicians(27 urologists and 9 radiation oncologists), Steginga et al.[26] found participants were reluctant to refer patients toPCSGs, fearing that biased viewpoints and misinformationwithin the groups might contribute to men’s uncertaintyand decisional regret. Whether these findings generalizeto PPs more widely, or apply in the Canadian contextis unknown.In this study, our primary objective was to establishbaseline data by addressing the question: what are PPsperceptions of the value of PCSGs?MethodsAn initial pilot survey of PPs was undertaken, designedto test logistics and gather information prior to conduc-ting a larger scale investigation. The pilot study wasdesigned to collect baseline data from subjects and im-prove study design including consideration if the initialfindings support the tools/approach selected, feasibility ofthe selected methods, and technical and cultural issuesthat should be addressed to improve the quality, rigourand efficiency of later work. In this inductive pilot studyto elicit data on PPs perceptions regarding PCSGs a sim-ple survey approach was adopted based on Steginga et al.’stool [26]. This survey utilized both Likert scaled ques-tions to gather quantitative data and open-ended ques-tions to collect qualitative data to further explore the PPsperceptions.SubjectsFollowing review by the University of British Columbia’sBehavioural Research Ethics Board’s approval, a non-probability convenience sample of Canadian-based PPswas recruited in two ways. In the first week of launchingthe survey questionnaire (SQ) 14 subjects responded toadvertisements and completed the survey online. Shortlythereafter, the study lead (second author) provided abrief background and the purpose of the study ahead ofinviting approximately 1,400 CME delegates at the2012 St. Paul’s Hospital Continuing Medical Education(CME) conference, Vancouver, British Columbia tocomplete the SQ. Two research staff distributed hard copySQs and postcard flyers with details for accessing the SQonline at the CME conference and 126 attendees com-pleted the survey in hard copy (n = 93) and online (n =33). All participants were offered an honorarium of a $50gift card as an incentive acknowledging their contributionto the study. For the pilot study there were no specific ex-clusion criteria and this group was selected as it repre-sented a diverse range of PPs from a variety of provincesand urban and rural areas who could be expedientlyaccessed to provide some initial data.Survey instrumentThe instrument selected to solicit the PP’s views wascomposed of a 56-item questionnaire based on an exist-ing Australian study tool [26]. This tool, was developedfrom findings drawn from qualitative interviews withAustralian-based HCPs, and subsequently pilot-tested andvalidated with 36 PCa specialists in 2006. We incorpo-rated five demographic questions and six sets of attitu-dinal items to measure beliefs about: positive influences ofPCSGs; negative influences of PCSGs; reasons for atten-ding PCSGs; the attributes of effective PCSGs; and thevalue of face-to-face and web-based PCSGs. Each set of at-titudinal items included 5–9 questions that were eachrated by respondents using a 5-point Likert scale (where1 = strongly disagree and 5 = strong agree). An open-ended question to provide additional information was alsoincluded in the survey: “Are there any other commentsyou would like to make about prostate cancer supportgroups and/or this survey?” This instrument is availablefrom the researchers on request. Descriptive univariatestatistics were used to analyze the survey responses usingmedian scores (being more appropriate for ordinal Likertdata). An interpretive content analysis of responses to theopen-ended questions was also undertaken and the parti-cipant’s responses were read, coded and analyzed to iden-tify and report key thematic elements and patternsemerging from the data.ResultsSeptember 2012 through January 2013, a total of 140Canadian PPs in a variety of settings including hospitaland/or private practice completed the survey in hardcopy (n = 93: 66%) and online (n = 47: 34%). Womencomprised 61% (n = 85), and respondents ranged in agefrom 27 to 69 years (Median = 44.1 years). The majority(55%) had over 5 years’ experience with PCa patients, and11% had over 30 years of experience with this patient popu-lation. The remaining 45% of respondents indicated thatthey had less than five years’ experience with this patientgroup. A minority of PPs in the sample (36%) reported ac-tually referring patients to PCSGs, and few (6%) reportedpresenting content at PCSGs. For more respondent demo-graphic details, please refer to Table 1. Demographics.Garrett et al. BMC Family Practice 2014, 15:56 Page 2 of 9http://www.biomedcentral.com/1471-2296/15/56Features of PCSGs that positively influence men’sadjustment to PCaRespondents provided ratings of seven features of PCSGsthat were potentially positive influences on men’s adjust-ment to PCa (Figure 1). The ratings of these features wereuniformly high. Access to information and communitysupport were identified as the biggest benefits of attend-ance, whilst friendship and reassurance were the leaststrongly endorsed. Yet this finding is relative, as 80% ofthe respondents agreed or strongly agreed that these latterfeatures also had a positive effect on men’s adjustment toPCa, indicating they were still perceived as beneficial.Features of PCSGs that negatively influence men’sadjustment to PCaPPs rated nine items related to possible negative influencesof PCSGs including, meeting with dominant memberswho push their own views, dissemination of inaccurateinformation, hearing negative experiences, creating conflictover treatment decisions, promoting a specific clinician,creating confusion, supplying irrelevant information, caus-ing confrontation and promoting a single therapy. The me-dian response for all of these items was 3 (neutral) with nospecific negative factors being singled out as particularlyinfluential. Nevertheless, some negative perceptions of thevalue of PCSGs did arise in the open-ended responses, andare discussed below.Reasons for Attending PCSGsPPs rated five items in the survey related to why men at-tend PCSGs. The most highly endorsed reason to attendPCSGs was to gain information (median of 5), followedby discussion of PCa and therapies, and reassurance(median of 4; see Figure 2). This appears to be consistentwith the findings concerning positive influences of PCSGs,where groups act as information trading resources andthis feature is a primary motivator for attendance. Thereappeared to be less agreement on the value of socialinteraction and helping others to help promote PCSGattendance.Reasons for not attending PCSGsPerceived reasons for not attending PCSGs were assessedwith 9 items in the survey (see Figure 3). Privacy and ig-norance of what PCSGs could offer were the most clearlyendorsed reasons for not attending PCSGs (median of 4),illustrating concerns that men don’t want to discuss theirproblems with others, and also a perceived lack of patient’sknowledge about the groups. Denial, a desire to move pastthe PCa experience, a concern they may feel “indebted”and a perceived weakness in sharing emotion were alsohighly endorsed by PPs (median of 4) as reasons whysome men might not want to attend PCSGs. Several re-spondents in the open-ended responses also identifiedlanguage as a potential barrier to attendance.Characteristics of effective PCSGsRespondents were asked to rate six items designed to as-sess their views on the characteristics of effective face-to-face PCSGs (see Figure 4). Avoiding bias by not promotingone view of treatment was the most highly endorsed char-acteristic of effective PCSGs (median rating of 5). Having atrained facilitator, discussion of a diversity of therapies,having a range of different health profession’s input, gettingsupport from other health organizations, and being patientdriven were also generally agreed as the most importantcharacteristics for group success (median rating of 4).Characteristics of Effective Web-based PCSGsSubjects were also asked to consider a range of aspectsof Web-based PCSGs, and consider what they thoughtwould be most effective. They rated the seven itemsTable 1 DemographicsAge (years) – Mean = 44.1 (Range = 27–69)20-30 62 (44.3%)31-59 57 (40.7%)60′s 19 (13.6%)Unspecified 2 (1.4%)GenderFemale 85 (60.7%)Male 54 (38.6%)Unspecified 1 (0.7%)Practice location (province)AB 13 (9.3%)BC 89 (63.6%)NB 2 (1.4%)MB 17 (12.1%)ON 8 (5.7%)PE 1 (0.7%)SK 8 (5.7%)Unspecified 2 (1.4%)Years working with PCa patients0-5 63 (45%)6-20 38 (27.1%)21+ 37 (26.4%)Unspecified 2 (1.4%)Linkages to PCSGsPresenter at group 9 (6.4%)Refereed patients to group 51 (36.4%)Group member 1 (0.7%)No linkages 79 (56.4%)n.b. percentages may not total 100 due to rounding.Garrett et al. BMC Family Practice 2014, 15:56 Page 3 of 9http://www.biomedcentral.com/1471-2296/15/56in this question positively (median of 4; see Figure 5).Provision of summarized PCa information was identi-fied as the most essential feature of effective web-basedPCSGs, closely followed by the provision of multimediaevidence-based HCP presentations. Facilitation fosteringcamaraderie was also highly valued, as was Web 2.0 inter-activity. Over 60% thought that a separate web area formen would be important and a login should not be re-quired. More mixed views with no consensus were evidentas to whether the website should be led by a PCa survivor.Content-analysis of open-ended responsesSixty-three of the respondents shared additional insightsvia written comments. Table 2 presents the five broadthemes along with illustrative quotes derived from thecontent analysis of the open-text comments.The effective marketing of PCSGs was a significant themeas several respondents commented on the need for this.Many subjects mentioned the importance of increasingprofessional and public awareness of PCa and PCSGs toreduce stigma and break with male stereotypes. One PPnoted that “…patients don’t know where to go and MDsdon’t know where to refer.” Specific suggestions includedhaving PCa and PCSGs-related pamphlets and written re-sources, or posters in multiple languages in PP offices.One PP confessed that he had had never recommendedPCSGs to PCa patients, because he was not aware of theexistence of PCSGs.The need for inclusivity in PCSGs, particularly for PCSGsthat cater to specific ethnic groups and partners/caregivers,was also highlighted. Several respondents suggested thatpartners and caregivers should be encouraged to attend14030120232755312339514682537482174419500% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%InformationHelp OthersDiscussion of Ca./Tx.Social InteractionReassurance1 Strongly Disagree 2 Disagree 3 Neutral 4 Agree 5 Strongly AgreeFigure 2 Reasons why men choose to attend a PCSG.6543234013546261214172420846515049656545827169664546810% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%Provide InformationEmotional SupportSharing ExperiencesSocial IdentityReassuranceFriendshipCommunity1 Strongly Disagree 2 Disagree 3 Neutral 4 Agree 5 Strongly AgreeFigure 1 Positive factors how PCSGs influence men’s adjustment to PCa.Garrett et al. BMC Family Practice 2014, 15:56 Page 4 of 9http://www.biomedcentral.com/1471-2296/15/56and invited to ask questions and share their experiences.In contrast, privacy was also a significant concern forPCSG effectiveness. Several respondents recognized men’sreluctance to engage health services and highlighted thepotential for web-based PCSGs to help overcome men’sconcerns about confidentiality and anonymity (particularlyin rural communities).Accessibility to PCSGs in local communities and theneed for web-based PCSGs to reach specific sub-groupsincluding young, blue-collar, and rural based PCa pa-tients with limited access to healthcare were highlighted.Several respondents expressed concerns about theelderly and their limited access to the Internet. Therewere also concerns that older PCa patients have lim-ited computer literacy and/or access to the Web (seeTable 2).In agreement with the Likert responses, respondentssaw a balanced range of health professionals’ input as akey factor and that patient-centred PCSGs were key tosuccess. However, this did not necessarily translate toseeing benefits in having PCSGs actually led by PCa sur-vivors, as some commented they thought this might notnecessarily be productive.Respondents also agreed that PCSGs educate PCa pa-tients and raise awareness on a range of important topicsincluding prognosis, up-to-date treatment options, andside effects.DiscussionIn terms of methodological design, the study had a typi-cally low response rate of approximately 10% for remotelyadministered survey questionnaires [31] and this may beimproved through targeted communication strategiessuch as additional warning and follow up e-mails prior toand after distributing the survey [32]. The survey toolproved satisfactory in providing useful data to explore1616312833275143015546114452857474317523375477838547163306857152825610534250% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%PrivacyNo NeedDenialLanguage DifficultiesHave Enough Info.Want to Move OnIgnorance of PCSGIndebtednessWeakness1 Strongly Disagree 2 Disagree 3 Neutral 4 Agree 5 Strongly AgreeFigure 3 Reasons why men choose not to attend a PCSG.11211106101131226333721325541874757649528360261740452050560% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%Web 2.0 InteractivitySeparate area for menEBP Mulitmedia ContentLogin not requiredLed by PCa survivorSummarized PCa info.Facilitates camaraderie1 Strongly Disagree 2 Disagree 3 Neutral 4 Agree 5 Strongly AgreeFigure 4 Reasons why men choose not to attend a PCSG.Garrett et al. BMC Family Practice 2014, 15:56 Page 5 of 9http://www.biomedcentral.com/1471-2296/15/56PPs perceptions and the open-ended questions generateduseful supplementary data, supporting the use of mixedmethod data collection strategies. This indicates that theuse of supplementary interviews may also be useful in fu-ture studies. No other specific technical or cultural issuesarose from the methodology.The pilot study indicates that information seeking isone of the main reasons men attend PCSGs (Figure 1and Table 2), in supporting the findings of previouslyreported work [10,12,13]. The PPs recognized that manymen do not want to self-disclose and have concerns thatPCSGs might not meet their needs (Table 2), and theseperceptions are also in line with previous research aboutwhy men don’t attend [10,12]. Language, ethnic and cul-tural barriers were all identified by PPs as barriers toPCSG effectiveness, suggesting that ensuring PCSGs areinclusive (including providing support for partners) maybe important to encourage participation by diverseFigure 5 Key factors for the effectiveness of a web-based PCSG.Table 2 Key thematic elements from open text questions (numbers indicate additional similar comments)Broad themes Positive comments Negative commentsMarketing “Schedule groups during sporting event” “Need better advertising,pts don’t know where to go. MD’s don’t know where to refer. (3)“I have never recommended or been aware of such groups.”“Please expand your services to other commonly usedlanguages in Canada”There should be better promotion of prostate cancer support groupsin order to “destigmatize” the challenges associated with the illnessand its treatments.“Should promote general men’s health, not just prostatecancer issues.”“…calling it a “support group” might scare away somemen.”“Regularly scheduled.” (2)“…media supported by government agencies.”Inclusivity “Important to consider spouses experience with prostate cancer.” (3) “…language + culture barriers are significant.” (4)“Ethnic diverse prostate support groups would be helpful.” (3)Privacy “..an outlet for men to share their experience and stay anonymousmay help other patients.” (2)“The vast majority of men prefer not to talk in groupsetting” (2)Accessibility “Web based support groups are important.” (4) “Elderly patients… are not comfortable with web-based ser-vices” (2)“There should be a support group in each community - if notweb-based access available” (2)“A good portion of the largest group are not on the web soan office based group program needed” (2)“…web based access important but how do we access/educate them [blue-collar workers).”Balance “I am strongly in favor of support groups that are led/driven bypatient needs and interests.”“As a physician…I was very reluctant to join any groups,fearing I would become the ’2nd opinion.”“The support group needs to be balanced to help patients workthrough this in a way that doesn’t alienate them.”“I do not think have a group lead that’s a “survivor” isnecessarily a good thing.”Education “…education is most important…” (2) “…dissemination ofup-to-date treatment options.”-Garrett et al. BMC Family Practice 2014, 15:56 Page 6 of 9http://www.biomedcentral.com/1471-2296/15/56groups of men with PCa as well as garnering PPs refer-rals to PCSGs.The views expressed (Figures 1, 2 & Table 2) indicatedthat PPs considered PCSG attendees would be less en-gaged with sharing in the groups, and more likely to at-tend in order to obtain information. In some respects,this may indicate that PPs do not anticipate men aslonger-term attendees to these groups. The improveduptake of PCSGs would also seem contingent on im-proved strategic marketing as ignorance of PCSGs re-mains a concern (Figure 3 & Table 2). Formal linkageswith government agencies, other community-based or-ganizations and multidisciplinary HCPs could help sup-port this. PPs’ core work involves providing information,and by encouraging PPs to more explicitly promote theavailability and potential benefits of PCSGs, patientsmight be more likely to attend.The respondents held positive attitudes toward Web-based PCSGs and endorsed their use as a useful step to-wards some men eventually participating in face-to-facegroup meetings or workshops (Figure 5 & Table 2). Al-though there were concerns that older PCa patients havelimited computer literacy and/or access (Table 2), recentreports identify older adults as the fastest growing groupof Internet and computer users [33] so this may not besuch a serious issue as envisaged. The optimal structureand content for web-based PCSGs remain to be estab-lished, but other patient populations have effectivelyused Web 2.0 social media to share information, gainpeer support, and even create a longitudinal database ofdisease progression, symptoms, responses to therapiesand coping mechanisms (e.g., http://crohnology.com forCrohn’s and colitis patients).There was no clear consensus amongst PPs on whowas best placed to facilitate PCSGs. There was not astrong endorsement for PCa survivors to take on thisrole amongst the PPs in our sample (Figure 5). Al-though, overall being patient-driven PCSGs were seen asimportant (Figure 4), concerns about peer-led groupswere also evident. While HCPs are likely to be well pre-pared to facilitate PCSGs, the involvement of HCPs infacilitating PCSGs has been a topic of concern in thepast [34-36]. It may also be unrealistic to expect thatHCPs can assume or sustain facilitation roles. Many lackknowledge about how the groups work [29,30,37] andthey may not be able to take on additional responsibi-lities because of other demands on their resources [38].Also there may be some overlap between PCSG psycho-social oncology services and those provided by PPs andother HCPs [39].LimitationsAs an inductive exploratory pilot study with a popula-tion drawn from a convenience sample predominatelymade up of conference attendees, we do not know if thefindings are generalizable to other PPs practicing withinor outside Canada. The web-based survey approach alsohas limitations in terms of technological issues (lack oftechnological familiarity on the part of respondents ortheir willingness to use a computer to complete the sur-vey, and browser incompatibility problems). That only36% of the participants had referred patients to PCSGs,whilst 56% had no formal linkages to PCSGs can also beconsidered a limitation of this initial work. Nevertheless,no specific problems arose with the survey methodologyor content and amid these limitations this foundationalwork indicates that PPs may need to be encouraged toraise awareness about PCSGs among PCa patients.ConclusionsThese pilot study findings indicate that the approachand Steginga survey instrument used can be usefully ap-plied in wider studies to explore PPs attitudes towardsPCSGs, with careful attention to strategies to maximizeresponse rates. Formal interviews to ascertain more de-tailed qualitative data to triangulate findings are also de-sirable. PPs value the role and potential of PCSGs toplay an important educational role for PCa patients andtheir families. The PPs perceptions of PCSGs are positiveand attitudes identified in this pilot study appear sup-portive of PP referrals to PCSGs. That said, if men andtheir partners are to benefit from PCSGs it is clear thatPPs should be further encouraged to formally connectand endorse PCSGs as a legitimate resource for thepsychosocial support of men who experience PCa andtheir families.Identifying and addressing the perceived barriers to at-tending PCSGs, and strategic marketing initiatives arealso important. PPs attitudes toward Web-based PCSGssuggest that this approach holds good potential for en-hancing access among men who would not ordinarily at-tend a face-to-face group session. This initial work hasprovided some valuable insights into these issues andset the ground for larger–scale studies to explore theseaspects in the wider Canadian context.AbbreviationsHCP: Health care provider; PP: Primary practitioners (aka General Practitioners);PCa: Prostate cancer; PCSGs: Prostate cancer support groups.Competing interestsThe authors declare that they have no competing interests.Authors’ contributionsThe study presented here was carried out in collaboration between allauthors. JLO, JLB and MM contributed substantially to the conception anddesign of the study. JLO, JB, MM, BG and CSH carried out the participantrecruitment and data collection. JLB, JSO, JLO and JB were involved in thedata interpretation. BG, JLO and CSH drafted the initial manuscript, and JB,MM and JSO were involved in revising and providing substantial contentand revisiting data analysis in the later phase of the manuscript production.All authors read and approved the final manuscript.Garrett et al. BMC Family Practice 2014, 15:56 Page 7 of 9http://www.biomedcentral.com/1471-2296/15/56Authors’ informationDr. Bernard Garrett and Dr. John L. Oliffe are Associate Professors at theUniversity of British Columbia, School of Nursing. Dr. Joan L. Bottorff is aProfessor in the School of Nursing and Director of the Institute for HealthyLiving at the University of British Columbia’s Okanagan campus. Dr. MichaelMcKenzie is a Radiation Oncologist at the BC Cancer Agency and ClinicalProfessor of the Division of Radiation Oncology and DevelopmentalRadiotherapeutics at the University of British Columbia. Christina Han is asocial science researcher at the University of British Columbia, School ofNursing. Dr. Ogrodniczuk is Professor of Psychiatry at the University of BritishColumbia.AcknowledgementThis study was made possible by the Canadian Institutes of Health Research(CIHR; Grant #: 1R06913). We would like to thank St. Paul’s Hospital,Vancouver, BC. for their assistance with data collection. Also, special thanksto all the primary practitioners who participated in this study as well asEstephanie Sta. Maria for her assistance with data collection.Author details1School of Nursing, University of British Columbia, T201, 2211 Wesbrook Mall,V6T 2B5 Vancouver, BC, Canada. 2School of Nursing, University of BritishColumbia Okanagan, FIP246A - Fipke Centre, 3333 University Way, V1V 1 V7Kelowna, BC, Canada. 3British Columbia Cancer Agency, Vancouver Centre,600 West 10th Avenue, V5Z 4E6 Vancouver, BC, Canada. 4Department ofPsychiatry, University of British Columbia, 420 - 5950 University Blvd., V6T 1Z3Vancouver, BC, Canada.Received: 25 June 2013 Accepted: 25 March 2014Published: 28 March 2014References1. Canadian Cancer Society’s Steering Committee on Cancer Statistics:Canadian Cancer Statistics. 2012. http://www.cancer.ca/en/cancer-information/cancer-101/canadian-cancer-statistics-publication/?region=on.2. 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BMC Family Practice 2014, 15:56 Page 8 of 9http://www.biomedcentral.com/1471-2296/15/5637. McDowell ME, Occhipinti S, Ferguson M, Dunn J, Chambers SK: Predictorsof change in unmet supportive care needs in cancer. Psycho-Oncol 2010,19(5):508–513.38. Forsythe LP, Alfano CM, Leach CR, Ganz PA, Stefanek ME, Rowland JH:Who provides psychosocial follow-up care for post-treatment cancersurvivors? A survey of medical oncologists and primary care physicians.J Clinic Oncol 2012, 20(23):2897–2905.39. Stanton AL: What happens now? Psychosocial care for cancer survivorsafter medical treatment completion. J Clinic Oncol 2012, 30(11):1215–1220.doi:10.1186/1471-2296-15-56Cite this article as: Garrett et al.: The value of prostate cancer supportgroups: a pilot study of primary physicians’ perspectives. BMC FamilyPractice 2014 15:56.Submit your next manuscript to BioMed Centraland take full advantage of: • Convenient online submission• Thorough peer review• No space constraints or color figure charges• Immediate publication on acceptance• Inclusion in PubMed, CAS, Scopus and Google Scholar• Research which is freely available for redistributionSubmit your manuscript at www.biomedcentral.com/submitGarrett et al. BMC Family Practice 2014, 15:56 Page 9 of 9http://www.biomedcentral.com/1471-2296/15/56

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