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Kwok G, Sharma A, Mandato I, Devine KA. Feasibility and Acceptability of a Meditation Mobile App Intervention for Adolescent and Young Adult Survivors of Childhood Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:584. [PMID: 38791797 PMCID: PMC11121627 DOI: 10.3390/ijerph21050584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/29/2024] [Accepted: 04/30/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Adolescent and young adult (AYA) survivors of childhood cancer are increasingly recognized as a vulnerable group with unique emotional, social, and practical needs due to the intersection of cancer survivorship and normal developmental processes. Mindfulness meditation has shown early efficacy in improving psychological distress among cancer patients. However, the overall scientific study of app-based mindfulness-based interventions is still in its early stages. The goal of this study was to evaluate the feasibility and acceptability of a commercially available mindfulness mobile app intervention "Ten Percent Happier" among AYA survivors of childhood cancer. METHODS We conducted a single-arm pilot intervention with 25 AYA survivors of childhood cancer ages 18-29 years. RESULTS A total of 108 potentially eligible individuals were initially identified for screening. Of the 45 individuals reached (contact rate = 41.67%), 20 declined to participate; 25 were enrolled in the study and completed the baseline survey (enrollment rate = 55.56%). Twenty-one participants completed the study (retention rate = 84%). Changes in several outcomes were promising, with medium to large effect sizes: Mindfulness (d = 0.74), Negative Emotion (d = 0.48), Perceived Stress (d = 0.52), and Mental Health (d = 0.45). Furthermore, results suggested that participants with consistent app usage showed greater improvement in reported outcomes than those who stopped their usage (e.g., Mindfulness: d = 0.74, Perceived Stress: d = 0.83, Mental Health: d = 0.51; Meaning and Purpose: d = 0.84; and Sleep Disturbance: d = 0.81). Qualitative feedback indicated high satisfaction, but participants suggested adding group or individual peer support to improve their experience with the app. CONCLUSIONS AYA survivors can be difficult to reach, but a mindfulness app was feasible and acceptable to this group. In particular, the robust retention rate and high satisfaction ratings indicate that the meditation mobile app was well received. Preliminary results suggest positive changes in health-related quality of life outcomes, warranting a larger efficacy trial.
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Affiliation(s)
- Gary Kwok
- Center for Discovery and Innovation, Hackensack Meridian Health, Nutley, NJ 07110, USA
- Pediatric Population Science, Outcomes, and Disparities Research Section, Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Archana Sharma
- Pediatric Population Science, Outcomes, and Disparities Research Section, Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Ivelisse Mandato
- Pediatric Population Science, Outcomes, and Disparities Research Section, Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
| | - Katie A. Devine
- Pediatric Population Science, Outcomes, and Disparities Research Section, Division of Pediatric Hematology/Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ 08901, USA
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Kang KA, Han SJ, Chun J, Kim HY, Oh Y, Yoon H. Healthy lifestyle interventions for childhood and adolescent cancer survivors: a systematic review and meta-analysis. CHILD HEALTH NURSING RESEARCH 2023; 29:111-127. [PMID: 37170490 PMCID: PMC10183760 DOI: 10.4094/chnr.2023.29.2.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 02/17/2023] [Indexed: 05/13/2023] Open
Abstract
PURPOSE This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS). METHODS Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software. RESULTS Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO2, exercise capacity-upper body, body mass index) revealed no statistical significance. CONCLUSION Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.
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Affiliation(s)
- Kyung-Ah Kang
- Professor, College of Nursing, Sahmyook University, Seoul, Korea
| | - Suk Jung Han
- Professor, College of Nursing, Sahmyook University, Seoul, Korea
| | - Jiyoung Chun
- Assistant Professor, College of Nursing, Sahmyook University, Seoul, Korea
| | - Hyun-Yong Kim
- Researcher, Logos Health Design Institute, Sahmyook University, Seoul, Korea
| | - Yerin Oh
- Researcher, College of Nursing, Sahmyook University, Seoul, Korea
| | - Heejin Yoon
- Researcher, College of Nursing, Sahmyook University, Seoul, Korea
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Mobley EM, Moke DJ, Milam J, Ochoa CY, Stal J, Osazuwa N, Kemp J, Bolshakova M, Dinalo J, Motala A, Hempel S. Interventions to address disparities and barriers to pediatric cancer survivorship care: a scoping review. J Cancer Surviv 2022; 16:667-676. [PMID: 34132984 PMCID: PMC8674368 DOI: 10.1007/s11764-021-01060-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 05/18/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Many childhood cancer survivors experience disparities due to barriers to recommended survivorship care. With an aim to demonstrate evidence-based approaches to alleviate barriers and decrease disparities, we conducted a scoping review of (1) proposed strategies and (2) evaluated interventions for improving pediatric cancer survivorship care. METHODS We searched research databases (PubMed, CINAHL, and PsycINFO), research registries, and grey literature (websites of professional organizations and guideline clearing houses) for guidelines and published studies available through October 2020 (scoping review registration: https://doi.org/10.17605/OSF.IO/D8Q7Y ). RESULTS We identified 16 proposed strategies to address disparities and barriers endorsed by professional organizations including clinical practice guidelines (N=9), policy statements (N=4), and recommendations (N=3). Twenty-seven published studies evaluated an intervention to alleviate disparities or barriers to survivorship care; however, these evaluated interventions were not well aligned with the proposed strategies endorsed by professional organizations. Most commonly, interventions evaluated survivorship care plans (N=11) or models of care (N=11) followed by individual survivorship care services (N=9). Interventions predominantly targeted patients rather than providers or systems and used technology, education, shared care, collaboration, and location-based interventions. CONCLUSIONS Published studies aimed at overcoming disparities and barriers to survivorship care for childhood cancer survivors revealed that gaps remain between published recommendations and empirical evaluations of interventions aiming to reduce barriers and disparities. IMPLICATIONS FOR CANCER SURVIVORS Additional research is needed to identify evidence-based interventions to improve survivorship care for childhood cancer survivors.
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Affiliation(s)
- Erin M Mobley
- Department of Surgery, College of Medicine, University of Florida, Jacksonville, FL, USA.
| | - Diana J Moke
- Department of Hematology, Oncology, and Blood and Marrow Transplantation, Children's Hospital Los Angeles, Los Angeles, CA, USA
- Department of Pediatrics, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Joel Milam
- Department of Epidemiology and Biostatistics, University of California, CA, Irvine, Irvine, USA
| | - Carol Y Ochoa
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Julia Stal
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Nosa Osazuwa
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Jai Kemp
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Maria Bolshakova
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Jennifer Dinalo
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Aneesa Motala
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
| | - Susanne Hempel
- Southern California Evidence Review Center, Keck School of Medicine, University of Southern California, CA, Los Angeles, USA
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Briggs LG, Labban M, Alkhatib K, Nguyen DD, Cole AP, Trinh QD. Digital technologies in cancer care: a review from the clinician's perspective. J Comp Eff Res 2022; 11:533-544. [PMID: 35416050 DOI: 10.2217/cer-2021-0263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Physicians are increasingly utilizing digital health technologies (DHT) such as smartphone applications, network-enabled wearable devices, web-based communication platforms, videoconferencing, chatbots, artificial intelligence and virtual reality to improve access to, and quality of, care. DHT aid in cancer screening, patient education, shared decision-making, promotion of positive health habits, symptom monitoring and intervention, patient-provider communication, provision of psychological support and delivery of effective survivorship care. This narrative review outlines how physicians may utilize digital health to improve or augment their delivery of cancer care. For the full potential of DHT to be realized, experts must develop appropriate solutions to issues surrounding the regulation, liability, quality, security, equity and reimbursement of DHT.
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Affiliation(s)
- Logan G Briggs
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Muhieddine Labban
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Khalid Alkhatib
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - David-Dan Nguyen
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Alexander P Cole
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Quoc-Dien Trinh
- Center for Surgery & Public Health, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
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5
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Siembida EJ, Loomans-Kropp HA, Tami-Maury I, Freyer DR, Sung L, Crosswell HE, Pollock BH, Roth ME. Comparing Barriers and Facilitators to Adolescent and Young Adult Clinical Trial Enrollment Across High- and Low-Enrolling Community-Based Clinics. Oncologist 2022; 27:363-370. [PMID: 35522559 PMCID: PMC9074986 DOI: 10.1093/oncolo/oyac030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/22/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Adolescent and young adult (AYA) patients with cancer are underrepresented on cancer clinical trials (CCTs), and most AYAs are treated in the community setting. Past research has focused on individual academic institutions, but factors impacting enrollment vary across institutions. Therefore, we examined the patterns of barriers and facilitators between high- and low-AYA enrolling community-based clinics to identify targets for intervention. MATERIALS AND METHODS We conducted 34 semi-structured interviews with stakeholders employed used at National Cancer Institute Community Oncology Research Program (NCORP) affiliate sites ("clinics"). Stakeholders (eg, clinical research associates, patient advocates) were recruited from high- and low-AYA enrolling clinics. We conducted a content analysis and calculated the percentage of stakeholders from each clinic type that reported the barrier or facilitator. A 10% gap between high- and low-enrollers was considered the threshold for differences. RESULTS Both high- and low-enrollers highlighted insufficient resources as a barrier and the presence of a patient eligibility screening process as a facilitator to AYA enrollment. High-enrolling clinics reported physician gatekeeping as a barrier and the improvement of departmental collaboration as a facilitator. Low-enrollers reported AYAs' uncertainty regarding the CCT process as a barrier and the need for increased physician endorsement of CCTs as a facilitator. CONCLUSIONS High-enrolling clinics reported more barriers downstream in the enrollment process, such as physician gatekeeping. In contrast, low-enrolling clinics struggled with the earlier steps in the CCT enrollment process, such as identifying eligible trials. These findings highlight the need for multi-level, tailored interventions rather than a "one-size-fits-all" approach to improve AYA enrollment in the community setting.
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Affiliation(s)
- Elizabeth J Siembida
- Institute of Health System Science, Northwell Health, Manhasset, NY, USA,Corresponding author: Elizabeth J. Siembida, Institute of Health System Science, Northwell Health, 600 Community Drive, Suite 403, Manhasset, NY 11030, USA. Tel: (516) 600-1757;
| | - Holli A Loomans-Kropp
- Cancer Prevention Fellowship Program, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA,Gastrointestinal and Other Cancers Research Group, Division of Cancer Prevention, National Cancer Institute, Rockville, MD, USA
| | - Irene Tami-Maury
- Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - David R Freyer
- Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA,Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA,Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lillian Sung
- Department of Pediatrics, Hospital for Sick Children, Toronto, ON, Canada
| | | | - Brad H Pollock
- Department of Public Health Sciences, School of Medicine, University of California, Davis, Davis, CA, USA
| | - Michael E Roth
- Department of Pediatrics, Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Souza DAGDE, Araújo-Filho I, Cabral ELDS, Souza RPDE, Varella AGR, Sena EMABDE, Rêgo ACM, Melo BLDEB, Costa-Junior JFDA, Pinheiro FI. Surgery remember@: an innovation to reduce surgical cancellations. Rev Col Bras Cir 2022; 48:e20213206. [PMID: 35019074 PMCID: PMC10683425 DOI: 10.1590/0100-6991e-20213206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 10/20/2021] [Indexed: 11/22/2022] Open
Abstract
The use of mobile phones has dramatically increased all over the world. Such revolution in the communication amongst individuals has a great impact in patient care, supporting their self-management and promoting shared responsibility with health services. Given that improved communication facilitates compliance with scheduled procedures and reduces surgical cancellations, the current work aims to develop a communication tool named Surgery Remember@ to mitigate surgical suspensions due to patient absenteeism. The present article is a study of technological production divided into four chapters: literature review; analysis of the hospital administrative profile; software development; and process mapping for software implementation. Taking into account that in the last three years the problem of absenteeism was the main cause of institutional surgical cancellations; the development of Surgery Remember@ endeavours to reduce surgery cancellations, improving efficiency and reducing costs. It is known that sending messages three days before the surgical procedure makes it possible to replace patients in the event of cancellations, optimizing the human and material resources in the operating room. The confirmation of the pre-aesthetic consultation is also positive, for it allows the verification of perioperative assistance improvement. Hence, besides being viable and easy to implement, the software developed allows the addition of other features based on user requirements, proving to be an asset to reduce surgery cancellations.
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Affiliation(s)
- Danielly Acioli Galvão DE Souza
- - UFRN, Programa de Pós Graduação em Gestão e Inovação em Saúde - Natal - RN - Brasil
- - Hospital Universitário Alberto Antunes - HUPAA, Centro Cirúrgico - Maceió - AL - Brasil
| | - Irami Araújo-Filho
- - UFRN, Programa de Pós Graduação em Gestão e Inovação em Saúde - Natal - RN - Brasil
- - Laureate Universities - Universidade Potiguar, Programa de Pós Graduação em Biotecnologia - Natal - RN - Brasil
- - Universidade Federal do Rio Grande do Norte, Departamento de Cirúrgia Experimental - Natal - RN - Brasil
| | - Eric Lucas Dos Santos Cabral
- - Universidade Federal do Rio Grande do Norte, Programa de Pós Graduação em Engenharia de Produção - Natal - RN - Brasil
| | - Ricardo Pires DE Souza
- - Universidade Federal do Rio Grande do Norte, Programa de Pós Graduação em Engenharia de Produção - Natal - RN - Brasil
- - Universidade Federal do Rio Grande do Norte, Departamento de Engenharia de Produção - Natal - RN - Brasil
| | | | - Erika Maria Araújo Barbosa DE Sena
- - Hospital Universitário Alberto Antunes - HUPAA, Centro Cirúrgico - Maceió - AL - Brasil
- - Universidade Federal do Alagoas, Instituto de Química e Biologia - RENORBIO/ Ponto focal UFAL - Maceió - AL - Brasil
| | - Amália Cinthia Meneses Rêgo
- - Laureate Universities - Universidade Potiguar, Programa de Pós Graduação em Biotecnologia - Natal - RN - Brasil
| | | | - João Florêncio DA Costa-Junior
- - Universidade Federal do Rio Grande do Norte, Programa de Pós Graduação em Engenharia de Produção - Natal - RN - Brasil
- - Universidade Federal do Rio Grande do Norte, Departamento de Ciências Administrativas - Natal - RN - Brasil
| | - Francisco Irochima Pinheiro
- - Laureate Universities - Universidade Potiguar, Programa de Pós Graduação em Biotecnologia - Natal - RN - Brasil
- - Universidade Federal do Rio Grande do Norte, Departamento de Cirúrgia Experimental - Natal - RN - Brasil
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The Pediatric Cancer Survivors' User Experiences With Digital Health Interventions: A Systematic Review of Qualitative Data. Cancer Nurs 2021; 45:E68-E82. [PMID: 34870939 DOI: 10.1097/ncc.0000000000000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Evidence suggests that digital health interventions are feasible and acceptable in pediatric cancer survivors. Efforts to synthesize user experiences, however, are limited. OBJECTIVE The aim of this study was to systematically identify, appraise, and synthesize qualitative evidence on the user experiences of pediatric cancer survivors participating in digital health interventions. METHODS We searched 4 databases to identify studies with qualitative data of the digital health intervention user experiences from childhood, adolescent, and young adult pediatric cancer survivors, published from the databases' inception to January 31, 2020. Studies that met inclusion criteria were selected and reviewed for quality. The extracted data were analyzed by thematic synthesis. RESULTS Sixteen articles met the inclusion criteria. Two analytic themes emerged, each with 3 descriptive themes: (1) the favorable experience of using digital health interventions, including "knowing about oneself and one's cancer," "connecting with others in a trustworthy and safe way," and "getting empowered and rewarded"; and (2) the challenges of using digital health interventions, including "challenges from the content of the program," "technology challenges," and "user challenges." CONCLUSIONS This systematic review supports the value of digital health interventions as an acceptable and convenient approach for delivering care to pediatric cancer survivors. It is essential to understand the users' positive experiences and challenges to customize interventions and achieve positive health outcomes. IMPLICATIONS FOR PRACTICE Nurses can contribute to the development and implementation of digital health interventions for pediatric cancer survivors through advocacy, navigation, feedback, and multidisciplinary collaboration. We recommended system-level support in modifying and developing relevant workflows or practice guidelines for implementation.
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Psihogios AM, King-Dowling S, O’Hagan B, Darabos K, Maurer L, Young J, Fleisher L, Barakat LP, Szalda D, Hill-Kayser CE, Schwartz LA. Contextual Predictors of Engagement in a Tailored mHealth Intervention for Adolescent and Young Adult Cancer Survivors. Ann Behav Med 2021; 55:1220-1230. [PMID: 33674863 PMCID: PMC8825221 DOI: 10.1093/abm/kaab008] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Despite the promise of mobile health (mHealth), engagement is often too low for durable health behavior change, and little is known regarding why certain individuals abandon mHealth tools. PURPOSE Guided by a mHealth engagement framework, we evaluated contextual predictors of objective engagement with an app for adolescents and young adults (AYA) who survived cancer. METHODS One hundred and ten AYA survivors (M age = 20.5, 43% female, 30% racial/ethnic minority) were randomized to receive a disease self-management app that delivered 1-2 tailored messages/day for 16 weeks, and contained a survivorship care plan (SCP). Demographic, disease, psychosocial, and setting characteristics were examined as predictors of three objective engagement outcomes: (a) % of active app days, (b) % of messages read, and (c) viewed SCP in the app versus not. A subsample (n = 10) completed qualitative interviews to further assess engagement barriers. RESULTS Self-reported uninterrupted app access (β = -0.56, p < .001), iPhone (vs. Android) ownership (β = 0.30, p < .001), and receiving the intervention in the summer (β = -0.20, p = .01) predicted more active days. Lower depressed mood (β = -0.30, p = .047) and uninterrupted app access (β = -0.50, p < .001) predicted more messages read. Qualitatively, technical glitches and competing priorities were described as engagement barriers, whereas certain types of messages (e.g., health goal messages) were perceived as engaging. Among participants who had uninterrupted app access (n = 76), higher baseline motivation to change, better health perceptions, using the app during the summer, and iPhone ownership predicted higher engagement. CONCLUSIONS Findings demonstrate the importance of comprehensively assessing and planning for multi-level ecological determinants of mHealth engagement in future trials. CLINICALTRIALS.GOV IDENTIFIER NCT03363711.
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Affiliation(s)
- Alexandra M Psihogios
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Sara King-Dowling
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bridget O’Hagan
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | - Katie Darabos
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Jordyn Young
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
| | | | - Lamia P Barakat
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Dava Szalda
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Christine E Hill-Kayser
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Lisa A Schwartz
- Division of Oncology, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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9
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Onyeaka HK, Zambrano J, Longley RM, Celano CM, Naslund JA, Amonoo HL. Use of digital health tools for health promotion in cancer survivors. Psychooncology 2021; 30:1302-1310. [PMID: 33742737 DOI: 10.1002/pon.5677] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 03/05/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Although digital health tools (DHTs) are a promising alternative and effective strategy to deliver cancer care and support, their role in health promotion among cancer survivors remains relatively unexplored. We aimed to investigate the acceptability and impact of DHT for health promotion in cancer survivors. METHODS Data was pooled from cycle three of the fifth edition of the Health Information National Trends Survey. Logistic regressions were conducted to evaluate differences between cancer survivors and the general population regarding ownership, usage, and perceived usefulness of DHT for health management. Regression models were used to identify sociodemographic predictors of DHT usage among cancer survivors. RESULTS Overall, cancer survivors were as likely as the general population to own and use DHT (e.g., health apps, wearable devices) for their care and they were likely to find these tools beneficial in tracking their health and communicating with healthcare providers. Cancer survivors who had health applications installed on their mobile device were more likely to meet national recommendations for diet (fruit and vegetable consumption) and strength training than those without health apps. Age, income, and education level were significant sociodemographic predictors of DHT ownership and usage. CONCLUSION Cancer survivors own and use DHT at similarly high rates to the general population, highlighting the potential for utilizing DHT to expand access and continuity of care in the growing and vulnerable oncology population. With increasing use of DHT in healthcare, future research that targets digital access disparities in cancer survivors from low SES is essential.
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Affiliation(s)
- Henry K Onyeaka
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - Juliana Zambrano
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Regina M Longley
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Christopher M Celano
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.,Harvard Medical School, Boston, Massachusetts, USA
| | - John A Naslund
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Hermioni L Amonoo
- Harvard Medical School, Boston, Massachusetts, USA.,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, Massachusetts, USA
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10
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The Use and Effect of the Health Storylines mHealth App on Female Childhood Cancer Survivors' Self-efficacy, Health-Related Quality of Life and Perceived Illness. Cancer Nurs 2020; 45:61-69. [PMID: 33337669 DOI: 10.1097/ncc.0000000000000917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND mHealth apps have been not been well tested among childhood cancer survivors (CCSs) to track physical and psychosocial functioning for improved self-management of post-treatment needs. OBJECTIVES This pilot study had 3 aims: (1) assess the usage of the Health Storylines mHealth app; (2) examine its effect in improving self-efficacy in managing survivorship healthcare needs, health-related quality of life, and perceived illness; and (3) determine if app usage moderated the effects on the above patient-reported outcome measures among female CCSs. METHODS Study participants accessed the Health Storylines mHealth app on their own personal device. This single-group, pilot study included 3 measurement points: baseline and 3 and 6 months after initiation of using the app. RESULTS Use of the mHealth app ranged from 0 times to 902 times. Every study participant who used the app (n = 26) also used the mental health app component of the Health Storylines app. Generalized estimating equations were fit to examine the effect of the mHealth app use on self-efficacy, perceived illness, and health-related quality of life, between baseline, 3-month follow-up, and 6-month follow-up. No statistically significant changes were evident, on average, from baseline to 3- or 6-month follow-up on any outcome. Subsequent testing of effect moderation showed differential trends for high versus low users. CONCLUSIONS Studies are needed among this clinical population to determine who will benefit and who will perceive the app as a useful aspect of their survivorship care. IMPLICATIONS FOR PRACTICE Sharing mental health functioning tracked on mhealth apps with healthcare providers may inform needed interventions for young adult female CCSs.
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Molina-Recio G, Molina-Luque R, Jiménez-García AM, Ventura-Puertos PE, Hernández-Reyes A, Romero-Saldaña M. Proposal for the User-Centered Design Approach for Health Apps Based on Successful Experiences: Integrative Review. JMIR Mhealth Uhealth 2020; 8:e14376. [PMID: 32319965 PMCID: PMC7203616 DOI: 10.2196/14376] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 11/05/2019] [Accepted: 01/26/2020] [Indexed: 12/31/2022] Open
Abstract
Background Different strategies encompassed within mHealth have shown themselves to be effective for maintaining good health or controlling certain diseases. However, there is usually a very high rate of abandonment of health apps. Therefore, it would seem obvious that there is a need for involving the end users (whether they are health professionals, patients, or both) in the design process from the early stages in order to enable their needs and characteristics to be identified. In this sense, it is common knowledge that focusing on the user permits the consideration of valuable details aimed at making the correct adjustment between the patient, the technology, and the organization of attention. Objective The goal of the research was to propose a methodology based on the review of previous successful user experiences in setting up health apps by using qualitative techniques (focus groups and discussion groups) that includes the participation of information technology and health professionals and the patients themselves. Methods An integrative review was made of studies in which a qualitative methodology was employed mainly through focus and/or discussion groups for the design and development of health apps, consulting diverse databases (PubMed, Scopus, and Proquest) with the following search strategy: “mHealth AND apps AND focus group OR discussion group.” A total of 69 papers were included in the review. Results A proposal structured in 4 sessions of variable duration was made in which information technology and health professionals and patients take part: composing, preparing, and organizing contents (session 1); testing structure and usability (session 2); does the app fit the needs of end users? (session 3); and last testing—keep on improving (session 4). Throughout the sessions, we propose studying aspects like previous user experiences in mHealth, barriers to the adoption of mHealth, interface contents, management and browsability, usability, perceived quality, security and privacy, capacity to self-manage disease with the app, ergonomics, and glanceability, etc. Specific tools that have proved useful in previous research for measuring these aspects are presented. Conclusions These work sessions would be based on predominantly qualitative methodologies although, as they evolve, validated questionnaires permitting the assessment of the objectivity of certain technical aspects could be incorporated. With this proposal, a project centered on end users could be effected, responding to their needs. However, this requires validation that will be made via implementation in the development of health apps, with the subsequent measurement of results in terms of adherence and improvement in the clinical variables of the end users.
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Vandermorris A, Sampson L, Korenblum C. Promoting adherence in adolescents and young adults with cancer to optimize outcomes: A developmentally oriented narrative review. Pediatr Blood Cancer 2020; 67:e28128. [PMID: 31886630 DOI: 10.1002/pbc.28128] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/10/2019] [Accepted: 11/25/2019] [Indexed: 01/03/2023]
Abstract
Adherence is a critical consideration in ongoing efforts to improve outcomes among adolescents and young adults (AYAs) with cancer. In this narrative review, we embed existing conceptualizations of adherence within a developmental context to provide a novel vantage point from which to examine this important issue. Applying this developmentally oriented framework, we summarize the most current literature on strategies to enhance adherence in the AYA population. A developmentally informed approach to working with AYAs can elucidate unique strengths and vulnerabilities of this population and offer a new perspective on opportunities to respond to biopsychosocial barriers to adherence in a strengths-based, collaborative manner.
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Affiliation(s)
- Ashley Vandermorris
- Division of Adolescent Medicine, Department of Paediatrics, SickKids Hospital and University of Toronto, Toronto, Canada
| | - Lorna Sampson
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Chana Korenblum
- Princess Margaret Cancer Centre, University Health Network, Division of Adolescent Medicine, Department of Paediatrics, SickKids Hospital and University of Toronto, Toronto, Canada
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13
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Hernández-Reyes A, Molina-Recio G, Molina-Luque R, Romero-Saldaña M, Cámara-Martos F, Moreno-Rojas R. Effectiveness of PUSH notifications from a mobile app for improving the body composition of overweight or obese women: a protocol of a three-armed randomized controlled trial. BMC Med Inform Decis Mak 2020; 20:40. [PMID: 32093701 PMCID: PMC7041121 DOI: 10.1186/s12911-020-1058-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 02/17/2020] [Indexed: 11/28/2022] Open
Abstract
Background The penetration level of mobile technology has grown exponentially and is part of our lifestyle, at all levels. The use of the smartphone has opened up a new horizon of possibilities in the treatment of health, not in vain, around 40% of existing applications are linked to the mHealth segment. Taking advantage of this circumstance to study new approaches in the treatment of obesity and prescription of physical activity is growing interest in the field of health. The primary outcome (obese adult women) will be assessed according to age, fitness status, weight, and body composition status. Data will be collected at enrollment and weekly during 6 months of intervention on dietary practices, physical activity, anthropometry, and body composition. Analysis of effect will be performed comparing the outcomes between intervention and control arms. The message delivery is in progress. Methods A 3-arm clinical trial was established. A series of quantitative and qualitative measures were used to evaluate the effects of self-weighing and the establishment of objectives to be reached concerning the prescription of physical activity. At the end of this pilot study, a set of appropriate measures and procedures were identified and agreed upon to determine the effectiveness of messaging in the form of PUSH technology. The results were recorded and analyzed to begin a randomized controlled trial to evaluate the effectiveness of the proposed methodology. Conclusions The study is anticipated to establish feasibility of using PUSH notifications to evaluate whether or not an intervention of 6 months, directed by a team formed by Dietician-Nutritionist and nursing professionals, by means of an application for Smartphone and a personal consultation, improves the body composition of adult women with a fat percentage equal to or higher than 30% at the beginning of the study. Trial registration Clinical Trials ID: NCT03911583. First Submitted: April 9, 2019. Ethical oversight is provided by the Bioethical Committee of Córdoba University and registered in the platform clinicaltrials.gov. The results will be published in peer-reviewed journals and analysis data will be made public.
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Affiliation(s)
- A Hernández-Reyes
- Department of Bromatology and Food Technology, University of Córdoba, Campus Rabanales, ed. Darwin - annex. Office of Dr. Rafael Moreno, 14071, Córdoba, Spain.
| | - G Molina-Recio
- Nursing department, University of Medicine and Nursing of Córdoba, Córdoba, Spain
| | - R Molina-Luque
- Nursing department, University of Medicine and Nursing of Córdoba, Córdoba, Spain
| | | | - F Cámara-Martos
- Department of Bromatology and Food Technology, University of Córdoba, Campus Rabanales, ed. Darwin - annex. Office of Dr. Rafael Moreno, 14071, Córdoba, Spain
| | - R Moreno-Rojas
- Department of Bromatology and Food Technology, University of Córdoba, Campus Rabanales, ed. Darwin - annex. Office of Dr. Rafael Moreno, 14071, Córdoba, Spain
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14
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Hernández-Reyes A, Cámara-Martos F, Molina Recio G, Molina-Luque R, Romero-Saldaña M, Moreno Rojas R. Push Notifications From a Mobile App to Improve the Body Composition of Overweight or Obese Women: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e13747. [PMID: 32049065 PMCID: PMC7055755 DOI: 10.2196/13747] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 09/29/2019] [Accepted: 11/05/2019] [Indexed: 12/13/2022] Open
Abstract
Background Technology—in particular, access to the Internet from a mobile device—has forever changed the way we relate to others and how we behave in our daily life settings. In recent years, studies have been carried out to analyze the effectiveness of different actions via mobile phone in the field of health: telephone calls, short message service (SMS), telemedicine, and, more recently, the use of push notifications. We have continued to explore ways to increase user interaction with mobile apps, one of the pending subjects in the area of mHealth. By analyzing the data produced by subjects during a clinical trial, we were able to extract behavior patterns and, according to them, design effective protocols in weight loss programs. Objective A clinical trial was proposed to (1) evaluate the efficacy of push notifications in an intervention aimed at improving the body composition of adult women who are overweight or obese, through a dietary procedure, and (2) analyze the evolution of body composition based on push notifications and prescribed physical activity (PA). Methods A two-arm randomized controlled trial was carried out. A sample size of 117 adult obese women attended a face-to-face, 30-minute consultation once a week for 6 months. All patients were supplied with an app designed for this study and a pedometer. The control group did not have access to functionalities related to the self-monitoring of weight at home, gamification, or prescription of PA. The intervention group members were assigned objectives to achieve a degree of compliance with diet and PA through exclusive access to specific functionalities of the app and push notifications. The same diet was prescribed for all patients. Three possible PA scenarios were studied for both the control and intervention groups: light physical activity (LPA), moderate physical activity (MPA), and intense physical activity (IPA). For the analysis of three or more means, the analysis of variance (ANOVA) of repeated means was performed to evaluate the effects of the intervention at baseline and at 3 and 6 months. Results Receiving notifications during the intervention increased body fat loss (mean -12.9% [SD 6.7] in the intervention group vs mean -7.0% [SD 5.7] in the control group; P<.001) and helped to maintain muscle mass (mean -0.8% [SD 4.5] in the intervention group vs mean -3.2% [SD 2.8] in the control group; P<.018). These variations between groups led to a nonsignificant difference in weight loss (mean -7.9 kg [SD 3.9] in the intervention group vs mean -7.1 kg [SD 3.4] in the control group; P>.05). Conclusions Push notifications have proven effective in the proposed weight loss program, leading women who received them to achieve greater loss of fat mass and a maintenance or increase of muscle mass, specifically among those who followed a program of IPA. Future interventions should include a longer evaluation period; the impact of different message contents, as well as message delivery times and frequency, should also be researched. Trial Registration ClinicalTrials.gov NCT03911583; https://www.clinicaltrials.gov/ct2/show/NCT03911583
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Affiliation(s)
| | | | - Guillermo Molina Recio
- Department of Nursing, School of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | - Rafael Molina-Luque
- Department of Nursing, School of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | | | - Rafael Moreno Rojas
- Department of Bromatology and Food Technology, University of Córdoba, Córdoba, Spain
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15
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Schwartz LA, Daniel LC, Henry‐Moss D, Bonafide CP, Li Y, Psihogios AM, Butler ES, Szalda D, Ver Hoeve ES, Hobbie WL, Dowshen NL, Pierce L, Kersun LS, Barakat LP. Feasibility and acceptability of a pilot tailored text messaging intervention for adolescents and young adults completing cancer treatment. Psychooncology 2019; 29:164-172. [DOI: 10.1002/pon.5287] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 09/23/2019] [Accepted: 10/15/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Lisa A. Schwartz
- Philadelphia Pennsylvania
- University of Pennsylvania Philadelphia Pennsylvania
| | | | | | | | - Yimei Li
- Philadelphia Pennsylvania
- University of Pennsylvania Philadelphia Pennsylvania
| | | | | | - Dava Szalda
- Philadelphia Pennsylvania
- University of Pennsylvania Philadelphia Pennsylvania
| | | | | | - Nadia L. Dowshen
- Philadelphia Pennsylvania
- University of Pennsylvania Philadelphia Pennsylvania
| | - Lisa Pierce
- University of Pennsylvania Philadelphia Pennsylvania
| | - Leslie S. Kersun
- Philadelphia Pennsylvania
- University of Pennsylvania Philadelphia Pennsylvania
| | - Lamia P. Barakat
- Philadelphia Pennsylvania
- University of Pennsylvania Philadelphia Pennsylvania
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16
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Devine KA, Viola AS, Coups EJ, Wu YP. Digital Health Interventions for Adolescent and Young Adult Cancer Survivors. JCO Clin Cancer Inform 2019; 2:1-15. [PMID: 30652583 DOI: 10.1200/cci.17.00138] [Citation(s) in RCA: 97] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
This narrative review describes the evidence regarding digital health interventions targeting adolescent and young adult (AYA) cancer survivors. We reviewed the published literature for studies involving Internet, mHealth, social media, telehealth, and other digital interventions for AYA survivors. We highlight selected studies to illustrate the state of the research in this unique patient population. Interventions have used various digital modalities to improve health behaviors (eg, physical activity, nutrition, tobacco cessation), enhance emotional well-being, track and intervene on cancer-related symptoms, and improve survivorship care delivery. The majority of studies have demonstrated feasibility and acceptability of digital health interventions for AYA survivors, but few efficacy studies have been conducted. Digital health interventions are promising to address unmet psychosocial and health information needs of AYA survivors. Researchers should use rigorous development and evaluation methods to demonstrate the efficacy of these approaches to improve health outcomes for AYA survivors.
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Affiliation(s)
- Katie A Devine
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
| | - Adrienne S Viola
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
| | - Elliot J Coups
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
| | - Yelena P Wu
- Katie A. Devine, Adrienne S. Viola, and Elliot J. Coups, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; Yelena P. Wu, Huntsman Cancer Institute, Salt Lake City, UT
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17
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Casillas JN, Schwartz LF, Crespi CM, Ganz PA, Kahn KL, Stuber ML, Bastani R, Alquaddomi F, Estrin DL. The use of mobile technology and peer navigation to promote adolescent and young adult (AYA) cancer survivorship care: results of a randomized controlled trial. J Cancer Surviv 2019; 13:580-592. [PMID: 31350681 DOI: 10.1007/s11764-019-00777-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 06/12/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Adolescent and young adult (AYA) cancer survivors experience unique barriers that compromise receipt of survivorship care; therefore, development of innovative educational interventions to improve rates of AYA survivorship care is needed. The efficacy of text-messaging and peer navigation interventions was compared to standard-of-care survivorship educational materials to increase AYAs' (1) late effects knowledge and (2) knowledge, attitudes, and self-efficacy towards seeking survivor-focused care. METHODS This was a three-armed, prospective, randomized controlled trial with one control group and two intervention groups. The control group received current standard-of-care educational materials. One intervention group participated in a text-messaging program, and the second participated in a peer navigator program. Participants completed pre- and post-intervention questionnaires. Study outcome variables were quantified using Fisher exact tests, two-sample t tests, exact McNemar tests, conditional logistic regression models, and analysis of covariance. RESULTS Seventy-one survivors completed the study (control n = 24; text-messaging n = 23; peer navigation n = 24). Late effects knowledge was high at baseline for all groups. The text-messaging group had increased survivorship care knowledge compared to the control group (p < 0.05); the peer navigation group had increased survivorship care self-efficacy compared to the control group; p < 0.05. Both intervention groups showed increased attitudes towards seeking survivor-focused care compared to the control group (text-messaging p < 0.05; peer navigation p < 0.05). CONCLUSIONS Each intervention demonstrated significant benefits compared to the control group. IMPLICATIONS FOR CANCER SURVIVORS Given the preliminary effectiveness of both interventions, each can potentially be used in the future by AYA cancer survivors to educate and empower them to obtain needed survivorship care.
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Affiliation(s)
- Jacqueline N Casillas
- Department of Pediatrics, Division of Hematology/Oncology, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, A2-410 MDCC, Los Angeles, CA, 90095-1752, USA. .,Center for Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.
| | - Lindsay F Schwartz
- Department of Pediatrics, Division of Hematology/Oncology, UCLA David Geffen School of Medicine, 10833 Le Conte Avenue, A2-410 MDCC, Los Angeles, CA, 90095-1752, USA
| | - Catherine M Crespi
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Patricia A Ganz
- Center for Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Department of Medicine, Division of Hematology/Oncology, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.,Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Katherine L Kahn
- Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Margaret L Stuber
- Department of Psychiatry, Resnick Neuropsychiatric Hospital, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | - Roshan Bastani
- Center for Cancer Prevention and Control Research, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Faisal Alquaddomi
- Department of Computer Science, Cornell University, New York, NY, USA
| | - Deborah L Estrin
- Department of Computer Science, Cornell University, New York, NY, USA
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18
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Zabih V, Kahane A, O'Neill NE, Ivers N, Nathan PC. Interventions to improve adherence to surveillance guidelines in survivors of childhood cancer: a systematic review. J Cancer Surviv 2019; 13:713-729. [PMID: 31338733 DOI: 10.1007/s11764-019-00790-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 07/11/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE Many survivors of childhood cancer are at high risk of late effects of their cancer therapy, including cardiac toxicity and subsequent malignant neoplasms (SMN). Current North American guidelines recommend periodic surveillance for these late effects. We conducted a systematic review of the literature to estimate rates of adherence to recommended surveillance and summarize studies evaluating interventions intended to increase adherence. METHODS We searched MEDLINE, Embase, Web of Science, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) for articles published between January 2000 and September 2018 that reported adherence to surveillance for cardiac toxicity and SMN (breast and colorectal cancer) and interventions implemented to improve completion of recommended testing. Risk of bias was assessed using relevant Cochrane checklists. Due to heterogeneity and overlapping study populations, we used narrative synthesis to summarize the findings. This review was registered in PROSPERO: CRD42018098878. RESULTS Thirteen studies met our inclusion criteria for assessing adherence to surveillance, while five assessed interventions to improve rates of surveillance. No studies met criteria for low risk of bias. Completion of recommended surveillance was lowest for colorectal cancer screening (11.5-30.0%) followed by cardiomyopathy (22.3-48.1%) and breast cancer (37.0-56.5%). Factors such as patient-provider communication, engagement with the health care system, and receipt of information were consistently reported to be associated with higher rates of surveillance. Of five randomized controlled trials aimed at improving surveillance, only two significantly increase completion of recommended testing-one for echocardiography and one for mammography. Both involved telephone outreach to encourage and facilitate these tests. CONCLUSION The majority of childhood cancer survivors at high risk of cardiac toxicity or SMN do not receive evidence-based surveillance. There is paucity of rigorous studies evaluating interventions to increase surveillance in this population. IMPLICATIONS FOR CANCER SURVIVORS Robust trials are needed to assess whether tailored interventions, designed based on unique characteristics and needs of each survivor population, could improve adherence.
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Affiliation(s)
- Veda Zabih
- Division of Hematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada
| | | | | | - Noah Ivers
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Paul C Nathan
- Division of Hematology/Oncology, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1X8, Canada.
- Institute of Health Policy Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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Lorenzi NPC, Termini L, Longatto Filho A, Tacla M, de Aguiar LM, Beldi MC, Ferreira-Filho ES, Baracat EC, Soares-Júnior JM. Age-related acceptability of vaginal self-sampling in cervical cancer screening at two university hospitals: a pilot cross-sectional study. BMC Public Health 2019; 19:963. [PMID: 31319838 PMCID: PMC6637504 DOI: 10.1186/s12889-019-7292-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 07/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To determine whether age is a barrier against acceptability of cervicovaginal self-sampling in screening for cervical cancer at two gynecology outpatient clinics. METHODS This is a cross-sectional study involving 116 women over 21 years of age with an abnormal Pap smear. Clinical and laboratorial data were recorded in electronic files. Women received detailed self-collection instructions. After the self-sampling procedure (Evalyn Brush®), women were instructed to answer a questionnaire about vaginal self-sampling acceptability that consisted of seven multiple-choice items. The participants were divided into three age brackets: 21 to 29 years, 30 to 49 years, and 50 years and over. Chi-square, Fischer exact, Kolmogorov-Smirnov and Kruskal-Wallis tests were used. RESULTS The analysis of the participants' perception of the procedure stratified according to age groups showed a decline in the fear of hurting oneself during the procedure as age increased. Most participants reported that it was very easy to understand how to use the self-sampling brush and that it was easy to use it. Most of them were neither embarrassed nor afraid of getting hurt during the procedure. The majority preferred self-sampling to collection by a healthcare professional. The main reason was practicality: the possibility of choosing the place and time for sampling. CONCLUSIONS The participating women found self-collection simple to understand and easy to accept regardless of age. The younger women indicated more fear and discomfort in self-sampling, which points to the need for attraction strategies that are more appealing to the younger generations.
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Affiliation(s)
| | - Lara Termini
- Center for Translational Investigation in Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Adhemar Longatto Filho
- Molecular Oncology Research Center, Barretos Cancer Hospital/Pio XII Foundation, Barretos, SP, Brazil.,Department of Pathology, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.,Research Institute of Life and Health Sciences (ICVS), University of Minho, Braga, Portugal.,8ICVS / 3B's - Associated Laboratory to the Government of Portugal, Braga / Guimarães, Portugal
| | - Maricy Tacla
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Lana Maria de Aguiar
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Mariana Carmezim Beldi
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Edson Santos Ferreira-Filho
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Edmund Chada Baracat
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - José Maria Soares-Júnior
- Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
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Mehdizadeh H, Asadi F, Mehrvar A, Nazemi E, Emami H. Smartphone apps to help children and adolescents with cancer and their families: a scoping review. Acta Oncol 2019; 58:1003-1014. [PMID: 30915872 DOI: 10.1080/0284186x.2019.1588474] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Introduction: Considering the importance of empowering patients and their families by providing appropriate information and education, it seems smartphone apps provide a good opportunity for this group. The purpose of this review was to identify studies which used smartphone apps to help children and adolescents with cancer and their families. Method: Arksey and O'Malley's framework was employed in this review. To examine the evidence on the design and use of smartphone apps for the target group, PubMed, Embase, Scopus and Web of Science databases were searched from 2007 to November 2018. Results: Twenty-four articles met the inclusion criteria, with 33% being conducted in the USA and 21% in Canada. Moreover, in 20 studies (83%), app was specifically designed for children and adolescents, with only three studies (13%) for parents and one study (4%) for both. The main modules of smartphone apps in these studies included symptom assessment (90%), provision of information and education (74%), communication with caregivers (57%), social support (30%) and calendar and reminder (21%). Conclusions: Due to the easy access to smartphones without a costly infrastructure compared to landline phones, the use of mobile health (m-Health) has become a suitable method of providing healthcare services, especially for cancer. Use of smartphone apps, increases patient and families' access to reliable and suitable education and information regarding the disease. Thus, healthcare policy-makers in developing or underdeveloped countries can exploit the health-related potentials of m-Health following the experience of developed countries.
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Affiliation(s)
- Hamed Mehdizadeh
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farkhondeh Asadi
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azim Mehrvar
- MAHAK Hematology Oncology Research Center (MAHAK-HORC), MAHAK Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Eslam Nazemi
- Department of Electrical and Computer Engineering, Shahid Beheshti University, Tehran, Iran
| | - Hassan Emami
- Department of Health Information Technology and Management, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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21
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Psihogios AM, Li Y, Butler E, Hamilton J, Daniel LC, Barakat LP, Bonafide CP, Schwartz LA. Text Message Responsivity in a 2-Way Short Message Service Pilot Intervention With Adolescent and Young Adult Survivors of Cancer. JMIR Mhealth Uhealth 2019; 7:e12547. [PMID: 30998225 PMCID: PMC6495290 DOI: 10.2196/12547] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/15/2019] [Accepted: 02/05/2019] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE Within a 2-way text messaging study in AYAs who recently completed treatment for cancer, we sought to evaluate text message responsivity across different types of text messages. METHODS AYAs who recently completed treatment for cancer (n=26; mean age=16 years; 62% female, 16/26 participants) received 2-way text messages about survivorship health topics over a 16-week period. Using participants' text message log data, we coded responsivity to text messages and evaluated trends in responsivity to unprompted text messages and prompted text messages of varying content (eg, medication reminders, appointment reminders, and texts about personal experiences as a cancer survivor). RESULTS Across prompted and unprompted text messages, responsivity rapidly decreased (P ≤.001 and =.01, respectively) and plateaued by the third week of the intervention. However, participants were more responsive to prompted text messages (mean responsivity=46% by week 16) than unprompted messages (mean responsivity=10% by week 16). They also demonstrated stable responsivity to certain prompted content: medication reminders, appointment reminders, goal motivation, goal progress, and patient experience texts. CONCLUSIONS Our methodology of evaluating text message responsivity revealed important patterns of engagement in a 2-way text message intervention for AYA cancer survivors.
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Affiliation(s)
| | - Yimei Li
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Eliana Butler
- The Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | | | - Lauren C Daniel
- Rutgers University Camden, The Children's Hospital of Philadelphia, Camden, NJ, United States
| | - Lamia P Barakat
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher P Bonafide
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
| | - Lisa A Schwartz
- The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States
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22
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Schwartz LA, Psihogios AM, Henry-Moss D, Daniel LC, Ver Hoeve ES, Velazquez-Martin B, Butler E, Hobbie WL, Lunsford NB, Sabatino SA, Barakat LP, Ginsberg JP, Fleisher L, Deatrick JA, Jacobs LA, O’Hagan B, Anderson L, Fredericks E, Amaral S, Dowshen N, Houston K, Vachani C, Hampshire MK, Metz JM, Hill-Kayser CE, Szalda D. Iterative Development of a Tailored mHealth Intervention for Adolescent and Young Adult Survivors of Childhood Cancer. CLINICAL PRACTICE IN PEDIATRIC PSYCHOLOGY 2019; 7:31-43. [PMID: 38882593 PMCID: PMC11177339 DOI: 10.1037/cpp0000272] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Objectives Methods for developing mobile health (mHealth) interventions are not well described. To guide the development of future mHealth interventions, we describe the application of the agile science framework to iteratively develop a mHealth intervention for adolescent and young adult (AYA) survivors of childhood cancer. Methods We created the AYA STEPS mobile app (AYA Self-management via Texting, Education, and Plans for Survivorship) by modifying and integrating two existing programs: an online survivorship care plan (SCP) generator and a text messaging self-management intervention for AYA off treatment. The iterative development process involved three stages of agile science: 1) Formative work, 2) Obtaining feedback about the first AYA STEPS prototype, and 3) Pilot testing and finalization of a prototype. We determined preferences of AYA stakeholders as well as discovered and addressed technology problems prior to beginning a subsequent randomized controlled trial. Results AYA survivors reported that the app and the embedded tailored messages related to their health and SCP, were easy to use and generally satisfying and beneficial. Usage data supported that AYA were engaged in the app. Technology glitches were discovered in the pilot and addressed. Conclusions The iterative development of AYA STEPS was essential for creating a consistent and acceptable end user experience. This study serves as one example of how behavioral scientists may apply agile science to their own mHealth research.
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Affiliation(s)
- Lisa A. Schwartz
- The Children’s Hospital of Philadelphia
- University of Pennsylvania
| | | | | | - Lauren C. Daniel
- The Children’s Hospital of Philadelphia
- Rutgers University Camden
| | | | | | | | | | | | - Susan A. Sabatino
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention
| | - Lamia P. Barakat
- The Children’s Hospital of Philadelphia
- University of Pennsylvania
| | - Jill P. Ginsberg
- The Children’s Hospital of Philadelphia
- University of Pennsylvania
| | | | | | | | | | | | | | - Sandra Amaral
- The Children’s Hospital of Philadelphia
- University of Pennsylvania
| | - Nadia Dowshen
- The Children’s Hospital of Philadelphia
- University of Pennsylvania
| | - Keisha Houston
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention
| | | | | | | | | | - Dava Szalda
- The Children’s Hospital of Philadelphia
- University of Pennsylvania
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23
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Smith SR, Zheng JY, Silver J, Haig AJ, Cheville A. Cancer rehabilitation as an essential component of quality care and survivorship from an international perspective. Disabil Rehabil 2018; 42:8-13. [PMID: 30574818 DOI: 10.1080/09638288.2018.1514662] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: There has recently been an emphasis on improving cancer care globally, including access to lifesaving treatment and earlier identification of disease. This will lead to more survivors stricken by impairments related to the early and late effects of cancer treatment. An unintended consequence of the noble plan to improve oncology care worldwide is demand on health care systems that may be unable to accommodate increased patient care needs for myriad reasons. As a result, those with disabilities may suffer.Methods: Literature search and input from experts in the field were used to evaluate the growing need for cancer rehabilitation and survivorship care to reduce morbidity associated with cancer treatment.Results: Many governmental and non-governmental organizations have started initiatives to improve cancer care across the continuum, and reduce the symptom burden of those living with cancer. While the start is promising, many barriers must be overcome to ensure high-quality care that would reduce cost and improve patient access, including a lack of trained rehabilitation specialists, poor coordination of efforts, and funding restrictions. Furthermore, global efforts to improve rehabilitation care often do not emphasize cancer rehabilitation, potentially leaving a gap and increasing physical and economic costs of disability. Finally, low-resource countries face unique challenges in improving cancer rehabilitation care.Conclusion: Cancer rehabilitation and survivorship care are needed to improve health care quality, as there is an expected influx of cancer patients with new global efforts to improve oncology care. To accomplish this, rehabilitation initiatives must emphasize cancer rehabilitation as a component of any program, and oncology endeavors should include a plan for the rehabilitation of cancer survivors to reduce morbidity and health care cost.Implications for RehabilitationCancer rehabilitation has the potential to reduce morbidity and health care costs associated with cancer and disability worldwideAdvocacy from international organizations regarding cancer rehabilitation is increasing, but has been disjointed and incompleteLow-resource countries in particular face several barriers to providing cancer rehabilitation and survivorship care.
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Affiliation(s)
- Sean R Smith
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, MI, USA
| | - Jasmine Y Zheng
- Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania, PA, USA
| | - Julie Silver
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, MA, USA
| | - Andrew J Haig
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, MI, USA
| | - Andrea Cheville
- Department of Physical Medicine and Rehabilitation, The Mayo Clinic, Rochester, Minnesota, MN, USA
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24
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Baenziger J, Roser K, Mader L, Christen S, Kuehni CE, Gumy-Pause F, Tinner EM, Michel G. Can the theory of planned behavior help explain attendance to follow-up care of childhood cancer survivors? Psychooncology 2018; 27:1501-1508. [PMID: 29473254 DOI: 10.1002/pon.4680] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Revised: 02/09/2018] [Accepted: 02/12/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Childhood cancer survivors are at high risk for late effects. Regular attendance to long-term follow-up care is recommended and helps monitoring survivors' health. Using the theory of planned behavior, we aimed to (1) investigate the predictors of the intention to attend follow-up care, and (2) examine the associations between perceived control and behavioral intention with actual follow-up care attendance in Swiss childhood cancer survivors. METHODS We conducted a questionnaire survey in Swiss childhood cancer survivors (diagnosed with cancer aged <16 years between 1990 and 2005; ≥5 years since diagnosis). We assessed theory of planned behavior-related predictors (attitude, subjective norm, perceived control), intention to attend follow-up care, and actual attendance. We applied structural equation modeling to investigate predictors of intention, and logistic regression models to study the association between intention and actual attendance. RESULTS Of 299 responders (166 [55.5%] females), 145 (48.5%) reported attending follow-up care. We found that subjective norm, ie, survivors' perceived social pressure and support (coef = 0.90, P < 0.001), predicted the intention to attend follow-up; attitude and perceived control did not. Perceived control (OR = 1.58, 95%CI:1.04-2.41) and intention to attend follow-up (OR = 6.43, 95%CI:4.21-9.81) were positively associated with attendance. CONCLUSIONS To increase attendance, an effort should be made to sensitize partners, friends, parents, and health care professionals on their important role in supporting survivors regarding follow-up care. Additionally, interventions promoting personal control over the follow-up attendance might further increase regular attendance.
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Affiliation(s)
- Julia Baenziger
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Katharina Roser
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Luzius Mader
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Salome Christen
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Fabienne Gumy-Pause
- Department of Pediatrics, Onco-Hematology Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Eva Maria Tinner
- Division of Pediatric Hematology/Oncology, University Children's Hospital Bern, Bern, Switzerland
| | - Gisela Michel
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.,Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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