As described in further detail in Table 1, a total of n = 31 participants from four German-speaking countries participated in the questionnaire which is representative of the n = 28 health care centres participating in the multi-national pilot of the ‘My Logbook’ tool. Most participants worked in Germany (52%) or Austria (39%). The majority were psychologists (71%) or psychotherapists (23%), while the remaining participants were either physicians, educators, nurses, art/music therapists or other. One participant reported to be a survivor of paediatric cancer. Concerning the focus of work, participants were mostly employed in acute care (68%), followed by out-patient follow-up care (32%), in-patient follow-up care (19%), rehabilitation (13%) and research (13%). Professional experience was equally distributed across the three given categories: 0 to 5 years (35%), 5 to 10 years (26%) and more than 10 years (39%).

The results provide a differentiated insight into the feasibility and implementation of the ‘My Logbook’ tool considering the CFIR domains and subcategories. The achieved consensus is illustrated in Fig. 2. The domains of ‘intervention characteristics’ and ‘involvement’ both pass the threshold of the 80% acceptance level (combined responses from ‘Yes’ and ‘partly’) in every single CFIR subcategory represented by one or more items. In total, only seven of the 46 items did not reach the acceptance level of 80%. In the following, the results are displayed for every domain ‘intervention characteristics’, ‘inner setting’, ‘outer setting’, ‘involvement’, ‘implementation’ within CFIR. Table 2 and Table 3 give an overview of identified facilitators and barriers in implementing the tool ‘My Logbook’ within every domain. In general, there was an increase in the number of facilitators named in relation to ‘Intervention Characteristics’. The facilitators are also experienced as helpful in the other categories on average, although with a lower frequency. Barriers on the other hand did not show a significant increased rate.

Achieved consensus for each CFIR domain and subcategory for the ‘My Logbook’ tool. The horizontal black line marks the predetermined 80% threshold for acceptance

All 9 subcategories reached the acceptance level with at least 80% of participants selecting ‘Yes’ and ‘Partly’ as a response. Those subcategories included items assessing adaptability, complexity, trialability and cost, among others. Concerning the subcategory ‘relative advantage’ of the tool, participants highlighted the patient-orientation (80%) and psychosocial expertise (60%) as particularly useful compared to other interventions/standard care. Its consensus-orientation was only considered helpful by 26%. Concerning ‘adaptability’, more than 65% of participants assessed the age-appropriate materials, the visual methods and modular design of the ‘My Logbook’ tool as beneficial for implementation. Furthermore, 55% of respondents appreciated its appealing design. Regarding ‘trialability’, more than 80% judged the manual as useful, as did 68% for the workshops. Fifty-two percent stressed the study coordinator meetings as helpful, while different approaches were assessed as helpful by less than half of the participants. In terms of ‘design, quality and packaging’, the age-appropriate materials, the visual methods and the modular design were rated helpful by more than 60%. The aspects considered most relevant and helpful in the context of intervention characteristics were patient-orientation (87%) and as well as manuals instructing the application (84%), while dashboards and presenting scientific result (13%) and the use of social networks (3%) were rarely seen as relevant.

The domain ‘inner settings’ consists of 15 items, eleven of which reached the satisfactory level. The subcategories ‘networks & communication’, ‘compatibility’, ‘learning climate’ and ‘access to knowledge’ were evaluated most favourably. In contrast, the item ‘An improvement of the current situation of psychosocial care (…) is necessary and can be supported by “My Logbook”’ was rejected by 21% of the responding professionals (Yes = 50%, Partly = 29%; subcategory: ‘need for change’). The subcategory ‘relative priority’ (‘My Logbook’ has advantages compared to other methods/activities/interventions) was evaluated as follows: Yes = 36%, Partly = 39%, No = 25%. Similarly, ‘available resources’ (‘There are sufficient resources (…) available at my institution for the implementation of guideline-based tools such as “My Logbook”’; Yes = 12%, Partly = 54%, No = 35%) and ‘peer pressure’ (‘My Logbook’ is a ‘standard of care’ at my institutions or a fixed component of routine care; Yes = 19%, Partly = 19%, No = 63%) did not meet the predefined level of acceptance. Regarding ‘structural characteristics’, 65% highlighted time resources, and around 40% each stated staff changes and study specific organization as especially challenging aspects. For ‘networks & communication’, more than 55% considered workshops, the manual and study coordinator meetings as helpful, while only 10% did so for social networks or the document for care standards for patients of standard risk [20, 21]. Participants assessed psychosocial expertise (48%) and patient-orientation (55%) as helpful regarding ‘culture’. Less than 20% each found guideline-orientation, a consensus-based approach or a combination of research and practice to be relevant. For the subcategory ‘implementation climate’, more than 58% of participants saw the patient-focus, the concrete visual methods of the ‘My Logbook’ tool and its modular structure as challenging. Regarding the ‘readiness for implementation’, workshops were seen as most helpful (61%), followed by study coordinator meetings (48%), the manual (48%) and the specific booklets (48%).

The domain ‘outer setting’ consists of four subcategories: ‘Patient needs & resources’, ‘cosmopolitanism’, ‘peer pressure’ and ‘external policies & incentives’. Thereof, the subcategory ‘external policies & incentives’ (‘Standards, specifications, political frameworks, recommendations or guidelines, pay-for-performance exist for the implementation of ‘My Logbook’, integration into the benefits catalogue of social insurance, cooperation or public / benchmark reports’; Yes = 11%, Partly = 28%, No = 61%) did not reach the predefined level of acceptance. ‘Patient needs & resources’ and ‘cosmopolitanism’ reached the acceptance level without any rejections.

Concerning the subcategory ‘cosmopolitanism’ 52% of participants each considered study coordinator meetings and the workshops as helpful, followed by the manual (29%) and conference papers (35%).

The domain ‘involvement’, adapted from ‘characteristics of involved individuals’, consists of eight subcategories including ‘knowledge & beliefs’, ‘self-efficacy’ and ‘individual stage of change’, among others. All the positively formulated statements were perceived as adequate by over 80% of respondents.

The domain ‘implementation’ consists of ten subcategories, whereof only the item assessing ‘patients/customers’ was considered to be met by less than 80% of respondents (‘There are sufficiently effective strategies to attract and involve patients in the implementation or use of ‘My Logbook’ (e.g. reports in parent association magazines, flyers, information through the psychosocial service, newsletters); Yes = 50%, Partly = 28%, No = 22%). The subcategories considered most favourable for implementation were ‘reflecting & evaluating’, ‘champions’ and ‘engaging’.

Concerning the subcategory ‘planning’, 55% assessed psychosocial expertise as helpful, 48% the patient-orientation and each over 30% the guideline-orientation and having standard with a degree of individuality. In contrast, ‘making visible and strengthening the importance of psychosocial care and research’ and a ‘proof of efficacy’ was only considered relevant by 13% and 3% respectively. Regarding the subcategory ‘engaging’, the patient-orientation (52%) and modularity (48%) and the manual (42%) of the ‘My Logbook’ booklets were considered helpful. Social networks, homework and packaging were selected by less than 6% of participants. Barriers that were frequently chosen for the subcategory ‘execution’ were time resources (61%), staff changes (35%) and clinic-specific circumstances (29%). For ‘reflecting & evaluating’, participants evaluated the study coordinator meetings (48%) and the newsletter (42%) as useful. Also, the workshops (26%) and conference papers (29%) were often selected.