Project Area: Health policy and systems research
Project Summary
BACKGROUND:
Depression is a common comorbidity in cancer, affecting up to 30% of patients, with around 10% meeting criteria for major depression. Untreated depression is associated with poorer adherence to cancer treatment, increased symptom burden, reduced quality of life (QOL), and higher healthcare utilisation, generating significant economic and societal costs. Despite international consensus on integrating psychosocial care into routine oncology practice, systematic identification and management of depression remain inconsistent internationally and in Ireland. UK research highlighted this gap, with 73% of patients with cancer and major depression receiving no potentially effective depression treatment.
This doctoral research addresses these gaps by evaluating the acceptability, feasibility, and economic impact of implementing an evidence-based collaborative care model—SMaRT Oncology—within Irish oncology services. Collaborative care is a structured, team-based approach integrating mental health into routine cancer care and is the only intervention with a robust evidence-base. Models like SMaRT Oncology have demonstrated clinical effectiveness and cost-efficiency, but their applicability in Ireland is unknown.
OBJECTIVES:
1) Identify barriers and facilitators to implementing collaborative care and assess acceptability and feasibility using the Consolidated Framework for Implementation Research (CFIR).
2) Estimate the cost-effectiveness of SMaRT Oncology compared to usual care through model-based economic evaluation from the Health Service Executive (HSE) perspective, expressed as incremental cost per clinically significant depression reduction and quality-adjusted life years (QALYs).
3) Adapt SMaRT Oncology for cultural and operational fit within Irish healthcare through Collective Intelligence co-design workshops with patients, families, clinicians, managers and policymakers.
4) Co-create implementation recommendations to support scalable integration into oncology services.
METHODS:
A mixed-methods design will be employed across four interlinked work packages: qualitative evidence synthesis, key informant interviews, economic modelling, and participatory co-design workshops. Guided by the ADAPT framework, the project emphasises meaningful Patient and Public Involvement (PPI) throughout. National and international placements will strengthen implementation insights and capacity building: with the NCCP Cancer Survivorship team for policy exposure and at Oxford Cancer Centre for practical experience in collaborative care integration.
IMPACT:
Findings will inform national strategies, including the National Cancer Strategy, supporting greater integration of mental health care in oncology. By assessing feasibility and cost-effectiveness, this research will lay the foundation for scalable psycho-oncology services in Ireland, enhancing patient QOL and advancing global knowledge on collaborative care adaptation. The Scholar will gain expertise in evidence synthesis, mixed-methods research, implementation science, health economics, and participatory research, positioning them as a future leader in health services research.
Skills Required
(If applying for this project you will be asked to outline how you meet the skills required below)
Essential
- A degree in a relevant discipline (e.g., health economics, psychology, social science, allied health).
- Strong quantitative research skills and statistical analysis using Stata.
- Strong qualitative research skills, including experience in conducting interviews and thematic or framework analysis.
- Competence in evidence synthesis methods (e.g., systematic or scoping reviews).
- Ability to work independently and collaboratively within multidisciplinary teams.
- Excellent communication and interpersonal skills for key informant and interest-holder engagement and PPI activities.
- Strong organisational and project management skills.
- Experience in participant recruitment and ethical research conduct.
Desirable:
- Understanding of cost-effectiveness analysis and health economic modelling
- Evidence of scholarly output, ideally peer-reviewed publications.
- Experience in engaged research and/or PPI in research.
- Familiarity with NVivo for qualitative data analysis.
- Knowledge of health services research and implementation science frameworks (e.g., CFIR, ADAPT).
These skills will enable the Scholar to successfully execute the mixed-methods design, engage with diverse interest-holders, and produce high-quality outputs that inform policy and practice.
Supervisory team:
Dr Maria Pertl, PI/Primary Supervsior
Lecturer, Department of Health Psychology, RCSI University of Medicine and Health Sciences
Dr Paul Hanly, Lecturer in Economics, Department of Economics, Cork University Business School, University College Cork.
Dr Luke Solomons, Consultant in Psychological Medicine, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital and Honorary Senior Clinical Lecturer, Department of Psychiatry, University of Oxford.
Prof Frank Doyle, Associate Professor, Department of Health Psychology, School of Population Health, RCSI University of Medicine and Health Sciences.
The project will be based in RCSI
