Introduction There is limited research using learning collaboratives to implement conversation aids in clinical practice. We aimed to evaluate the independent association of learning collaborative components with the overall patient reach of a conversation aid for early-stage breast cancer treatment decisions.

Methods For each clinical site participating in the learning collaborative, we collected the following data on a monthly or quarterly basis over two years: extent of engagement and communication with learning collaborative leadership; number of patient evaluation surveys collected; use of the learning collaborative website; social interconnectedness with other learning collaborative members; and integration of the conversation aid into the electronic health record. We conducted multiple linear regression analysis to evaluate the role of each of these factors in predicting site-level patient reach (i.e. proportion of eligible patients receiving the conversation aid).

Results Full results available in June 2024. To date, patient reach varies substantially across the 15 sites, ranging from 47% (84/178) to 100% (174/174) of eligible patients receiving the conversation aid. Observed trends suggest that clinician engagement and communication with SHAIR Collaborative leadership promotes adoption and active use of the conversation aids.

Discussion A learning collaborative demonstrates promise in promoting adoption and use of conversation aids among breast cancer surgeons and clinical teams, leading to substantial patient reach. However, the interactivity needed in learning collaboratives, including communication with busy clinicians, requires thoughtful attention to maintaining participant engagement in key areas.

Conclusion Given varied patient reach and learning collaborative engagement across sites, certain learning collaborative activities are associated with higher levels of implementation.

This research was funded through a Patient-Centered Outcomes Research Institute Award (SDM- 2020C2–20307). This work is solely the responsibility of the authors and does not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.