A new guide may take months to develop. Staff review the language, clinicians contribute their expertise, patient education teams refine the content, and someone makes sure the finished piece meets organizational standards. By the time it is released, a great deal of thoughtful work may have gone into a relatively small resource.

Then, surprisingly and sadly, few people ever use  it.

The natural response is sometimes to question the resource itself. Perhaps patients are not interested in the topic. Maybe the format needs to change. Perhaps the organization needs something newer, shorter, more interactive, or more engaging.

Sometimes that’s the case; however, a good resource can go unused for reasons that have very little to do with its quality.

The simplest problem is that people do not know it exists. A patient guide may be familiar to the survivorship team but unknown to clinicians working during active treatment. A social worker may regularly share a useful community resource while colleagues in another department have never heard of it. A digital resource may be available through the patient portal, but patients have to know what to search for before they can find it.

This happens easily in large organizations. Resources are created at different times by different teams for different purposes. Someone who has worked in the organization for years may know exactly where to find them, while a newer employee may have no idea they are available. Even experienced staff cannot be expected to remember every guide, service, class, referral option, and community program that has accumulated over time.

Intimacy-related resources have an additional challenge in that patients may not go looking for them.

Someone dealing with sexual pain, loss of desire, changes in body image, difficulty with arousal, or tension with a partner may not know that their cancer center has information or support for any of these concerns. They may not even know that these experiences can be related to cancer or its treatment. Unless someone makes the connection, the resource and the patient may never find each other.

How a resource is introduced also matters. Handing someone a brochure without much explanation is different from saying, “Some people notice changes in intimacy or sexual function during treatment. We have a resource that explains some of what can happen and where you can get additional support if you need it.” The resource itself has not changed, but the patient now understands why they are receiving it and how it relates to their care.

Timing can make the same resource useful or forgettable. Information about intimacy provided shortly after diagnosis may be appreciated but have little immediate relevance to someone focused on getting through treatment. Months later, when physical recovery is underway or a relationship begins adjusting to life after treatment, that information may suddenly matter a great deal. Providing a resource once does not guarantee that it will be remembered by the patient when the actual need appears.

Clinicians face their own practical barriers. During a busy appointment, a resource that takes several minutes to locate may simply not get used. If staff have to remember which department created it, search through an intranet, or ask a colleague where the current version lives, even a very good resource can gradually disappear from everyday practice.

These are small implementation problems, but they have real consequences. Organizations may continue investing in new materials when useful resources already exist. Patients may conclude that support is unavailable. Staff may create their own lists and handouts because they cannot easily locate what has already been developed. Several departments may even create different resources for the same concern without realizing they are duplicating one another’s work.

Looking at resource use across an organization can therefore be surprisingly informative. Which materials are staff actually using? How do they find them? When are they introduced to patients? Are there resources everyone assumes are being shared that rarely make it into routine care? Do patients encounter the same information in different parts of the organization, or does access depend largely on whom they see?

These are some of the questions CancerEVOLVE considers within the Resources domain of the CancerEVOLVE intimacy-informed care framework. Having strong content matters, but so does the way that content enters everyday care. A resource becomes much more useful when staff know it exists, can find it easily, understand when to offer it, and have natural opportunities to introduce it to patients.

Before creating another resource, it can be worth looking closely at the ones already there. Sometimes the missing piece is not more and better content; rather, it is more and better ways for good content to reach the people it was created to help.