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McLaughlin E, Arshad N, Ellis K, Chen A, Fougere K, Culos-Reed SN, Wurz A. Experiences of young adults affected by cancer within an 8-week yoga intervention delivered by videoconference: a qualitative interview study. Ann Med 2024; 56:2309275. [PMID: 38289977 PMCID: PMC10829813 DOI: 10.1080/07853890.2024.2309275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/18/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Yoga may reduce negative cancer- and treatment-related effects and help improve a range of outcomes, including flexibility, mindfulness, and quality of life among adults affected by cancer. Yet there is little evidence for the role of yoga among young adults (18-39 years) affected by cancer. PURPOSE The purpose of this study was to explore the experiences of young adults affected by cancer in an 8-week yoga intervention delivered by videoconference. METHODS Young adults who were diagnosed with cancer between the ages of 18 and 39 years, at any stage of the cancer trajectory, who were living in Canada, and who completed an 8-week yoga intervention were approached to complete a semi-structured interview. A social constructivist paradigm was adopted. Interviews were transcribed verbatim and analyzed using reflexive thematic analysis. RESULTS Twenty-eight young adults (Mean age = 34.67 ± 5.11 years; n = 25 female) with varied cancer diagnoses participated. Participants' perspectives were represented across 6 themes: (1) I was juggling a number of challenges and changes throughout the yoga intervention; (2) I noticed some improvements in my mental and physical health; (3) I made time to discover new strategies to take care of myself; (4) I was able to see what my body is capable of; (5) I was held accountable and I appreciated that, and; (6) I was able to be around similar others in a safe (virtual) space. CONCLUSIONS Findings suggest that an 8-week yoga intervention may offer some benefits for young adults affected by cancer. Self-care, self-compassion, mindfulness, feelings of physical competence, establishing a routine, and being around similar others were viewed as important components of the intervention and may have contributed to the benefits experienced. Findings underscore the potential utility of yoga as a supportive care intervention for young adults affected by cancer.
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Affiliation(s)
- Emma McLaughlin
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Nafeel Arshad
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada
| | - Kelsey Ellis
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Amy Chen
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kate Fougere
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - S. Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, Canada
| | - Amanda Wurz
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada
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LeBeau K, Raponi JM, Walker D, Swygert A, Marchi E. Social support among chronically ill adolescent and young adult patients using a hospital-based online health community as part of a palliative care program: A qualitative study. Palliat Support Care 2024:1-10. [PMID: 38450450 DOI: 10.1017/s1478951524000208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Chronically ill adolescent and young adult (AYA) patients experience barriers to accessing psychosocial support/palliative care, increasing their risk for negative psychosocial outcomes. Online health communities (OHCs) have been recommended for AYAs as part of palliative care support programs; however, we lack research investigating palliative care programs targeting AYAs' psychosocial support needs that are delivered virtually and able to engage with patients both during and beyond inpatient admissions. Streetlight is a palliative care program designed for chronically ill AYAs. Developed as a complementary component that extends beyond the hospital setting, Streetlight Gaming and Online Team (SGOT) is an OHC aimed at facilitating social support to influence psychosocial outcomes. We investigated the existence and enactment of social support among chronically ill AYAs using SGOT and compared this to existing online social support categories to determine which support types are present within SGOT. METHODS This was a qualitative phenomenological study. We performed deductive thematic analysis based on existing online social support categories. Nine semi-structured interviews were conducted with SGOT participants. RESULTS Social companionship/belonging, esteem/emotional, and informational support were most prevalent within SGOT. Thirteen subthemes emerged representing how social support impacted AYAs' psychosocial wellbeing. Notably, coping with/managing illness, sense of community and normalcy, recommendations and advice, and shared interests unrelated to illnesses were subthemes that resonated with AYAs and added value to their experiences. SIGNIFICANCE OF RESULTS SGOT is an impactful OHC used to meet AYAs' social support needs. What makes SGOT especially unique is its virtual delivery, wherein AYAs can conveniently maintain beneficial relationships with other chronically ill same-aged peers. AYAs need spaces where they can feel normal and access continuous support, both within and beyond inpatient admissions. This study enhances our understanding of online AYA psychosocial support programs. Findings can be used by healthcare professionals to implement similar palliative care and psychosocial support programs.
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Affiliation(s)
- Kelsea LeBeau
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
- U.S. Department of Veterans Affairs, VA North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
| | - Jayne-Marie Raponi
- College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Drew Walker
- Department of Behavioral, Social and Health Education Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Anna Swygert
- Department of Pediatrics, University of Florida Health, Gainesville, FL, USA
| | - Emily Marchi
- Department of Pediatrics, University of Florida Health, Gainesville, FL, USA
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Cho E, Akard TF. Perspectives From Adolescent and Young Adult Cancer Survivors for a Planned Nurse-Patient Dyadic Storytelling Intervention. J Holist Nurs 2024; 42:49-63. [PMID: 37475533 DOI: 10.1177/08980101231189392] [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] [Indexed: 07/22/2023]
Abstract
Purpose: This qualitative study aimed to explore the perspectives of adolescents and young adults (AYA) on a planned nurse-patient dyadic storytelling intervention. Background: Cancer is a highly distressful event for AYA. AYA with cancer experience multidimensional suffering while dealing with their developmental transition from adolescence to young adulthood. Their unique needs require appropriate, well-tailored psychosocial support. Nurses can provide such support through storytelling approaches. METHOD AYA cancer survivors participated in cross-sectional qualitative interviews to provide feedback on the nurse-patient storytelling intervention model. ANALYSIS Qualitative content analysis was used to interpret and categorize the data. FINDINGS Barriers and facilitators of the intervention emerged. Themes related to barriers included (a) the disadvantages of an online program, (b) the limitations of the in-person program, (c) interacting with nurses, (d) sharing personal stories with others, and (e) the timing of the program. Themes regarding facilitators included (a) benefits to AYA with cancer, (b) benefits to nurses, (c) benefits of online/in-person programs, and (d) willingness to participate. Conclusions: AYA with cancer may benefit from the nurse-patient dyadic storytelling intervention. Developing innovative methods to optimize and customize interventions based on preferences is essential. Future research should involve nurse feedback and tailored approaches for AYA with cancer.
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Affiliation(s)
- Eunji Cho
- Connell School of Nursing, Boston College, Boston, MA, USA
| | - Terrah Foster Akard
- School of Nursing, Vanderbilt University, Nashville, TN, USA
- School of Medicine, Vanderbilt University, Nashville, TN, USA
- Graduate School, Vanderbilt University, Nashville, TN, USA
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Salsman JM, McLouth LE, Tooze JA, Little-Greene D, Cohn M, Kehoe MS, Moskowitz JT. An eHealth, Positive Emotion Skills Intervention for Enhancing Psychological Well-Being in Young Adult Cancer Survivors: Results from a Multi-Site, Pilot Feasibility Trial. Int J Behav Med 2023; 30:639-650. [PMID: 36890329 PMCID: PMC10485177 DOI: 10.1007/s12529-023-10162-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Young adult (YA) cancer survivors experience clinically significant distress and have limited access to psychosocial support. Given growing evidence for unique adaptive benefits of positive emotion in the context of health-related and other life stress, we developed an eHealth positive emotion skills intervention for post-treatment survivors called EMPOWER (Enhancing Management of Psychological Outcomes With Emotion Regulation) and evaluated feasibility and proof of concept for reducing distress and enhancing well-being. METHOD In this single-arm pilot feasibility trial, post-treatment YA cancer survivors (ages 18-39) participated in the EMPOWER intervention which included 8 skills (e.g., gratitude, mindfulness, acts of kindness). Participants completed surveys at baseline (pre-intervention), 8 weeks (post-intervention), and 12 weeks (1-month follow-up). Primary outcomes included feasibility (assessed by participation percentage) and acceptability (would recommend EMPOWER skills to a friend). Secondary outcomes included psychological well-being (mental health, positive affect, life satisfaction, meaning/purpose, general self-efficacy) and distress (depression, anxiety, anger). RESULTS We assessed 220 YAs for eligibility; 77% declined. Of those screened, 44 (88%) were eligible and consented, 33 began the intervention, and 26 (79%) completed the intervention. Overall retention was 61% at 12 weeks. Average acceptability ratings were high (8.8/10). Participants (M = 30.8 years, SD = 6.6) were 77% women, 18% racial/ethnic minorities, and 34% breast cancer survivors. At 12 weeks, EMPOWER was associated with improved mental health, positive affect, life satisfaction, meaning/purpose, and general self-efficacy (ps < .05, ds = .45 to .63) and decreased anger (p < .05, d = - 0.41). CONCLUSION EMPOWER demonstrated evidence of feasibility and acceptability as well as proof of concept for enhancing well-being and reducing distress. Self-guided, eHealth interventions show promise for addressing YA cancer survivors' needs and warrant additional research to optimize survivorship care. TRIAL REGISTRATION ClinicalTrials .gov NCT02832154, https://clinicaltrials.gov/ct2/show/NCT02832154.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine & Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - Laurie E McLouth
- Department of Behavioral Science and Center for Health Equity Transformation, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine & Atrium Health Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA
| | - Denisha Little-Greene
- Health Care Education, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | | | - Mia Sorkin Kehoe
- Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Aagesen M, la Cour K, Møller JJK, Stapelfeldt CM, Hauken MA, Pilegaard MS. Rehabilitation interventions for young adult cancer survivors: A scoping review. Clin Rehabil 2023; 37:1347-1374. [PMID: 37083478 DOI: 10.1177/02692155231168720] [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] [Indexed: 04/22/2023]
Abstract
OBJECTIVE To map existing research concerning rehabilitation interventions for young adult cancer survivors (YACS) that address at least one factor from the biopsychosocial health model. DESIGN Scoping review. DATA SOURCES Searches were performed in EMBASE, MEDLINE, PsycINFO, CINAHL and Cochrane in January 2022 and updated in March 2023, and grey literature between February and April 2022. METHODS The review followed Joanna Briggs Institute's methodology for scoping reviews. Quantitative, qualitative and mixed methods studies evaluating interventions for YACS of any cancer who had completed primary treatment and were between 18 and 39 years old at diagnosis were included. Two authors independently screened studies for eligibility, and standardised forms were used for data extraction. Descriptive statistics, narrative summaries and thematic analysis were used to analyse the data. RESULTS The search revealed 5706 records, of which 70 were full-text screened. The 20 included studies represented a heterogeneous group of 444 young adults with different cancer types, mean age above 25, and an overrepresentation of females. Most studies were feasibility and pilot studies. The 20 studies consisted of 14 unique interventions focusing primarily on one dimension of the biopsychosocial health model like biological or psychological factors. In the 14 interventions, the most frequent intervention element was peer-to-peer support (n = 12). The interventions were often delivered online (n = 9), lasting 3-12 months (n = 8). A wide variety of theories, providers and outcome measures were used. CONCLUSION The results show that current research on multicomponent, biopsychosocial and age-specific rehabilitation for YACS remains at an early stage.
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Affiliation(s)
- Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- The Research Unit for User Perspectives and Community-Based Interventions, The Research Group for Occupational Science, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Karen la Cour
- The Research Unit for User Perspectives and Community-Based Interventions, The Research Group for Occupational Science, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jens-Jakob Kjer Møller
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Nyborg, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Christina M Stapelfeldt
- The Danish Clinical Quality Program - National Clinical Registries (RKKP), Aarhus N, Denmark
- Department of Public Health, Aarhus University, Aarhus C, Denmark
| | - May Aasebø Hauken
- Faculty of Psychology, Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Marc Sampedro Pilegaard
- Central Region Denmark, DEFACTUM, Aarhus, Denmark
- Department of Social Medicine and Rehabilitation, Regional Hospital Gødstrup, Herning, Denmark
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Lazard AJ, Meernik C, Collins MKR, Vereen RN, Benedict C, Valle CG, Love B. Social Media Use for Cancer Support Among Young Adults with Cancer. J Adolesc Young Adult Oncol 2023; 12:674-684. [PMID: 37257189 DOI: 10.1089/jayao.2023.0025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Purpose: Social media can facilitate peer support among young adults with cancer; however, information is needed about what social media are used, by whom, and how to inform resource and intervention recommendations. Methods: In December 2021, we conducted an online survey with 396 young adults with cancer, ages 18-39, with any diagnosis ages 15-39. Participants reported their social media use to connect with other young adults with cancer, including frequency of use, type of support, and affect (positive to negative) when using to connect with cancer peers. Results: Participants were on average 31 years old (SD = 5.2), with an average age of 27 at diagnosis (63.4% male, 62.1% non-Hispanic White). Almost all (97.5%) reported using social media to connect with other young adults with cancer. Many (48.0%) used three or more social media platforms for cancer support, including Facebook (44.4%), YouTube (43.6%), Instagram (43.4%), Snapchat (36.9%), and Twitter (36.9%). Daily use for cancer support was common (32.9%-60.9%) among those who used social media, particularly among those who were younger; are not transgender; live in urban areas; or had brain, gynecologic, or testicular cancers. Across social media platforms, young adults with cancer reported seeking and sharing emotional support (88.9%), informational support (84.1%), and making connections (81.3%). Conclusion: Young adults with cancer use social media to connect with cancer peers for support. Commonly used existing social media (e.g., Facebook, YouTube, Instagram) should be prioritized in interventions to reach young adults who desire more age-appropriate resources to improve their psychosocial health.
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Affiliation(s)
- Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Clare Meernik
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Meredith K Reffner Collins
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rhyan N Vereen
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Catherine Benedict
- Department of Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Carmina G Valle
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brad Love
- Center for Health Communication, The University of Texas, Austin, Texas, USA
- GRYT Health, Rochester, New York, USA
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Phillips CS, Bockhoff J, Berry DL, Buchbinder E, Frazier AL, LaCasce A, Ligibel J, Luskin MR, Woods H, Knoerl R. Exploring Young Adults' Perspectives of Participation in a Mindfulness-Based Music Therapy Intervention Before and During the COVID-19 Pandemic. J Adolesc Young Adult Oncol 2023; 12:569-576. [PMID: 36752714 DOI: 10.1089/jayao.2022.0090] [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] [Indexed: 02/09/2023] Open
Abstract
Purpose: To explore adolescent and young adults' (AYAs) experiences with participation in a mindfulness-based music therapy intervention during cancer treatment before and during the COVID-19 pandemic. Methods: Sixteen young adults (20-39 years old) who received cancer treatment and participated in a mindfulness-based music therapy intervention for anxiety and stress were interviewed using a semistructured interview guide. Interviews were audio recorded and transcribed verbatim. The interview guide contained prompts about reasons for joining the study, usual coping strategies, experience with the in-person and virtual delivery formats of the intervention, and suggestions for improvement. Themes were derived from the data using inductive content analysis methods. Results: Findings from the interviews included the following: (1) virtual group participants reported difficulty finding a private place to attend the intervention sessions, (2) participants experienced a sense of relaxation in response to intervention participation, (3) in-person group participants felt a sense of connection to the music and their family members who were present during the intervention, while virtual group participants felt a sense of connection to mindfulness, (4) virtual group participants reported that practicing music and mindfulness together was synergistic, and (5) in-person intervention delivery was preferred to virtual intervention delivery. Conclusion: This study provides insight into the contextual factors that impact satisfaction with the intervention and the effect of the intervention on anxiety and stress. Overall, while virtual mindfulness-based music therapy delivery may be more feasible, there are still important advantages to in-person delivery that should be considered in the design of future mindfulness-based music therapy interventions. ClinicalTrials.gov Identifier: NCT03709225.
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Affiliation(s)
- Carolyn S Phillips
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Julianna Bockhoff
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Donna L Berry
- Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, Washington, USA
| | - Elizabeth Buchbinder
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - A Lindsay Frazier
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Ann LaCasce
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Jennifer Ligibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Marlise R Luskin
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Heather Woods
- The Leonard P. Zakim Center for Integrative Therapies and Healthy Living, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Robert Knoerl
- Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Weiner LS, Nagel S, Irene Su H, Hurst S, Levy SS, Arredondo EM, Hekler E, Hartman SJ. A remotely delivered, peer-led intervention to improve physical activity and quality of life in younger breast cancer survivors. J Behav Med 2023; 46:578-593. [PMID: 36479658 PMCID: PMC9735111 DOI: 10.1007/s10865-022-00381-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 11/20/2022] [Indexed: 12/12/2022]
Abstract
Younger breast cancer survivors (YBCS) consistently report poorer quality of life (QOL) than older survivors. Increasing physical activity (PA) may improve QOL, but this has been understudied in YBCS. This single arm pilot study evaluated the feasibility and acceptability of a 3-month, peer-delivered, remote intervention to increase PA and improve QOL in YBCS. Data were collected from October 2019 - July 2020. Participants (n = 34, 43.1 ± 5.5 years old, 46 ± 34.4 months post-diagnosis, BMI = 30.2 ± 7.4 kg/m2) completed six video sessions with a trained peer mentor; self-monitored PA with a Fitbit activity tracker; and interacted with a private Fitbit Community for social support. At baseline, 3-and 6-months, participants completed QOL questionnaires and PA was measured through accelerometer (moderate-to-vigorous PA [MVPA]) and self-report (strength and flexibility). A parallel mixed-methods approach (qualitative interviews and quantitative satisfaction survey at 3-months) explored intervention feasibility and acceptability. One-way repeated-measures ANOVAs examined impacts on PA and QOL at 3-and 6-months. The intervention was feasible as evidenced by efficient recruitment, high retention, and adherence to intervention components. Remote delivery, working with a peer mentor, and using Fitbit tools were highly acceptable. From baseline to 3-months, participants increased time spent in objectively measured MVPA, strength, and flexibility exercises, and reported meaningful improvements to body image, fatigue, anxiety, and emotional support. A fully remote, peer-to-peer intervention is an acceptable and promising strategy to increase PA and improve QOL in YBCS. Refinements to the intervention and its delivery should be further assessed in future studies, toward the goal of disseminating an evidence-based, scalable intervention to the growing number of YBCS.Trial registration Prospectively registered as NCT04064892.
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Affiliation(s)
- Lauren S Weiner
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA.
- UC San Diego Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA, USA.
| | | | - H Irene Su
- UC San Diego Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA, USA
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics, Gynecology, and Reproductive Sciences, UC San Diego, La Jolla, CA, USA
| | - Samantha Hurst
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA
| | - Susan S Levy
- School of Exercise & Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Elva M Arredondo
- Institute for Behavioral and Community Health, San Diego State University Research Foundation, San Diego, CA, USA
- School of Public Health, San Diego State University, San Diego, CA, USA
| | - Eric Hekler
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA
- Center for Wireless & Population Health Systems, Qualcomm Institute, San Diego, CA, USA
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA
- UC San Diego Moores Cancer Center, 3855 Health Sciences Drive, La Jolla, CA, USA
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9
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Wurz A, McLaughlin E, Hughes K, Ellis K, Chen A, Cowley L, Molina H, Duchek D, Eisele M, Culos-Reed SN. Exploring feasibility, perceptions of acceptability, and potential benefits of an 8-week yoga intervention delivered by videoconference for young adults affected by cancer: a single-arm hybrid effectiveness-implementation pilot study. Pilot Feasibility Stud 2023; 9:37. [PMID: 36899410 PMCID: PMC9999078 DOI: 10.1186/s40814-023-01244-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 01/12/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Young adults affected by cancer face physical and psychological challenges and desire online supportive care. Yoga can be delivered online and may improve physical and psychological outcomes. Yet, yoga has rarely been studied with young adults affected by cancer. To address this, an 8-week yoga intervention was developed, and a pilot study was deemed necessary to explore feasibility, acceptability, implementation, and potential benefits. METHODS A mixed-methods, single-arm hybrid effectiveness-implementation pilot study evaluating the yoga intervention was conducted. Feasibility was assessed by tracking enrollment, retention, attendance, completeness of data, and adverse events. Acceptability was explored through interviews. Implementation metrics included training time, delivery resources, and fidelity. Potential effectiveness was evaluated by exploring changes in physical (i.e., balance, flexibility, range of motion, functional mobility) and psychological (i.e., quality of life, fatigue, resilience, posttraumatic growth, body image, mindfulness, perceived stress) outcomes at pre- (week 0), post- (week 8), and follow-up (week 16) time points. Data were analyzed with descriptive statistics, repeated measures analysis of variance, and content analysis. RESULTS Thirty young adults participated in this study (recruitment rate = 33%). Retention to study procedures was 70%, and attendance ranged from 38 to 100%. There were little missing data (< 5%) and no adverse events. Though most participants were satisfied with the yoga intervention, recommendations for improvement were shared. Sixty study-specific training hours and > 240 delivery and assessment hours were accrued and fidelity was high. Functional mobility, flexibility, quality of life (energy/fatigue, social well-being), body image (appearance evaluation), mindfulness (non-reactivity), and perceived stress improved significantly over time (all p< 0.050; [Formula: see text]). No other significant changes were observed (all p> 0.050; [Formula: see text]). CONCLUSIONS The yoga intervention may confer physical and psychological benefits, though intervention and study-specific modifications are required to improve feasibility and acceptability. Requiring study participation and providing greater scheduling flexibility could enhance recruitment and retention. Increasing the frequency of classes offered each week and offering more opportunities for participant interaction could improve satisfaction. This study highlights the value of doing pilot work and provides data that has directly informed intervention and study modifications. Findings could also be used by others offering yoga or supportive care by videoconference to young adults affected by cancer. TRIAL REGISTRATION Not available-not registered.
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Affiliation(s)
- Amanda Wurz
- School of Kinesiology, University of the Fraser Valley, Chilliwack, Canada. .,Faculty of Kinesiology, University of Calgary, Calgary, Canada.
| | - Emma McLaughlin
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kimberly Hughes
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Kelsey Ellis
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | - Amy Chen
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | | | | | - Delaney Duchek
- Faculty of Kinesiology, University of Calgary, Calgary, Canada
| | | | - S Nicole Culos-Reed
- Faculty of Kinesiology, University of Calgary, Calgary, Canada.,Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Canada.,Department of Psychosocial Resources, Tom Baker Cancer Centre, Cancer Care, Alberta Health Services, Calgary, Canada
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Leske M, Koczwara B, Morris J, Beatty L. Modality preferences for health behaviour interventions for post-treatment cancer survivors: a theoretical investigation. Support Care Cancer 2023; 31:143. [PMID: 36729337 PMCID: PMC9892669 DOI: 10.1007/s00520-023-07607-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 01/24/2023] [Indexed: 02/03/2023]
Abstract
PURPOSES User preferences for how programs are delivered are an important consideration when developing healthy living interventions. The aim of this study was to investigate (a) if cancer survivors prefer telephone or internet delivery for a healthy living intervention and (b) what factors were associated with delivery preference. METHODS Australian cancer survivors (18 + years) were invited to complete an online or hardcopy cross-sectional survey measuring social and clinical demographic factors and validated measures of self-efficacy, health literacy, and social support. RESULTS Of the 168 respondents, the majority were female (n = 147, 92%) and breast cancer survivors (n = 122, 80%) and preferred internet delivery (n = 109, 65%). Participants who preferred internet delivery had a longer time since diagnosis (M = 9.85 years, SD = 8.20) compared to those who preferred telephone (M = 6.80 years, SD = 5.54), p = .03. However, logistic regression analyses demonstrated that no other variables (age, gender, socio-economic status, BMI, education, self-efficacy, health literacy, nor social support) had a direct association on delivery preference. CONCLUSIONS Cancer survivors appear to prefer internet delivery to telephone, particularly for those further along the survivorship trajectory. Future intervention development should therefore consider the internet modality for delivering accessible health interventions and offer the program to long-term cancer survivors. Whether these findings are replicable in the current post-pandemic phase is an important avenue for future research.
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Affiliation(s)
- Morgan Leske
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia.
| | - Bogda Koczwara
- College of Medicine and Public Health, Flinders University, Adelaide, SA Australia ,Department of Medical Oncology, Southern Adelaide Local Health Network, Adelaide, SA Australia
| | | | - Lisa Beatty
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA Australia
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The physicAl aCtivity Counselling for young adult cancEr SurvivorS (ACCESS) trial: A protocol for a parallel, two-arm pilot randomized controlled trial. PLoS One 2022; 17:e0273045. [PMID: 36584027 PMCID: PMC9803096 DOI: 10.1371/journal.pone.0273045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 07/15/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Young adults aged 18-39 years commonly experience persistent side effects following cancer treatment that can impair their quality of life. Physical activity (PA) holds promise as a behavioral intervention to mitigate persistent side effects and improve quality of life. Yet, few young adults are active enough to incur these benefits and efforts to promote PA after cancer treatment ends are lacking. Therefore, we developed a novel theory-driven behavior change intervention to promote PA via videoconferencing technology in young adults who have completed cancer treatment, and are undertaking a pilot randomized controlled trial (RCT) to gather evidence to inform the design of a large, full-scale RCT. The specific aims of this parallel, two-arm pilot RCT are to: (1) assess intervention and trial protocol feasibility and acceptability; and (2) generate data on PA behavior. To promote transparency, improve reproducibility, and serve as a reference for forthcoming publication of results, we present the study protocol for this pilot RCT (version 7) within this paper. METHODS Young adults who have completed cancer treatment are being recruited from across Canada. After informed consent is obtained and baseline assessments are completed, participants are randomized to the intervention group (i.e., a 12-week behavior change intervention delivered via videoconferencing technology by trained PA counsellors) or usual care group (i.e., no intervention). Several feasibility outcomes covering enrollment, allocation, follow-up, and analysis are tracked by study staff. Acceptability is assessed through interviews exploring participants' experiences, thoughts, and perspectives of the trial protocol (i.e., intervention and usual care groups), as well as participants' views of the intervention and its mode of delivery (i.e., intervention group only) and PA counsellors' experiences delivering the intervention. PA behavior is measured using accelerometers at baseline (pre-randomization), post-intervention, and at follow-up (24 weeks post-baseline). DISCUSSION There are growing calls to develop interventions to support young adults' motivation to engage in PA and adopt an active lifestyle to improve their quality of life after cancer treatment ends. Real-time videoconferencing shows promise for disseminating behavior change interventions to young adults and addressing participation barriers. Considering the importance of establishing intervention and trial protocol feasibility and acceptability prior to evaluating intervention efficacy (or effectiveness), this pilot RCT is critical to understand how participants embrace, engage with, and complete the intervention and trial protocol. Indeed, these data will help to determine which refinements, if any, are required to the intervention and trial protocol (e.g., implementation approach, evaluation methods) prior to a large, full-scale RCT aiming to test the effects of the intervention on PA behavior. Additionally, the PA behavior data collected will be useful to inform the sample size calculation for a large, full-scale RCT. TRIAL REGISTRATION The trial was registered with the ClinicalTrials.gov database (ID: NCT04163042) on November 14, 2019, prior to the start of the trial in February, 2021.
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12
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Oswald LB, Lyleroehr M, Gudenkauf LM, Armstrong GE, Tometich DB, Sanford SD, Loecher N, Geiss C, Rodriguez Y, Scheel KL, Nieves-Lopez A, Jim HSL, Gonzalez BD, Antoni MH, Penedo FJ, Reed D, Katsanis E, Salsman JM, Victorson D, Fox RS. Development and initial testing of TOGETHER-YA: an eHealth-delivered and group-based psychosocial intervention for young adult cancer survivors. Support Care Cancer 2022; 30:10067-10076. [PMID: 36229547 PMCID: PMC9722531 DOI: 10.1007/s00520-022-07382-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 10/01/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE This study aimed to (1) develop TOGETHER-YA, an e-Health-delivered and group-based health-related quality of life (HRQOL) intervention for young adult (YA) cancer survivors aged 18-39 (Part 1), and (2) determine its initial feasibility and acceptability in a single-arm pilot trial (Part 2). METHODS TOGETHER-YA is a manualized, 10-week intervention for YA survivors that includes elements of relaxation training, cognitive-behavioral therapy, and health education. In Part 1, content was adapted from existing evidence-based interventions with feedback from YAs (N = 22) in four iterative focus groups. In Part 2, YA survivors (N = 11) participated in a single-arm pilot trial of TOGETHER-YA. Intervention groups were led by a trained facilitator over videoconference. Primary outcomes were feasibility (i.e., recruitment, session attendance, retention) and acceptability (i.e., participant satisfaction). RESULTS Focus groups reacted positively to TOGETHER-YA and provided actionable recommendations for enhancing its relevance and acceptability, which were implemented. In initial testing, all feasibility and acceptability benchmarks were met; 58% of eligible YAs were recruited, participants attended M = 6 intervention sessions (SD = 3), and 82% of participants were retained post-intervention. On average, participants "agreed" to "strongly agreed" with positive statements about the weekly sessions and the overall program. CONCLUSION TOGETHER-YA was developed in collaboration with YA cancer survivors and found to be feasible and acceptable in initial testing. TOGETHER-YA is the first HRQOL intervention for a broad range of YA survivors that is eHealth-delivered for convenience and group-based for peer support. Future large-scale trials should test its efficacy for improving HRQOL. TRIAL REGISTRATION NCT05048316, September 17, 2021; NCT05054569, September 23, 2021.
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Affiliation(s)
- Laura B Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA.
| | - Madison Lyleroehr
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lisa M Gudenkauf
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Grace E Armstrong
- Department of Counseling, The Family Institute of Northwestern University, Evanston, IL, USA
| | - Danielle B Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Stacy D Sanford
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Nele Loecher
- Department of Mental Health Law and Policy, University of South Florida, Tampa, FL, USA
| | - Carley Geiss
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Kelsey L Scheel
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Amarilis Nieves-Lopez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Brian D Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, MFC-HOB, 12902 USF Magnolia Drive, MFC-HOB, Tampa, FL, 33612, USA
| | - Michael H Antoni
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Frank J Penedo
- Department of Psychology, University of Miami, Coral Gables, FL, USA
- Cancer Control Research Program, Sylvester Comprehensive Cancer Center, FL, Miami, USA
| | - Damon Reed
- Department of Individualized Cancer Management, Moffitt Cancer Center, Tampa, FL, USA
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona College of Medicine, Tucson, AZ, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
| | - John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA
| | - Rina S Fox
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- University of Arizona Cancer Center, Tucson, AZ, USA
- University of Arizona College of Nursing, Tucson, AZ, USA
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Cancer Survivors' Evolving Perceptions of a New Supportive Virtual Program. Curr Oncol 2022; 29:8431-8441. [PMID: 36354724 PMCID: PMC9689835 DOI: 10.3390/curroncol29110664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/31/2022] [Accepted: 11/02/2022] [Indexed: 11/09/2022] Open
Abstract
This qualitative study begins to explore cancer survivors' evolving perceptions of "Focus on the Future," a 6-week supportive virtual program led by trained volunteers and health care professionals. Through purposive sampling, participants (n = 10) enrolled in the program were individually interviewed shortly before attending, mid-way through, and at program completion. Interviews were digitally recorded and transcribed verbatim. Thematic analysis was used to develop key elements of program expectations and users' perceptions over time. Three themes transpired from the data: (1) Trustworthiness and timeliness of survivorship information and expert guidance, (2) Normalization of survivors' experiences, and (3) Virtual program delivery issues. Some participants' perceptions remained unchanged from pre-program expectations to post-program completion such as appreciating the efficiency of virtual delivery and "health safe" exchanges given the COVID-19 pandemic. In contrast, other perceptions became more polarized including drawbacks related to "more superficial" virtual connections and uneven topic relevance as the program evolved. Program participants appreciated timely information and support from volunteers and experts through virtual means and consecutive weekly sessions. Gauging participants' perceptions across time also offer opportunities to adjust program content and delivery features. Future research should explore key program development strategies to ensure that cancer supportive programs are optimally person-centered, co-designed, and situation-responsive.
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Aagesen M, Pilegaard MS, Hauken MA, Wæhrens EEE, la Cour K. Users' perspective on rehabilitation interventions for young adult cancer survivors: A group concept mapping study. Eur J Cancer Care (Engl) 2022; 31:e13734. [PMID: 36218020 PMCID: PMC9786878 DOI: 10.1111/ecc.13734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/09/2022] [Accepted: 09/22/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE We aim to identify and prioritise rehabilitation interventions to strengthen participation in everyday life for young adult cancer survivors (YACS) between 18 and 39 years, involving the perspectives of YACS and relevant stakeholders. METHODS A group concept mapping study was conducted in Denmark from 2019 to 2020. Online, participants generated and sorted ideas followed by rating their importance. Multidimensional scaling followed by hierarchical cluster analyses were applied to generate a cluster rating map of the prioritised interventions, which participants validated at a face-to-face meeting. Finally, a concluding conceptual model of prioritised rehabilitation intervention for YACS was developed. RESULTS The study involved 25 YACS, three family members and 31 professionals working with YACS. The conceptual model included 149 ideas classified into eight intervention components created by the participants: (1) Treatment and possibilities within the social and healthcare system, (2) Rights and Finance, (3) Education and Work, (4) Psychological problems, (5) Body and Everyday Life, (6) Peer-to-peer, (7) Sexuality and Relationships and (8) Family and Friends. All components were rated equally important, whereby 17 ideas across the eight components were rated very important. CONCLUSION This study indicates that rehabilitation of YACS should be composed of eight equally important intervention components requiring an interdisciplinary approach.
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Affiliation(s)
- Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative Care, Odense University Hospital, Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Marc Sampedro Pilegaard
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark,OPEN, Open Patient data Explorative NetworkOdense University HospitalOdenseDenmark
| | - May Aasebø Hauken
- Centre for Crisis Psychology, Faculty of PsychologyUniversity of BergenBergenNorway
| | - Eva Elisabet Ejlersen Wæhrens
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark,The Parker Institute, Copenhagen University Hospitals Bispebjerg–FrederiksbergFrederiksbergDenmark
| | - Karen la Cour
- The Research Unit for User Perspectives and Community‐based Interventions, the Research Group for Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
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15
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Andersen NH, Christiansen JA, la Cour K, Aagesen M, Tang LH, Joergensen DS, Pilegaard MS. Differences in functioning between young adults with cancer and older age groups: A cross-sectional study. Eur J Cancer Care (Engl) 2022; 31:e13660. [PMID: 35843622 PMCID: PMC9788033 DOI: 10.1111/ecc.13660] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 04/14/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study aimed to explore whether young adults with cancer have different functioning compared to older age groups with cancer. METHODS This study is a cross-sectional study including 654 adults (≥18 years) with cancer. Exposure was age groups categorised as (1) young adults (n = 121) = 18-39 years; (2) middle-aged adults (n = 406) = 40-64 years; and (3) older people (n = 127) = ≥65 years. Outcomes were physical, role, social and cognitive functioning. Analyses consisted of linear regression models. RESULTS Middle-aged adults had a statistically significant worse physical functioning compared to young adults (-3.90: [95% CI: -6.84; -0.95]). The older age group also had a statistically significant worse physical functioning compared to young adults (-7.63: [95% CI: -11.29; -3.96]). Young adults had statistically significant lower role functioning (-7.11: [95% CI: -1.13; -13.08]) and cognitive functioning (-13.82: [95% CI: -7.35; -20.29]) compared to the older age group. There was no statistically significant difference in social functioning between the age groups. CONCLUSION Young adults with cancer seem to have other functioning problems compared with higher age groups. These findings support current research regarding the need to develop age-specific and appropriate rehabilitation services for young adults with cancer.
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Affiliation(s)
- Nanna Hejselbaek Andersen
- The Research Unit for User Perspectives and Community‐based Interventions, Occupational Therapy and Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Josephine Aagesen Christiansen
- The Research Unit for User Perspectives and Community‐based Interventions, Occupational Therapy and Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Karen la Cour
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative CareOdense University HospitalOdenseDenmark
| | - Maria Aagesen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative CareOdense University HospitalOdenseDenmark
| | - Lars Hermann Tang
- Department of Physiotherapy and Occupational TherapyNæstved‐Slagelse‐Ringsted HospitalsRegion ZealandDenmark,Department of Regional Health ResearchUniversity of Southern DenmarkOdenseDenmark
| | - Dorthe Soested Joergensen
- REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative CareOdense University HospitalOdenseDenmark
| | - Marc Sampedro Pilegaard
- The Research Unit for User Perspectives and Community‐based Interventions, Occupational Therapy and Occupational Science, Department of Public HealthUniversity of Southern DenmarkOdenseDenmark,REHPA, The Danish Knowledge Centre for Rehabilitation and Palliative CareOdense University HospitalOdenseDenmark
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16
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Valle CG, Camp LN, Diamond M, Nezami BT, LaRose JG, Pinto BM, Tate DF. Recruitment of young adult cancer survivors into a randomized controlled trial of an mHealth physical activity intervention. Trials 2022; 23:254. [PMID: 35379294 PMCID: PMC8981777 DOI: 10.1186/s13063-022-06148-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 03/04/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Purpose
Few studies have recruited young adult cancer survivors (YACS) from around the USA into remotely-delivered behavioral clinical trials. This study describes recruitment strategies used in the IMproving Physical Activity after Cancer Treatment (IMPACT) study, a 12-month randomized controlled trial of a mobile physical activity intervention for YACS.
Methods
We conducted formative work to guide development of recruitment messages and used a variety of methods and channels to recruit posttreatment YACS (diagnosed ages 18–39, participating in < 150 min/week of moderate-to-vigorous intensity activity). We used targeted social media advertisements, direct mailings, clinical referrals, and phone calls to potentially eligible individuals identified through local tumor registries. We also asked community organizations to share study information and advertized at a national conference for YACS.
Results
The final sample of 280 participants (23% identified as racial/ethnic minority individuals, 18% male, mean 33.4 ± 4.8 years) was recruited over a 14-month period. About 38% of those who completed initial screening online (n = 684) or via telephone (n = 63) were randomized. The top recruitment approach was unpaid social media, primarily via Facebook posts by organizations/friends (45%), while direct mail yielded 40.7% of participants. Other social media (paid advertisements, Twitter), email, clinic referrals, and conference advertisements each yielded 3% or fewer participants. The most cost-effective methods per participant recruited were unpaid social media posts and direct mailings.
Conclusions
The IMPACT trial successfully met enrollment goals using a national strategy to recruit physically inactive YACS. Our approaches can inform recruitment planning for other remotely-delivered intervention trials enrolling YACS.
Trial registration
ClinicalTrials.govNCT03569605. Registered on 26 June 2018.
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Baudot A, Barth N, Colas C, Garros M, Garcin A, Oriol M, Roche F, Chauvin F, Mottet N, Hupin D. The physical activity experience of prostate cancer patients: a multicentre peer motivation monitoring feasibility study. The Acti-Pair study. Pilot Feasibility Stud 2022; 8:12. [PMID: 35063040 PMCID: PMC8781045 DOI: 10.1186/s40814-022-00966-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 01/05/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Although the benefits of physical activity (PA) on health are recognised, prostate cancer patients do not follow PA recommendations. The barriers to PA, whether physical, environmental or organisational, are known. Furthermore, even when such barriers are overcome, this achievement is not systematically accompanied by a change in lifestyle habits. The proposal of a programme enabling the integration of PA in the patient's everyday life represents a new challenge in the personalized management of cancer patients. Peer-mentoring interventions have demonstrated their effectiveness in increasing adherence to PA by patients. This study aimed (1) to assess the feasibility of a peer-mentoring intervention: the Acti-Pair program in a local context and (2) to assess the effectiveness of the intervention in this context. METHODS AND ANALYSIS A pre-post design pilot study will be used to evaluate feasibility, potential effectiveness and implementation outcomes overs in prostate cancer patients. We performed a mixed quantitative and qualitative prospective study to assess means and process indicators and the implementation of the Acti-Pair program. This study will be performed in cancer centres of Loire district and will be comprised of three successive stages (1) diagnosis of the target population, (2) recruitment and training of peers, and (3) implementation of this intervention in the Loire department. DISCUSSION This study will allow us to extend the peer-mentoring intervention to other contexts and assess the effectiveness of this intervention and its generalisability.
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Affiliation(s)
- A Baudot
- INSERM, U1059, SAINBIOSE, Université de Lyon, Université Jean-Monnet, Saint-Etienne, France
- Department of Clinical Investigation Centre, CIC 1408-INSERMClinical Investigation Centre, CIC 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France
- Clinical Research Unit Innovation and Pharmacology, University Hospital of Saint-Etienne, Saint-Etienne, France
- Presage Institute - Hygee Centre, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - N Barth
- INSERM, U1059, SAINBIOSE, Université de Lyon, Université Jean-Monnet, Saint-Etienne, France
- Chaire Santé des Ainés - Ingénierie de la prévention, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
- Auvergne Rhône-Alpes (AURA) Gerontopole, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - C Colas
- INSERM, U1059, SAINBIOSE, Université de Lyon, Université Jean-Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - M Garros
- Sport-Health House, Departmental Olympic and Sports Committee of the Loire (42), Saint-Etienne, France
| | - A Garcin
- INSERM, U1059, SAINBIOSE, Université de Lyon, Université Jean-Monnet, Saint-Etienne, France
- Clinical Research Unit Innovation and Pharmacology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - M Oriol
- National Centre for Health Examination Prevention (CETAF), Saint Etienne, France
| | - F Roche
- INSERM, U1059, SAINBIOSE, Université de Lyon, Université Jean-Monnet, Saint-Etienne, France
- Chaire Santé des Ainés - Ingénierie de la prévention, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
- Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - F Chauvin
- Department of Clinical Investigation Centre, CIC 1408-INSERMClinical Investigation Centre, CIC 1408-INSERM, University Hospital of Saint-Etienne, Saint-Etienne, France
- Presage Institute - Hygee Centre, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - N Mottet
- Department of Urology, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - D Hupin
- INSERM, U1059, SAINBIOSE, Université de Lyon, Université Jean-Monnet, Saint-Etienne, France.
- Chaire Santé des Ainés - Ingénierie de la prévention, Université de Lyon, Université Jean Monnet, Saint-Etienne, France.
- Department of Clinical and Exercise Physiology, University Hospital of Saint-Etienne, Saint-Etienne, France.
- Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
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Survivors' preferences for the organization and delivery of supportive care after treatment: An integrative review. Eur J Oncol Nurs 2021; 54:102040. [PMID: 34571444 DOI: 10.1016/j.ejon.2021.102040] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/08/2021] [Accepted: 09/11/2021] [Indexed: 01/18/2023]
Abstract
PURPOSE Quality supportive care during cancer survivorship contributes to positive physical and psychosocial health. However, the potential positive impacts are influenced by survivors' perceptions of and ability to access the supportive care services that they deem important to their well-being. The purpose of this integrative review was to examine cancer survivors' preferences for the organization and delivery of supportive care services in the post-treatment period. METHODS We conducted a systematic search for relevant quantitative, qualitative and mixed methods studies. Included studies were analyzed using directed content analysis, focused on models of care and type of provider, site of care, specialized services, structural supports through transitions, and sources of information. RESULTS Sixty-nine studies were included. Overall, survivors' preferences are not static and fluctuate over time based on their perceived health needs, concerns and points of transition in care. While specialist supportive care led by consultant oncologists is often identified as the preferred model of care, survivors' also express preferences for integrated and shared models of care, involving oncology nurses, primary care and multidisciplinary professionals to optimise coordination and impact of supportive care. Flexibility in care delivery, leveraging technology and expertise, was preferred to ensure convenient and timely access to supportive care. CONCLUSIONS Cancer survivors express preferences for the organization and delivery of supportive care in the post-treatment phase that fluctuate based on their perceived health needs. The development of novel survivorship health services must consider survivors' preferences and allow flexibility in care delivery to facilitate engagement, uptake, and effectiveness.
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Lazard AJ, Collins MKR, Hedrick A, Varma T, Love B, Valle CG, Brooks E, Benedict C. Using Social Media for Peer-to-Peer Cancer Support: Interviews With Young Adults With Cancer. JMIR Cancer 2021; 7:e28234. [PMID: 34473063 PMCID: PMC8446843 DOI: 10.2196/28234] [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: 02/25/2021] [Revised: 06/16/2021] [Accepted: 07/11/2021] [Indexed: 01/19/2023] Open
Abstract
Background Web-based social support can address social isolation and unmet support needs among young adults with cancer (aged 18-39 years). Given that 94% of young adults own and use smartphones, social media can offer personalized, accessible social support among peers with cancer. Objective This study aims to examine the specific benefits, downsides, and topics of social support via social media among young adults with cancer. Methods We conducted semistructured interviews with young adults with cancer, aged between 18 and 39 years, who were receiving treatment or had completed treatment for cancer. Results Most participants (N=45) used general audience platforms (eg, Facebook groups), and some cancer-specific social media (eg, Caring Bridge), to discuss relevant lived experiences for medical information (managing side effects and treatment uncertainty) and navigating life with cancer (parenting and financial issues). Participants valued socializing with other young adults with cancer, making connections outside their personal networks, and being able to validate their emotional and mental health experiences without time and physical constraints. However, using social media for peer support can be an emotional burden, especially when others post disheartening or harassing content, and can heighten privacy concerns, especially when navigating cancer-related stigma. Conclusions Social media allows young adults to connect with peers to share and feel validated about their treatment and life concerns. However, barriers exist for receiving support from social media; these could be reduced through content moderation and developing more customizable, potentially cancer-specific social media apps and platforms to enhance one’s ability to find peers and manage groups.
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Affiliation(s)
- Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Meredith K Reffner Collins
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Ashley Hedrick
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Tushar Varma
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Brad Love
- School of Advertising and Public Relations, The University of Texas at Austin, Austin, TX, United States.,Gryt Health, New York, NY, United States
| | - Carmina G Valle
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Erik Brooks
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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20
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Lazard AJ, Collins MKR, Hedrick A, Horrell LN, Varma T, Love B, Valle CG, Benedict C. Initiation and changes in use of social media for peer support among young adult cancer patients and survivors. Psychooncology 2021; 30:1859-1865. [PMID: 34165848 DOI: 10.1002/pon.5758] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/17/2021] [Accepted: 06/18/2021] [Indexed: 01/22/2023]
Abstract
PURPOSE Social isolation is a prominent challenge for many young adults with cancer. Despite desires for peer-to-peer connections through technology, little is known about how young adults initiate or use social media for support over time. METHODS We interviewed young adults with cancer (n = 45; age 18-39, in or post cancer treatment) to explore their initiation of social media for support, changes in use over time, and types of connections sought. RESULTS Young adults with cancer learn about online support through individual personal recommendations, advocacy organizations, or searching on Google or social media. Most were reluctant to use social media support initially because of feeling overwhelmed-from diagnoses, abundance of online information, or demands of participation-and joined when informational and emotional needs arose. Many wished they had joined earlier. Some participants use social media to make close connections while others simply want to "see" others' shared experiences or crowdsource information. CONCLUSION Young adults with cancer often haphazardly find online support from personal recommendations or Internet searches. Desires for social media connections are not one-size-fits-all; there are important audience segmentations for the degree and type of peer support. IMPLICATIONS FOR CANCER SURVIVORS Better promotion of online social support options and benefits-early in one's cancer timeline and systematically through healthcare providers, cancer organizations, or family and friends-could improve access to helpful peer-to-peer support.
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Affiliation(s)
- Allison J Lazard
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Meredith K Reffner Collins
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Ashley Hedrick
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Lindsey N Horrell
- Connell School of Nursing, Boston College, Newton, Massachusetts, USA
| | - Tushar Varma
- Hussman School of Journalism and Media, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Brad Love
- School of Advertising and Public Relations, The University of Texas at Austin, Austin, Texas, USA.,Gryt Health, Rochester, New York, USA
| | - Carmina G Valle
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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21
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Poort H, Ryan A, MacDougall K, Malinowski P, MacDonald A, Markin Z, Pirl W, Greer J, Fasciano K. Feasibility and Acceptability of a Mobile Phone App Intervention for Coping With Cancer as a Young Adult: Pilot Trial and Thematic Analysis. J Med Internet Res 2021; 23:e25069. [PMID: 34114957 PMCID: PMC8235294 DOI: 10.2196/25069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/04/2021] [Accepted: 04/25/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Many young adult patients do not receive adequate psychosocial services to help them cope with cancer. OBJECTIVE This study aims to assess the feasibility and acceptability of a smartphone app (iaya) intervention that was designed to create an engaged community of young adult patients and help them learn emotional coping skills. METHODS For this single-group pilot trial, 25 young adult patients aged 18-39 years who were receiving active cancer treatment were asked to use the iaya app for 12 weeks. To collect app use data, we used Mixpanel, an analytics platform for apps. Feasibility was assessed through rates of app sessions and the number of coping exercises engaged, and intervention acceptability was evaluated by using an app usability questionnaire and through qualitative interviews at study completion. We collected patient-reported outcome data at baseline and at week 12 to explore self-efficacy for coping with cancer, self-efficacy for managing emotions, perceived emotional support, and quality of life. RESULTS Baseline patient-reported outcome data indicated that participants scored relatively low on perceived emotional support but reasonably high on self-efficacy for coping with cancer and managing emotions as well as quality of life. Participants had a mean of 13 app sessions (SD 14) and 2 coping exercises (SD 3.83) in 12 weeks. Only 9% (2/23) of participants met our combined feasibility definition of ≥10 app sessions and ≥3 coping skills from different categories. The participants' mean usability score was 73.7% (SD 10.84), which exceeded our predefined threshold of ≥70%, and qualitative feedback was generally positive. CONCLUSIONS Although perceived acceptable by patients, the iaya smartphone app did not meet the a priori feasibility criteria as a stand-alone app intervention. Future studies should screen participants for unmet coping needs and consider integrating the app as part of psychosocial care for young adult patients.
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Affiliation(s)
- Hanneke Poort
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Annelise Ryan
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Katelyn MacDougall
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Paige Malinowski
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Anna MacDonald
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | | | - William Pirl
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Joseph Greer
- Center for Psychiatric Oncology and Behavioral Sciences, Massachusetts General Hospital, Boston, MA, United States
| | - Karen Fasciano
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, United States
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22
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Christopherson U, Wells SJ, Parker N, Lyons EJ, Swartz MD, Blozinski A, Basen-Engquist K, Peterson S, Swartz MC. Use of active video games with or without videoconferencing on health outcomes in adolescent and young adult cancer survivors: a systematic review. J Cancer Surviv 2021; 16:714-727. [PMID: 34086184 PMCID: PMC8175926 DOI: 10.1007/s11764-021-01065-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 05/26/2021] [Indexed: 01/20/2023]
Abstract
PURPOSE Adolescent and young adult (AYA) cancer survivors experience greater functional deficits compared to non-cancer peers or older survivors with a similar diagnosis. Physical activity (PA) is a key strategy for mitigating functional decline, and motivation and peer support are critical PA facilitators in AYA cancer survivors. Active video games (AVGs) may be a "gateway" method to promote PA. Further, integrating AVGs into group videoconferencing, a medium used by AYAs to socialize, can capitalize on peer support needed for PA motivation. Thus, we examined the use of AVGs and/or videoconferencing in PA interventions that included AYA survivors and the effect on physical function and health outcomes. METHODS Seven electronic databases were searched from incept to January 2020. Search terms included videoconferencing, video games, exercise, and cancer. The protocol is registered on PROSPERO: CRD42020163491. Two reviewers evaluated eligibility and methodological quality using Cochrane's risk of bias tools. RESULTS Six unique studies were included with 97% reviewer agreement. All used AVGs, none used videoconferencing alone, and one used both. Study designs and outcome measures were heterogeneous. Only one study solely targeted AYA survivors. Most were low to medium quality. Few showed significant improvements in quality of life (QOL) and fatigue (n=3), coordination/balance (n=2), and aerobic capacity (n=1). CONCLUSIONS PA interventions using AVGs and/or videoconferencing may improve QOL and fatigue, but evidence on function is lacking. Rigorous interventions targeting AYA survivors are needed. IMPLICATIONS FOR CANCER SURVIVORS Using AVGs and/or videoconferencing to facilitate PA may improve QOL and fatigue.
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Affiliation(s)
- Ursela Christopherson
- Division of Rehabilitation Sciences, The University of Texas Medical Branch, Galveston, TX USA
| | - Stephanie J. Wells
- Department of Pediatrics Research, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Nathan Parker
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Elizabeth J. Lyons
- Department of Nutrition and Metabolism, The University of Texas Medical Branch, Galveston, TX USA
| | - Michael D. Swartz
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, TX USA
| | - Anna Blozinski
- Department of Biostatistics and Data Science, The University of Texas Health Science Center at Houston, Houston, TX USA
| | - Karen Basen-Engquist
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Susan Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Maria C. Swartz
- Department of Pediatrics Research, The University of Texas MD Anderson Cancer Center, Houston, TX USA
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23
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Murphy KM, Burns J, Victorson D. Consider the Source: Examining Attrition Rates, Response Rates, and Preliminary Effects of eHealth Mindfulness Messages and Delivery Framing in a Randomized Trial with Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2021; 10:272-281. [PMID: 33347390 PMCID: PMC8220541 DOI: 10.1089/jayao.2020.0102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Young adults with cancer often experience stress, depression, and anxiety. Mindfulness meditation is an effective intervention for these outcomes, and maintenance support may be needed for long-term improvements. eHealth technologies provide a promising delivery strategy for maintenance interventions. Methods: Following an 8-week mindfulness-based stress reduction (MBSR) course, 62 young adult cancer survivors were randomized to 8 weeks of instructor-framed messages, peer-framed messages, or no messages. On average, participants were 33.6 years old. The majority of participants were college-educated Caucasian females. We examined attrition rates between participants who received messages and those who did not, and compared response rates from different perceived sources. In addition, we evaluated the preliminary effects of eHealth support on mindfulness and associated outcomes. Results: No significant differences in attrition or message response rates across groups were observed. Repeated measures models revealed significant group by time interactions on perceived stress, anxiety, and depression. There were no differences between the groups that received eHealth messages and the group that did not. There was a significant difference in anxiety symptoms from post-MBSR to post-messaging between messaging groups. Individuals who received instructor-framed messages reported increased symptoms of anxiety over time. Conclusion: Attrition and response rates did not differ across groups, suggesting that eHealth may be a feasible strategy for providing maintenance support. However, further evaluation of feasibility, acceptability, and optimal content and dose of such an intervention is needed. Additionally, young adult cancer survivors may be more likely to benefit from eHealth interventions that are not delivered by authority figures.
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Affiliation(s)
- Karly M. Murphy
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Winston Salem, North Carolina, USA
| | - James Burns
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - David Victorson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern Memorial Hospital, Chicago, Illinois, USA
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24
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Sansom-Daly UM, Wakefield CE, Ellis SJ, McGill BC, Donoghoe MW, Butow P, Bryant RA, Sawyer SM, Patterson P, Anazodo A, Plaster M, Thompson K, Holland L, Osborn M, Maguire F, O’Dwyer C, De Abreu Lourenco R, Cohn RJ. Online, Group-Based Psychological Support for Adolescent and Young Adult Cancer Survivors: Results from the Recapture Life Randomized Trial. Cancers (Basel) 2021; 13:2460. [PMID: 34070134 PMCID: PMC8158368 DOI: 10.3390/cancers13102460] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/30/2021] [Accepted: 05/03/2021] [Indexed: 12/20/2022] Open
Abstract
Telehealth interventions offer a practical platform to support adolescent and young adult (AYA) cancer survivors' mental health needs after treatment, yet efficacy data are lacking. We evaluated an online, group-based, videoconferencing-delivered cognitive-behavioral therapy (CBT) intervention ('Recapture Life') in a 3-arm randomized-controlled trial comparing Recapture Life with an online peer-support group, and a waitlist control, with the aim of testing its impact on quality of life, emotional distress and healthcare service use. Forty AYAs (Mage = 20.6 years) within 24-months of completing treatment participated, together with 18 support persons. No groupwise impacts were measured immediately after the six-week intervention. However, Recapture Life participants reported using more CBT skills at the six-week follow-up (OR = 5.58, 95% CI = 2.00-15.56, p = 0.001) than peer-support controls. Recapture Life participants reported higher perceived negative impact of cancer, anxiety and depression at 12-month follow-up, compared to peer-support controls. Post-hoc analyses suggested that AYAs who were further from completing cancer treatment responded better to Recapture Life than those who had completed treatment more recently. While online telehealth interventions hold promise, recruitment to this trial was challenging. As the psychological challenges of cancer survivorship are likely to evolve with time, different support models may prove more or less helpful for different sub-groups of AYA survivors at different times.
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Affiliation(s)
- Ursula M. Sansom-Daly
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Claire E. Wakefield
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Sarah J. Ellis
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Brittany C. McGill
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Mark W. Donoghoe
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
- Stats Central, Mark Wainwright Analytical Centre, UNSW Sydney, Kensington, NSW 2033, Australia
| | - Phyllis Butow
- Centre for Medical Psychology & Evidence-Based Decision-Making (CeMPED), School of Psychology, University of Sydney, Sydney, NSW 2050, Australia;
| | | | - Susan M. Sawyer
- Department of Paediatrics, The University of Melbourne, Melbourne, VIC 3052, Australia;
- Royal Children’s Hospital Centre for Adolescent Health, Melbourne, VIC 3052, Australia
- Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
| | - Pandora Patterson
- Research, Evaluation and Policy Unit, CanTeen, Sydney, NSW 2042, Australia;
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia
| | - Antoinette Anazodo
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
- Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
| | - Megan Plaster
- Western Australia Youth Cancer Service, Sir Charles Gairdner Hospital, WA 6009, Australia;
| | - Kate Thompson
- Victorian Adolescent & Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia;
- Department of Social Work, The University of Melbourne, Melbourne, VIC 3010, Australia
| | - Lucy Holland
- Queensland Child and Youth Clinical Network, Clinical Excellence Queensland, Herston, QLD 4006, Australia;
- School of Nursing, Queensland University of Technology, Brisbane, QLD 4000, Australia
| | - Michael Osborn
- Youth Cancer Service SA/NT, Royal Adelaide Hospital, Adelaide, SA 5000, Australia;
| | - Fiona Maguire
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Catherine O’Dwyer
- Sydney Youth Cancer Service, Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, NSW 2031, Australia; (F.M.); (C.O.)
| | - Richard De Abreu Lourenco
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Haymarket, NSW 2000, Australia;
| | - Richard J. Cohn
- School of Women’s and Children’s Health, UNSW Sydney, Kensington, NSW 2033, Australia; (C.E.W.); (S.J.E.); (B.C.M.); (M.W.D.); (A.A.); (R.J.C.)
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW 2031, Australia
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25
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Perumbil Pathrose S, Patterson P, Ussher J, Everett B, Salamonson Y, McDonald F, Biegel GM, He S, Ramjan L. Feasibility, Acceptability, and Psychosocial Outcomes of a Mindfulness-Based Interactive e-Book for Young People with Cancer. J Adolesc Young Adult Oncol 2021; 11:27-34. [PMID: 33844926 DOI: 10.1089/jayao.2020.0185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Receiving a cancer diagnosis for young people is likely to adversely impact the individual's quality of life. Mindfulness-based interventions (MBIs) are an emerging strategy used to improve psychosocial well-being. However, challenges have been reported in relation to adherence and accessibility of face-to-face mindfulness programs among young people. This study examined the feasibility and acceptability of a mindfulness-based interactive e-Book to improve psychosocial well-being of young people with cancer. Methods: Concurrent mixed methods approach with a pre-intervention-post-intervention survey and semistructured interviews evaluated the feasibility and acceptability of a MBI delivered over a 6-week period, and its effect on psychosocial well-being of young people with cancer 15 to 24 years of age. Results: Of the 31 young people, both survivors and on active treatment, enrolled in the study, 20 (64.5%) completed the post-intervention survey. Textual data and interviews (n = 3) revealed that young people enjoyed the intervention and found it useful and easy to navigate, but wanted more attention paid to cancer-specific stressors, as well as opportunities for face-to-face or online interactions. Psychosocial well-being measures demonstrated a statistically significant decrease in depressive symptoms (2.35 to 1.25, p = 0.03) and psychological distress (23.63 to 19.79, p = 0.03), along with nonsignificant increases in mindfulness (20.05 to 22.9, p = 0.08) and quality of life (62.0 to 69.1, p = 0.13). Conclusion: Young people found the self-help MBI, delivered in an interactive e-Book platform, useful and acceptable. There were psychosocial benefits, although recruitment and retention were study challenges and can be improved in future research.
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Affiliation(s)
| | - Pandora Patterson
- Research & Youth Cancer Services, Canteen Australia, Newtown, Australia.,Cancer Nursing Research Unit, Sydney University, Sydney, Australia
| | - Jane Ussher
- Women's Health Psychology, Translational Research Institute (THRI), School of Medicine, Western Sydney University, Penrith, Australia
| | - Bronwyn Everett
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Yenna Salamonson
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Fiona McDonald
- Research & Youth Cancer Services, Canteen Australia, Newtown, Australia.,Cancer Nursing Research Unit, Sydney University, Sydney, Australia
| | | | - Steven He
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
| | - Lucie Ramjan
- School of Nursing and Midwifery, Western Sydney University, Penrith, Australia
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26
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Hanghøj S, Boisen KA, Hjerming M, Pappot H. Adolescents' and young adults' experiences of a prototype cancer smartphone app. Digit Health 2021; 7:2055207621997258. [PMID: 33717500 PMCID: PMC7917410 DOI: 10.1177/2055207621997258] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 02/03/2021] [Indexed: 01/01/2023] Open
Abstract
Objective Smartphone cancer-related apps have been shown to meet some of the needs of adolescents and young adults (AYAs) during their cancer trajectory. However, there is a lack of apps evaluated by AYAs; thus, the quality of many of these apps has been contested. The aim of this study was to investigate the usefulness of a cancer smartphone app called Kræftværket. The AYA participants reflected on their first experiences of the app and whether it was a relevant and useful tool during and after their cancer trajectory. Methods A total of 20 AYA cancer patients aged 16-29 years (n = 10 on treatment, n = 10 in follow up) were provided with a prototype of the Kræftværket app during a 6-week test period (April-May 2018). After the test period, n = 17 participated in focus group interviews, which were analyzed thematically. Results The following themes were found: Sharing personal information (anonymity, safe communication, tough topics, videos and YouTube clips, tracking statistics); Normalcy (Seeing oneself reflected in in others, not alone, general and specific communities); Need for interaction (response from the app, information provided by the app, the app should give more back); and An everyday tool (integrating the app into daily routines, competition between app and Facebook group, temporary needs). Conclusions The app was perceived to be most relevant at disease onset. During the treatment period, both diagnosis-specific information and communities were requested. There was a call for a clearer distinction between the purpose of the app and other Facebook communities and for a notification function.
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Affiliation(s)
- Signe Hanghøj
- Center of Adolescent Medicine, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kirsten A Boisen
- Center of Adolescent Medicine, Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maiken Hjerming
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
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27
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What do cancer survivors and their health care providers want from a healthy living program? Results from the first round of a co-design project. Support Care Cancer 2021; 29:4847-4858. [PMID: 33544245 DOI: 10.1007/s00520-021-06019-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/19/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Healthy lifestyles are an important part of cancer survivorship, though survivors often do not adhere to recommended guidelines. As part of the co-design of a new online healthy living intervention, this study aimed to understand cancer survivors', oncology healthcare professionals' (HCP) and cancer non-government organisation (NGO) representatives' preferences regarding intervention content and format. METHODS Survivors, HCP and NGO representatives participated in focus groups and interviews exploring what healthy living means to survivors, their experience with past healthy living programs and their recommendations for future program content and delivery. Sessions were audio recorded, transcribed verbatim and analysed thematically. RESULTS Six focus groups and eight interviews were conducted including a total of 38 participants (21 survivors, 12 HCP, 5 NGO representatives). Two overarching messages emerged: (1) healthy living goes beyond physical health to include mental health and adjustment to a new normal and (2) healthy living programs should incorporate mental health strategies and peer support and offer direction in a flexible format with long-term accessibility. There was a high degree of consensus between participant groups across themes. CONCLUSIONS These findings highlight the need for integration of physical and mental health interventions with flexibility in delivery. Future healthy living programs should investigate the potential for increased program adherence if mental health interventions and a hybrid of delivery options were included.
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28
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Valle CG, Pinto BM, LaRose JG, Diamond M, Horrell LN, Nezami BT, Hatley KE, Coffman EM, Polzien K, Hales DP, Deal AM, Rini CM, Rosenstein DL, Tate DF. Promoting physical activity in young adult cancer survivors using mHealth and adaptive tailored feedback strategies: Design of the Improving Physical Activity after Cancer Treatment (IMPACT) randomized controlled trial. Contemp Clin Trials 2021; 103:106293. [PMID: 33515784 DOI: 10.1016/j.cct.2021.106293] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/02/2020] [Accepted: 01/21/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Despite the health benefits of physical activity for cancer survivors, nearly 60% of young adult cancer survivors (YACS) are physically inactive. Few physical activity interventions have been designed specifically for YACS. PURPOSE To describe the rationale and design of the IMPACT (IMproving Physical Activity after Cancer Treatment) trial, which tests the efficacy of a theory-based, mobile physical activity intervention for YACS. METHODS A total of 280 physically inactive YACS (diagnosed at ages 18-39) will be randomized to a self-help control or intervention condition. All participants will receive an activity tracker and companion mobile app, cellular-enabled scale, individual videochat session, and access to a Facebook group. Intervention participants will also receive a 6-month mobile intervention based on social cognitive theory, which targets improvements in behavioral capability, self-regulation, self-efficacy, and social support, and incorporates self-regulation strategies and behavior change techniques. The program includes: behavioral lessons; adaptive goal-setting in response to individuals' changing activity patterns; tailored feedback based on objective data and self-report measures; tailored text messages; and Facebook prompts encouraging peer support. Assessments occur at baseline, 3, 6, and 12 months. The primary outcome is total physical activity min/week at 6 months (assessed via accelerometry); secondary outcomes include total physical activity at 12 months, sedentary behavior, weight, and psychosocial measures. CONCLUSIONS IMPACT uniquely focuses on physical activity in YACS using an automated tailored mHealth program. Study findings could result in a high-reach, physical activity intervention for YACS that has potential to be adopted on a larger scale and reduce cancer-related morbidity. ClinicalTrials.gov Identifier: NCT03569605.
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Affiliation(s)
- Carmina G Valle
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | | | - Jessica Gokee LaRose
- Department of Health Behavior and Policy, School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Molly Diamond
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lindsey N Horrell
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Brooke T Nezami
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Karen E Hatley
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Erin M Coffman
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristen Polzien
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Derek P Hales
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christine M Rini
- Department of Medical Social Sciences, Feinberg School of Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL, USA
| | - Donald L Rosenstein
- Departments of Psychiatry and Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Deborah F Tate
- Department of Nutrition, Gillings School of Global Public Health and School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Adams SC, Petrella A, Sabiston CM, Vani MF, Gupta A, Trinh L, Matthew AG, Hamilton RJ, Mina DS. Preferences for exercise and physical activity support in adolescent and young adult cancer survivors: a cross-sectional survey. Support Care Cancer 2021; 29:4113-4127. [PMID: 33409722 PMCID: PMC7787126 DOI: 10.1007/s00520-020-05897-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/16/2020] [Indexed: 02/05/2023]
Abstract
Purpose Exercise and physical activity (hereafter, collectively referred to as PA) preferences and benefits are becoming increasingly well characterised in cancer survivors, yet evidence from adolescent and young adult cancer survivors (AYAs) is scant. We describe the overall PA behaviour and support preferences of AYAs and explore subgroup differences to inform AYA-specific research and support. Methods AYAs diagnosed with cancer between the ages of 18–39 years, irrespective of current age, were approached in clinic at a large cancer centre for this cross-sectional survey that assessed self-reported demographics, medical history, PA behaviour and PA support preferences. Results A total of 318 AYAs completed the survey. Approximately 40% of AYAs were not meeting PA guidelines, and only 5% reported engagement with cancer PA support services. Most AYAs wanted PA support (78%), to increase PA levels (70%), and were interested in engaging in PA interventions that were individually supervised (82%), home-based (79%), performed ≥ 3 days/week (75%) and for ≥ 30 minutes/session (78%), offered following treatment (63%), restricted by age (63%), and involved strength (83%), walking (78%), and flexibility (75%) exercise. PA preferences most often differed according to sex, treatment status, current PA behaviour and PA support setting. Conclusion AYAs have a great capacity and interest in specific types of PA support. Poor engagement with existing PA support services highlights the need for further AYA-specific research. Better understanding of AYAs' unique PA behaviour and support preferences can inform the development of urgently needed research and support services for this understudied and rapidly growing population. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-020-05897-w.
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Affiliation(s)
- Scott C Adams
- Department of Cardiology, Toronto General Hospital Research Institute, Toronto, ON, M5G 2C4, Canada.
- Ted Rogers Cardiotoxicity Prevention Program, Peter Munk Cardiac Centre, University Health Network, Toronto, ON, M5S2W6, Canada.
- Faculty of Kinesiology & Physical Education, University of Toronto, M5S2W6, Toronto, ON, Canada.
| | - Anika Petrella
- Faculty of Kinesiology & Physical Education, University of Toronto, M5S2W6, Toronto, ON, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology & Physical Education, University of Toronto, M5S2W6, Toronto, ON, Canada
| | - Madison F Vani
- Faculty of Kinesiology & Physical Education, University of Toronto, M5S2W6, Toronto, ON, Canada
| | - Abha Gupta
- Department of Supportive Care, Princess Margaret Cancer Centre, M5G2C1, Toronto, ON, Canada
- Hospital for Sick Children, M5G1X8, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, M5S1A8, Toronto, ON, Canada
| | - Linda Trinh
- Faculty of Kinesiology & Physical Education, University of Toronto, M5S2W6, Toronto, ON, Canada
| | - Andrew G Matthew
- Department of Supportive Care, Princess Margaret Cancer Centre, M5G2C1, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, M5S1A8, Toronto, ON, Canada
| | - Robert J Hamilton
- Faculty of Medicine, University of Toronto, M5S1A8, Toronto, ON, Canada
- Division of Urology, Department of Surgery, University Health Network, M5G1L7, Toronto, ON, Canada
| | - Daniel Santa Mina
- Faculty of Kinesiology & Physical Education, University of Toronto, M5S2W6, Toronto, ON, Canada
- Department of Supportive Care, Princess Margaret Cancer Centre, M5G2C1, Toronto, ON, Canada
- Faculty of Medicine, University of Toronto, M5S1A8, Toronto, ON, Canada
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Hashem F, Corbett K, Stephensen D, Swaine I, Ali H, Hutchins I. The importance of cancer patients' functional recollections to explore the acceptability of an isometric-resistance exercise intervention: A qualitative study. Health Sci Rep 2020; 3:e186. [PMID: 32995560 PMCID: PMC7507341 DOI: 10.1002/hsr2.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 07/03/2020] [Accepted: 07/21/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND AND AIMS Although it has been widely recognized the potential of physical activity to help cancer patients' preparation for and recovery from surgery, there is little consideration of patient reflections and recovery experiences to help shape adherence to exercise programs. The aim was to explore the acceptability of our newly proposed isometric exercise program in a large general hospital trust in England providing specialist cancer care by using patient recollections of illness and therapy prior to undertaking a randomized controlled trial. METHODS Four Focus groups (FGs) were conducted with cancer survivors with an explicit focus on patient identity, functional capacity, physical strength, exercise advice, types of activities as well as the timing of our exercise program and its suitability. Thematic framework analysis was used with NVivo 11. RESULTS FG data was collected in January 2016. A total of 13 patients were participated, 10 were male and 3 were female with participants' ages ranging from 39 to 77. Data saturation was achieved when no new information had been generated reaching "information redundancy." Participants reflected upon their post-surgery recovery experiences on the appropriateness and suitability of the proposed intervention, what they thought about its delivery and format, and with hindsight what the psychological enablers and barriers would be to participation. CONCLUSION Based upon the subjective recollections and recovery experiences of cancer survivors, isometric-resistance exercise interventions tailored to individuals with abdominal cancer has the potential to be acceptable for perioperative patients to help increase their physical activity and can also help with emotional and psychological recovery.
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Affiliation(s)
- Ferhana Hashem
- Centre for Health Services StudiesUniversity of KentCanterburyUK
| | - Kevin Corbett
- Centre for Critical Research in Nursing and MidwiferyMiddlesex University LondonLondonUK
| | - David Stephensen
- Kent Haemophilia & Thrombosis CentreEast Kent Hospitals NHS Foundation TrustCanterburyUK
| | - Ian Swaine
- School of Human Science, Faculty of Education, Health and Human SciencesUniversity of GreenwichLondonUK
| | - Haythem Ali
- General and Upper GI surgery & Musculoskeletal Outpatient Physiotherapist Therapy ServicesMaidstone and Tunbridge Wells NHS TrustTunbridge WellsUK
| | - Irena Hutchins
- General and Upper GI surgery & Musculoskeletal Outpatient Physiotherapist Therapy ServicesMaidstone and Tunbridge Wells NHS TrustTunbridge WellsUK
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Devine KA, Viola A, Levonyan-Radloff K, Mackowski N, Bozzini B, Chandler A, Xu B, Ohman-Strickland P, Mayans S, Farrar-Anton A, Sahler OJZ, Masterson M, Manne S, Arent S. Feasibility of FitSurvivor: A technology-enhanced group-based fitness intervention for adolescent and young adult survivors of childhood cancer. Pediatr Blood Cancer 2020; 67:e28530. [PMID: 32589339 PMCID: PMC7674223 DOI: 10.1002/pbc.28530] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/23/2020] [Accepted: 06/08/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND This study evaluated the feasibility of a technology-enhanced group-based fitness intervention for adolescent and young adult (AYA) survivors of childhood cancer. PROCEDURE AYA survivors ages 13-25 years were randomized to the intervention (eight in-person group sessions with mobile app and FitBit followed by 4 weeks of app and FitBit only) or waitlist control. Assessments were at 0, 2, 3, 6, and 9 months. Feasibility was evaluated by enrollment, retention, attendance, app engagement, and satisfaction. Secondary outcomes included physical activity, muscular strength/endurance, cardiorespiratory fitness, health-related quality of life, and fatigue. RESULTS A total of 354 survivors were mailed participation letters; 68 (19%) were screened, of which 56 were eligible and 49 enrolled (88% of those screened eligible, 14% of total potentially eligible). Forty-nine survivors (Mage = 18.5 years, 49% female) completed baseline assessments and were randomized (25 intervention, 24 waitlist). Thirty-seven (76%) completed the postintervention assessment and 32 (65%) completed the final assessment. On average, participants attended 5.7 of eight sessions (range 1-8). Overall intervention satisfaction was high (M = 4.3, SD = 0.58 on 1-5 scale). Satisfaction with the companion app was moderately high (M = 3.4, SD = 0.97). The intervention group demonstrated significantly greater improvement in lower body muscle strength compared to the waitlist postintervention, and small but not statistically significant changes in other secondary measures. CONCLUSIONS A group-based intervention with a mobile app and fitness tracker was acceptable but has limited reach due to geographical barriers and competing demands experienced by AYA survivors.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Sherri Mayans
- Hackensack Meridian Health, Hackensack University Medical Center
| | | | | | | | | | - Shawn Arent
- Rutgers, The State University of New Jersey,University of South Carolina
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Weiner LS, Nagel S, Su HI, Hurst S, Hartman SJ. A Remotely Delivered, Peer-Led Physical Activity Intervention for Younger Breast Cancer Survivors (Pink Body Spirit): Protocol for a Feasibility Study and Mixed Methods Process Evaluation. JMIR Res Protoc 2020; 9:e18420. [PMID: 32673270 PMCID: PMC7381067 DOI: 10.2196/18420] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/03/2020] [Accepted: 05/12/2020] [Indexed: 12/13/2022] Open
Abstract
Background Younger breast cancer survivors consistently report a greater impact of their cancer experience on quality of life compared with older survivors, including higher rates of body image disturbances, sexual dysfunction, and fatigue. One potential strategy to improve quality of life is through physical activity, but this has been understudied in younger breast cancer survivors, who often decrease their activity during and after cancer treatment. Objective The aim of this study is to explore the feasibility and acceptability of a technology-based, remotely delivered, peer-led physical activity intervention for younger breast cancer survivors. We will also assess the preliminary impact of the intervention on changes in physical activity and multiple aspects of quality of life. Methods This study is a community-academic partnership between University of California, San Diego and Haus of Volta, a nonprofit organization that promotes positive self-image in younger breast cancer survivors. This ongoing pilot study aims to recruit 30 younger breast cancer survivors across the United States (<55 years old, >6 months post primary cancer treatment, self-report <60 min of moderate-to-vigorous-intensity physical activity [MVPA]) into a 3-month peer-delivered, fully remote exercise program. Participants will complete 6 biweekly video chat sessions with a trained peer mentor, a fellow younger breast cancer survivor. Participants will receive a Fitbit Charge 3; weekly feedback on Fitbit data from their peer mentor; and access to a private, in-app Fitbit Community to provide and receive support from other participants and all peer mentors. At baseline, 3 months, and 6 months, participants will complete quality of life questionnaires, and MVPA will be measured using the ActiGraph accelerometer. Feasibility and acceptability will be explored through a mixed methods approach (ie, quantitative questionnaires and qualitative interviews). Intervention delivery and adaptations by peer mentors will be tracked through peer mentor self-evaluations and reflections, review of video-recorded mentoring sessions, and monthly templated reflections by the research team. Results Recruitment began in September 2019. As of February 2020, the physical activity intervention is ongoing. Final measures are expected to occur in summer 2020. Conclusions This study explores the potential for physical activity to improve sexual function, body image, and fatigue, key quality of life issues in younger breast cancer survivors. Using peer mentors extends our reach into the young survivor community. The detailed process evaluation of intervention delivery and adaptations by mentors could inform a future hybrid-effectiveness implementation trial. Finally, remote delivery with commercially available technology could promote broader dissemination. Trial Registration ClinicalTrials.gov NCT04064892; https://clinicaltrials.gov/ct2/show/NCT04064892 International Registered Report Identifier (IRRID) DERR1-10.2196/18420
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Affiliation(s)
- Lauren S Weiner
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, CA, United States.,Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
| | | | - H Irene Su
- Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Diego, La Jolla, CA, United States
| | - Samantha Hurst
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, CA, United States
| | - Sheri J Hartman
- Department of Family Medicine & Public Health, University of California, San Diego, La Jolla, CA, United States.,Moores Cancer Center, University of California, San Diego, La Jolla, CA, United States
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Skiba MB, McElfresh JJ, Howe CL, Crane TE, Kopp LM, Jacobs ET, Thomson CA. Dietary Interventions for Adult Survivors of Adolescent and Young Adult Cancers: A Systematic Review and Narrative Synthesis. J Adolesc Young Adult Oncol 2020; 9:315-327. [DOI: 10.1089/jayao.2019.0105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Meghan B. Skiba
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Jennifer J. McElfresh
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Carol L. Howe
- University of Arizona Health Sciences Library, University of Arizona, Tucson, Arizona, USA
| | - Tracy E. Crane
- Department of Biobehavioral Sciences, College of Nursing, University of Arizona, Tucson, Arizona, USA
| | - Lisa M. Kopp
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Elizabeth T. Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
| | - Cynthia A. Thomson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA
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Salsman JM, McLouth LE, Cohn M, Tooze JA, Sorkin M, Moskowitz JT. A Web-Based, Positive Emotion Skills Intervention for Enhancing Posttreatment Psychological Well-Being in Young Adult Cancer Survivors (EMPOWER): Protocol for a Single-Arm Feasibility Trial. JMIR Res Protoc 2020; 9:e17078. [PMID: 32463014 PMCID: PMC7290453 DOI: 10.2196/17078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/10/2020] [Accepted: 02/27/2020] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Adolescent and young adult cancer survivors (AYAs) experience clinically significant distress and have limited access to supportive care services. Interventions to enhance psychological well-being have improved positive affect and reduced depression in clinical and healthy populations but have not been routinely tested in AYAs. OBJECTIVE The aim of this protocol is to (1) test the feasibility and acceptability of a Web-based positive emotion skills intervention for posttreatment AYAs called Enhancing Management of Psychological Outcomes With Emotion Regulation (EMPOWER) and (2) examine proof of concept for reducing psychological distress and enhancing psychological well-being. METHODS The intervention development and testing are taking place in 3 phases. In phase 1, we adapted the content of an existing, Web-based positive emotion intervention so that it would be suitable for AYAs. EMPOWER targets 8 skills (noticing positive events, capitalizing, gratitude, mindfulness, positive reappraisal, goal setting, personal strengths, and acts of kindness) and is delivered remotely as a 5-week, Web-based intervention. Phase 2 consisted of a pilot test of EMPOWER in a single-arm trial to evaluate feasibility, acceptability, retention, and adherence and to collect data on psychosocial outcomes for proof of concept. In phase 3, we are refining study procedures and conducting a second pilot test. RESULTS The project was part of a career development award. Pilot work began in June 2015, and data collection was completed in March 2019. The analysis is ongoing, and results will be submitted for publication by May 2020. CONCLUSIONS If this intervention proves feasible and acceptable, EMPOWER will be primed for a subsequent large, multisite randomized controlled trial. As a scalable intervention, it will be ideally suited for AYA survivors who would otherwise not have access to supportive care interventions to help manage posttreatment distress and enhance well-being. TRIAL REGISTRATION ClinicalTrials.gov NCT02832154, https://clinicaltrials.gov/ct2/show/NCT02832154. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/17078.
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Affiliation(s)
- John M Salsman
- Department of Social Sciences and Health Policy, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Laurie E McLouth
- Department of Behavioral Science, Markey Cancer Center, University of Kentucky College of Medicine, Lexington, KY, United States
| | - Michael Cohn
- Osher Center for Integrative Medicine, University of California San Francisco, San Francisco, CA, United States
| | - Janet A Tooze
- Department of Biostatistics and Data Science, Wake Forest Baptist Comprehensive Cancer Center, Wake Forest School of Medicine, Winston Salem, NC, United States
| | - Mia Sorkin
- Department of Obstetrics & Gynecology, University of Chicago, Chicago, IL, United States
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
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Mindfulness-Based Interventions for Young People With Cancer: An Integrative Literature Review. Cancer Nurs 2020; 44:349-360. [PMID: 32384422 DOI: 10.1097/ncc.0000000000000821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Mindfulness-based interventions (MBIs) have demonstrated benefits for adults with chronic illness and are becoming increasingly popular among children and young people. Mindfulness-based interventions could have benefits for young people with cancer throughout the treatment journey, through to survivorship. OBJECTIVE The aim was to review intervention studies about MBI used with young people with cancer between the ages of 10 and 29 years. METHODS Six electronic databases were searched. The methodological quality of the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. RESULTS Six contemporary studies met the inclusion criteria. Three studies adapted MBI to be age appropriate and some studies modified the intervention based on cancer-specific needs of young people. Formal and informal MBI activities were found to be acceptable by young people; however, recruitment of the participants was identified as a barrier. Variability in psychosocial outcomes was noted in the review by some demonstrating improvement in areas such as mindfulness, anxiety, and social isolation and others not eliciting significant benefits. CONCLUSIONS Mindfulness-based intervention shows promise as an acceptable intervention that may improve psychosocial well-being for young people with cancer. Future research studies with adequate sample sizes are warranted to determine the effectiveness of MBI among young people with cancer. IMPLICATIONS FOR PRACTICE Mindfulness-based intervention seems to be a promising approach to promote psychosocial well-being and reduce disease burden in young people with cancer. As validated MBI may be implemented without expert training, this could be promoted by healthcare providers, including nurses who care for young people with cancer.
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Darabos K, Hoyt MA, Ford JS. Relational processes and psychological adjustment among young adults with cancer: The role of technology-related communication. Psychooncology 2019; 28:2406-2414. [PMID: 31713288 DOI: 10.1002/pon.5269] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/16/2019] [Accepted: 10/20/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Little attention has been paid to understanding how engaging in cancer-related interpersonal exchanges via varying modes of communication influences psychological well-being among young adults with cancer. This study explored the moderating role of communication mode on the relationship of relational processes of disclosure and responsiveness with psychological well-being. METHODS 61 young adults with cancer (Mage = 34.59, SD = 4.82) completed a questionnaire about their most recent cancer-related conversation. Participants reported on communication mode (ie, face-to-face, text message, and phone call) and relational processes of self- and support member- disclosure of thoughts, information, and feelings and how accepted, cared for, and understood they felt within the cancer-related conversation. Cancer adjustment measures included functional well-being and depressive symptoms. RESULTS There were no main effects of communication mode or relational processes. However, communication mode did moderate the relationship between relational processes and cancer adjustment. Greater relational processes of disclosure and responsiveness were associated with better functional well-being and lower depressive symptoms only among those who engaged in their most recent cancer-related conversation through technology-related communication and not for those engaged in face-to-face communication. CONCLUSION Relational processes that are likely to benefit psychological adjustment after cancer appear to be particularly advantageous over technology-based communication. Young adults commonly report feelings of social isolation and psychological distress after cancer. These findings suggest that technology-related communication holds promise as a way to strengthen support-related communication and protect against distress.
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Affiliation(s)
- Katie Darabos
- Department of Psychology, Hunter College/The Graduate Center, CUNY, New York, New York
| | - Michael A Hoyt
- Department of Population Health and Disease Prevention/Chao Family Comprehensive Cancer Center, University of California-Irvine, California
| | - Jennifer S Ford
- Department of Psychology, Hunter College/The Graduate Center, CUNY, New York, New York
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Naik H, Leung B, Laskin J, McDonald M, Srikanthan A, Wu J, Bates A, Ho C. Emotional distress and psychosocial needs in patients with breast cancer in British Columbia: younger versus older adults. Breast Cancer Res Treat 2019; 179:471-477. [PMID: 31630293 DOI: 10.1007/s10549-019-05468-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/08/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE This study evaluates the prevalence of emotional distress and psychosocial needs in young adult (YA, age 18-39) patients at the time of their breast cancer diagnosis compared to older patients. METHODS Through a province-wide program, BC Cancer patients complete the PsychoSocial Scan for CANcer-Revised (PSSCAN-R) questionnaire, which screens for the presence of symptoms of anxiety and depression and assesses psychosocial needs using the Canadian Problem Checklist (CPC). The study population comprised all breast cancer patients who completed the questionnaire within 6 months of their cancer diagnosis between 2011 and 2016. Clinical information was retrospectively collected from electronic health records. Univariate and multivariate analyses using the X2, Fisher's exact test, and logistical regression were used to compare patient age groups. RESULTS The cohort included 10,734 breast cancer patients: median age 62, 4% YA, 99% female, and 96% presented with non-metastatic disease. After adjusting for clinical and demographic variables, YA patients were more likely to report depression (33.6% vs. 25.5%, OR 1.47, p = 0.001) and anxiety symptoms (58.6% vs. 35.7%, OR 2.49, p < 0.001) than older patients. Psychosocial needs regarding work/school (OR 3.79, p < 0.001), intimacy/sexuality (OR 2.82, p < 0.001), and finances (OR 2.78, p < 0.001) were more common among YA than older adults. CONCLUSIONS After a breast cancer diagnosis, YAs have higher levels of emotional distress compared to older patients. Differences in specific psychosocial needs likely reflect differences in life stage between these age groups. The data suggest that YAs warrant specific attention with respect to early psychosocial assessment and tailored intervention.
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Affiliation(s)
- Hiten Naik
- University of British Columbia, Vancouver, Canada
| | - Bonnie Leung
- Department of Medical Oncology, BC Cancer, 600 10th Avenue West, Vancouver, BC, V5Z 4E6, Canada
| | - Janessa Laskin
- University of British Columbia, Vancouver, Canada.,Department of Medical Oncology, BC Cancer, 600 10th Avenue West, Vancouver, BC, V5Z 4E6, Canada
| | - Melanie McDonald
- Department of Psychosocial Oncology, BC Cancer, Vancouver, Canada
| | - Amirrtha Srikanthan
- Department of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Canada
| | - Jonn Wu
- University of British Columbia, Vancouver, Canada.,Department of Radiation Oncology, BC Cancer, Vancouver, Canada
| | - Alan Bates
- University of British Columbia, Vancouver, Canada.,Department of Psychosocial Oncology, BC Cancer, Vancouver, Canada
| | - Cheryl Ho
- University of British Columbia, Vancouver, Canada. .,Department of Medical Oncology, BC Cancer, 600 10th Avenue West, Vancouver, BC, V5Z 4E6, Canada.
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Touyz LM, Cohen J, Cohn RJ, Garnett SP, Anazodo A, Gohil P, Grech AM, Ng A, Wakefield CE. Childhood cancer survivors report preferring lifestyle interventions delivered in person rather than online: An adolescent and parent perspective. Pediatr Blood Cancer 2019; 66:e27922. [PMID: 31309668 DOI: 10.1002/pbc.27922] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/15/2019] [Accepted: 05/31/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Maintaining a healthy lifestyle can protect adolescent survivors of pediatric cancer against chronic diseases such as obesity and cardiovascular disease. In this study, we examined the attitudes of adolescent survivors of pediatric cancer and their parents toward improving lifestyle behaviors after cancer treatment, including their preferences for intervention delivery and perceived barriers and benefits to healthy eating and exercise. METHODS We recruited adolescent survivors of childhood cancer aged 11-19 years and their parents, from two hospitals. Participants completed a questionnaire via mail or at routine oncology clinic visits. RESULTS Thirty-three adolescents (response rate 39%, mean age 15, 61% male) and 32 parents (representing 30 parent-child dyads) participated. Parents were significantly more interested in having their child participate in a lifestyle intervention than adolescents (41% of adolescents and 72% of parents, P = .012). Both groups preferred that the survivor receive lifestyle support face to face rather than online. Adolescents preferred to involve their friends (39% of adolescents and 19% of parents) whereas parents preferred to involve the family in a lifestyle intervention (15% of adolescents and 47% of parents, P = .006). Adolescents and their parents perceived a dislike of the taste of fruits and vegetables, fatigue, lack of motivation, and fear of injury as barriers to change. They perceived that keeping healthy and having more energy were benefits to participation. Participants indicated that interventions that provide face-to-face personal training and dietary education at a local gym would be well accepted. CONCLUSIONS Adolescents who have had cancer in childhood have a preference for face-to-face contact with health professionals to overcome the barriers to participation in a lifestyle intervention.
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Affiliation(s)
- Lauren M Touyz
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Jennifer Cohen
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Richard J Cohn
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia
| | - Sarah P Garnett
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,The Children's Hospital at Westmead Clinical School, University of Sydney, Westmead, New South Wales, Australia
| | - Antoinette Anazodo
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Paayal Gohil
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Allison M Grech
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
| | - Anthea Ng
- Cancer Centre for Children, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Claire E Wakefield
- School of Women's and Children's Health, UNSW Sydney, Sydney, New South Wales, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia
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McNeil R, Egsdal M, Drew S, McCarthy MC, Sawyer SM. The changing nature of social support for adolescents and young adults with cancer. Eur J Oncol Nurs 2019; 43:101667. [PMID: 31586646 DOI: 10.1016/j.ejon.2019.09.008] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 08/22/2019] [Accepted: 09/18/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE The aim of this study was to explore adolescent and young adult (AYA) experiences and preferences for social support early within the continuum of cancer treatment. METHODS AYAs aged 15-25 years old at diagnosis were recruited from 6 clinical services that were purposively selected for providing specialist cancer care to AYAs across 3 Australian states and within paediatric and adult services. In-depth, semi-structured interviews were conducted by telephone 6-24 months from diagnosis. The narrative-based interviews included preferences for psychosocial support. Interviews were transcribed and thematic analysis was undertaken using grounded theory methodology. RESULTS 60 AYAs were interviewed (mean age 20.52 [SD 2.97] years; 58% male; 72% adult settings). Analysis revealed that parents provided the foundation of emotional, informational and instrumental social support, even for older AYAs and those with partners and children. Informal emotional engagement with cancer peers was strongly appreciated during hospital treatment, while healthy peers provided welcome diversion at this time and during the transition towards their usual life. Nurses and allied health staff provided informational support to hospitalised AYAs and also provided a strong source of emotional support. Formal peer support programs were not endorsed by AYAs early in treatment but appreciated to be of greater interest to some following treatment completion. CONCLUSION Social support was predominantly provided by family, peers and health professionals. The sources and types of support most welcomed by AYAs varied according to the intensity and phase of cancer treatment and where the young person was in their cancer trajectory.
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Affiliation(s)
- Robyn McNeil
- Murdoch Children's Research Institute, Melbourne, Australia; Royal Children's Hospital, Centre for Adolescent Health, Melbourne, Australia.
| | - Mette Egsdal
- Murdoch Children's Research Institute, Melbourne, Australia; Royal Children's Hospital, Centre for Adolescent Health, Melbourne, Australia; Department of Public Health, The University of Copenhagen, Copenhagen, Denmark
| | - Sarah Drew
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia
| | - Maria C McCarthy
- Murdoch Children's Research Institute, Melbourne, Australia; Children's Cancer Centre, Royal Children's Hospital, Melbourne, Australia
| | - Susan M Sawyer
- Murdoch Children's Research Institute, Melbourne, Australia; Royal Children's Hospital, Centre for Adolescent Health, Melbourne, Australia; Department of Paediatrics, The University of Melbourne, Australia
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Lazard AJ, Saffer AJ, Horrell L, Benedict C, Love B. Peer‐to‐peer connections: Perceptions of a social support app designed for young adults with cancer. Psychooncology 2019; 29:173-181. [DOI: 10.1002/pon.5220] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 08/29/2019] [Accepted: 08/31/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Allison J. Lazard
- School of Media and JournalismUniversity of North Carolina Chapel Hill North Carolina
- Lineberger Comprehensive Cancer CenterUniversity of North Carolina Chapel Hill North Carolina
- Center for Health CommunicationThe University of Texas at Austin Austin Texas
| | - Adam J. Saffer
- School of Media and JournalismUniversity of North Carolina Chapel Hill North Carolina
| | - Lindsey Horrell
- Gillings School of Global Public HealthUniversity of North Carolina Chapel Hill North Carolina
| | | | - Brad Love
- Center for Health CommunicationThe University of Texas at Austin Austin Texas
- Stan Richards School of Advertising and Public RelationsThe University of Texas at Austin Texas
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The Lifestyle Information and Intervention Preferences of Teenage and Young Adult Cancer Survivors: A Qualitative Study. Cancer Nurs 2019. [PMID: 28622193 PMCID: PMC6259678 DOI: 10.1097/ncc.0000000000000508] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Supplemental digital content is available in the text. Background: Little is currently known about how best to promote healthy lifestyle choices among teenage and young adult (TYA) cancer survivors. Such data gathered from a patient-centered perspective are instrumental for the development of health behavior change interventions for young people with cancer. Objective: This study aimed to explore the lifestyle information needs of TYA cancer survivors and their preferences regarding lifestyle information and intervention delivery. Lifestyle behaviors of interest were physical activity, diet, smoking, alcohol consumption, and sun safety. Methods: A total of 13 TYA cancer survivors (mean age, 22.9 years) participated in 10 individual interviews and 1 focus group (n = 3). Each interview and focus group followed the same semistructured interview guide, which was designed to explore young peoples’ motivation behind leading a healthy lifestyle, their past experience of searching for lifestyle information, and their preferences relating to lifestyle information delivery. Results: Three core themes emerged: cancer as a catalyst to lifestyle behavior change, factors influencing health behavior change, and health behavior information preferences. Social support emerged as facilitator of both health behavior change and self-efficacy. Conclusion: Young people with cancer want age-appropriate lifestyle information on a range of topics delivered in multiple formats at various time points. Implications for Practice: Health professionals working with TYA cancer survivors should address young peoples’ lifestyle information needs throughout the cancer care pathway and support young people to foster the confidence to make, and sustain, positive lifestyle behavior changes.
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Osma J, Suso-Ribera C, Peris-Baquero Ó, Gil-Lacruz M, Pérez-Ayerra L, Ferreres-Galan V, Torres-Alfosea MÁ, López-Escriche M, Domínguez O. What format of treatment do patients with emotional disorders prefer and why? Implications for public mental health settings and policies. PLoS One 2019; 14:e0218117. [PMID: 31181100 PMCID: PMC6557569 DOI: 10.1371/journal.pone.0218117] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 05/25/2019] [Indexed: 11/30/2022] Open
Abstract
Objective We analyzed the preference of three psychological intervention formats—individual, group, and online—in a sample of 267 patients with a primary diagnosis of emotional disorder in Spanish public mental health settings. Method We studied patients’ preferences considering sociodemographic characteristics, diagnoses, history of psychological treatments, number of sessions, and satisfaction with past interventions. Results Most participants (85.4%) preferred psychological treatment in an individual format, 14.2% in group, and 0.4% online. When comparing the people who chose individual and group treatment, no demographic or clinical differences were found. The arguments against group format were the lack of privacy and expression difficulties. Regarding online format, these included being considered impersonal and ineffective. Conclusion The rejection of group and online psychotherapy formats allows us to define the actions we should carry out in public mental health settings to improve the acceptance of more cost-effective therapy formats.
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Affiliation(s)
- Jorge Osma
- Departamento de psicología y sociología, Universidad de Zaragoza, Teruel, Spain
- Instituto de Investigaciones Sanitarias de Aragón, Zaragoza, Spain
- * E-mail:
| | - Carlos Suso-Ribera
- Departamento de psicología básica, clínica y psicobiología, Universitat Jaume I, Castellón, Spain
| | | | - Marta Gil-Lacruz
- Departamento de psicología y sociología, Universidad de Zaragoza, Teruel, Spain
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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] [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
Background: Text message interventions hold promise for adolescents and young adults (AYAs) with chronic health conditions, including childhood cancer survivors; however, engagement is often suboptimal. Limited research has studied mobile health intervention outcomes beyond efficacy. Understanding responsivity to different types of text messages (ie, when a participant texts back) can provide practical, actionable information to optimize engagement in future projects.
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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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Aubin S, Rosberger Z, Hafez N, Noory MR, Perez S, Lehmann S, Batist G, Kavan P. Cancer!? I Don't Have Time for That: Impact of a Psychosocial Intervention for Young Adults with Cancer. J Adolesc Young Adult Oncol 2019; 8:172-189. [DOI: 10.1089/jayao.2017.0101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Affiliation(s)
| | | | - Nada Hafez
- Jewish General Hospital, Montreal, Canada
| | | | | | | | | | - Petr Kavan
- Jewish General Hospital, Montreal, Canada
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Donovan E, Martin SR, Seidman LC, Zeltzer LK, Cousineau TM, Payne LA, Trant M, Weiman M, Knoll M, Federman NC. A Mobile-Based Mindfulness and Social Support Program for Adolescents and Young Adults With Sarcoma: Development and Pilot Testing. JMIR Mhealth Uhealth 2019; 7:e10921. [PMID: 30882352 PMCID: PMC6441858 DOI: 10.2196/10921] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 10/23/2018] [Accepted: 11/22/2018] [Indexed: 01/30/2023] Open
Abstract
Background Approximately 70,000 adolescents and young adults (AYA) are diagnosed with cancer each year in the United States. Sarcomas carry a particularly high symptom burden and are some of the most common cancers among AYA. Recent work has documented significant levels of unmet needs among AYA with cancer, particularly the need for psychosocial support. Mobile technology may be a cost-effective and efficient way to deliver a psychosocial intervention to AYA with cancer and cancer survivors. Objective The two aims of this study were to (1) develop a pilot version of a mobile-based mindfulness and social support program and (2) evaluate program usage and acceptability. An exploratory aim was to examine change in psychosocial outcomes. Methods Thirty-seven AYA with sarcoma or sarcoma survivors, parents, and health care providers participated in the study. Semistructured interviews were conducted with 10 AYA, parents of five of the adolescents, and six health care providers. Themes from the interviews helped to inform the development of a mobile-based mindfulness pilot program and a companion Facebook-based social support group. Twenty AYA consented to participate in a single-arm pre-post evaluation of the program; 17 downloaded the app and joined the Facebook group. Seven of these participants had participated in the semistructured interviews. Six additional health care providers consented to participate in the evaluation stage. Results On average, participants completed 16.9 of the 28 unique sessions and used the mindfulness app for a mean 10.2 (SD 8.2) days during the 28-day evaluation period. The majority of participants (16/17) engaged in the social group and posted at least one reply to the moderator’s prompts. The mean number of responses per person to the moderator of the social group was 15.2 of 31 (49%, range 0%-97%). Both AYA and health care providers responded positively to the Mindfulness for Resilience in Illness program and offered useful recommendations for improvements. Exploratory psychosocial analyses indicated there were no significant differences from pretest to posttest on measures of perceived social support, mindfulness, body image, or psychological functioning. Conclusions This study offers preliminary support for the feasibility and acceptability of a mobile-based mindfulness and Facebook-based social support program for AYA with sarcoma. The feedback from AYA and health care providers will assist in creating a fully developed intervention. Trial Registration ClinicalTrials.gov NCT03130751; https://clinicaltrials.gov/ct2/show/NCT03130751
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Affiliation(s)
- Elizabeth Donovan
- Department of Psychology, College of Natural, Behavioral, and Health Sciences, Simmons University, Boston, MA, United States.,BodiMojo, Inc, Boston, MA, United States
| | - Sarah R Martin
- Pediatric Pain and Palliative Care Program, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Laura C Seidman
- Pediatric Pain and Palliative Care Program, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Lonnie K Zeltzer
- Pediatric Pain and Palliative Care Program, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | | | - Laura A Payne
- Pediatric Pain and Palliative Care Program, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | | | - Marjorie Weiman
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Marla Knoll
- Department of Care Coordination, Mattel Children's Hospital, University of California, Los Angeles, CA, United States
| | - Noah C Federman
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
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O'Neill SC, Evans C, Hamilton RJ, Peshkin BN, Isaacs C, Friedman S, Tercyak KP. Information and support needs of young women regarding breast cancer risk and genetic testing: adapting effective interventions for a novel population. Fam Cancer 2019; 17:351-360. [PMID: 29124494 DOI: 10.1007/s10689-017-0059-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Young women from hereditary breast and ovarian cancer (HBOC) families face a unique set of challenges in managing their HBOC risk, where obtaining essential information to inform decision making is key. Previous work suggests that this need for specific health information also comes at a time of heightened distress and greater individuation from family. In this report, we describe our adaptation of a previously-studied behavioral intervention for this population, utilizing a systematic approach outlined by the Centers for Disease Control and Prevention. First, we assessed the information needs and levels of distress in this population and correlates of this distress. These data then were used to inform the adaptation and piloting of a three-session telephone-based peer coaching intervention. One hundred young women (M age = 25 years) who were first or second degree relatives of BRCA1/2 mutation carriers participated. Sixty-three percent of the sample endorsed unmet HBOC information needs and they, on average, reported moderate levels of cancer-related distress (M = 21.9, SD = 14.6). Greater familial disruption was associated with greater cancer-related distress in multivariable models (p < .05). Ten women who participated in the survey completed the intervention pilot. They reported lower distress from pre- to post- (15.8 vs. 12.0), as well as significantly lower decisional conflict (p < .05) and greater endorsement of an array of healthy coping strategies (i.e., active coping, instrumental coping, positive reframing, planning, p's < .05). Our survey results suggest that young adult women from HBOC families have unmet cancer genetic information and support needs. Our pilot intervention was able to reduce levels of decisional conflict and promote the use of effective coping strategies. This approach needs to be further tested in a larger randomized trial.
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Affiliation(s)
- Suzanne C O'Neill
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA.
| | - Chalanda Evans
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA
| | - Rebekah J Hamilton
- Armour Academic Center, College of Nursing, Rush University, 600 S. Paulina Street, Suite 1080, Chicago, IL, 60612, USA
| | - Beth N Peshkin
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA
| | - Claudine Isaacs
- Lombardi Comprehensive Cancer Center, Georgetown University, 3800 Reservoir Road, NW, Washington, DC, 20007, USA
| | - Sue Friedman
- FORCE, Inc., 16057 Tampa Palms Blvd. W, PMB #373, Tampa, FL, 33647, USA
| | - Kenneth P Tercyak
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA
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Milosevic E, Brunet J, Campbell KL. Exploring tensions within young breast cancer survivors' physical activity, nutrition and weight management beliefs and practices. Disabil Rehabil 2019; 42:685-691. [PMID: 30616419 DOI: 10.1080/09638288.2018.1506512] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: Although the benefits of physical activity, healthy eating, and weight management for breast cancer survivors are well established, little is known about how best to promote these practices among women diagnosed before age 40 years. We conducted a qualitative study to explore young breast cancer survivors' beliefs and practices regarding physical activity, nutrition, and weight management.Methods: Semi-structured interviews were conducted with 12 women (Mage=36 years, SD=3.4) who were within 5 years of breast cancer diagnosis. Data were analyzed using thematic analysis.Results: Participants' accounts revealed several tensions between the factors motivating them to engage in physical activity, healthy eating, and weight management and those deterring them. Tensions were captured within three themes: (1) prolonging life with a healthy lifestyle versus enjoying living; (2) perceiving benefits versus barriers, and; (3) seeking social connection versus protecting the self from social threats. Participants also noted preferences, which if considered could help them maintain healthy lifestyle practices.Conclusions: Although young breast cancer survivors value physical activity, healthy eating, and weight management, they are constantly weighing the benefits of these practices against their perceived drawbacks. To facilitate long-term participation among young breast cancer survivors, future programing must address their conflicting beliefs and priorities.Implications for RehabilitationPhysical activity, healthy eating, and weight management can play an important role in the health and wellbeing of breast cancer survivors.Young breast cancer survivors experience a 'tug-of-war' between the factors motivating them to be active and eat healthy and those deterring them.Following treatment for breast cancer, young women would benefit from tailored lifestyle-based programing that addresses their conflicting beliefs and priorities.Tailored programing might involve strategically scheduled program times or flexible programs designed to include the participation of family and friends.
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Affiliation(s)
- Elizabeth Milosevic
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, Canada
| | - Jennifer Brunet
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Kristin L Campbell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Mingoia J, Hutchinson AD, Gleaves DH, Wilson C. The impact of a social media literacy intervention on positive attitudes to tanning: A pilot study. COMPUTERS IN HUMAN BEHAVIOR 2019. [DOI: 10.1016/j.chb.2018.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Psychosocial challenges and health-related quality of life of adolescents and young adults with hematologic malignancies. Blood 2018; 132:385-392. [DOI: 10.1182/blood-2017-11-778555] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/05/2018] [Indexed: 12/28/2022] Open
Abstract
Abstract
Adolescents and young adults (AYAs) occupy a unique place within the hematologic malignancy community due to the challenges they face related to their disease biology and physical, psychosocial, and economic circumstances, as well as issues related to access to care and long-term follow-up. Efforts to define age-specific (supportive) care needs and targets for intervention in these areas are evolving. This review discusses the psychosocial issues AYAs with hematologic malignancies are dealing with, how these might affect their health-related quality of life, and the challenges in delivering high-quality supportive care to this underserved population.
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Blanch-Hartigan D, Kinel J. Addressing Career-Related Needs in Adolescent and Young Adult Cancer Survivors: University Career Service Professionals' Experience and Resources. J Adolesc Young Adult Oncol 2017; 7:245-248. [PMID: 29271688 DOI: 10.1089/jayao.2017.0064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Many adolescent and young adult (AYA) survivors are transitioning not only from patient to survivor but also transitioning to the workforce. AYA survivors report many career-related concerns. Career service professionals are well positioned to provide targeted resources. A survey of 40 career service professionals at colleges and universities in the United States revealed that although they have had experience working with AYA survivors, most do not feel adequately trained or aware of survivors' unique needs. However, they are highly receptive to specific resources for AYA survivors. Maximizing connections between career service professionals and AYA survivors may help address survivors' career-related concerns.
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Affiliation(s)
| | - Jesse Kinel
- Department of Natural and Applied Sciences, Bentley University , Waltham, Massachusetts
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