Promoting cancer prevention and screening: the impact of the Cancer Information Service. Part 7

Are cancer helplines effective in supporting caregivers? A systematic review

PURPOSE

The aims of this systematic review were to summarize the profile of caregivers accessing cancer helplines, to evaluate caregiver satisfaction with the helpline service, and to review the evidence base of intervention studies testing the efficacy of community-based cancer helplines in improving caregiver health and well-being.

METHODS

Four electronic databases (Medline, CINAHL, PsychINFO, and EMBASE) were systematically searched to identify relevant literature, including all articles published in English until May 2018. Reference lists of accepted papers were reviewed for the inclusion of additional potentially relevant articles, gray literature was excluded.

RESULTS

Forty-five publications met the inclusion criteria for this review. Forty-one papers reported on the proportion of caregivers accessing cancer helplines. Twenty-six studies described demographic and clinical characteristics of caregivers and eight reported on call characteristics. Reasons for contacting the service were stated in 21 studies and caregiver satisfaction with the helpline service was assessed in 12 articles. Fourteen studies investigated specific topics of interest (e.g., prevalence of sleep problems, distress screening, or clinical trial participation). Two randomized controlled trials examined the efficacy of cancer helplines in improving caregiver outcomes, with findings showing interventions to be effective in reducing distress and unmet needs, and in increasing positive adjustment.

CONCLUSIONS

There is limited scientific evidence regarding the efficacy of cancer helplines to improve caregivers' health and well-being. More intervention studies are needed to examine the benefits of cancer helplines to this study population to ensure structured referral pathways can be established.

Cancer information seeking among African Americans

BACKGROUND

Relatively little is known about the factors that impact African Americans' health information seeking, a behavior relevant to cancer disparity.

METHODS

In this article, we examine African American cancer information seeking using data from Cancer Information Service (CIS) call data (N = 32,834 African American callers).

RESULTS

Compared to members of other racial groups, fewer African American callers sought information on prevention and psychosocial support. African American calls were likely to result in information on medical referrals and support services.

CONCLUSIONS

Increased knowledge of CIS resources relevant to treatment and support may increase African American use of CIS.

African American men's perceptions of factors influencing health-information seeking

The lack of health information is one of several factors implicated in the poor health status of African American men. Although a growing body of research delineates the obstacles to African Americans' engagement in preventive health behaviors, relatively little is known about the barriers that adversely affect men's involvement in health-information seeking. This article presents qualitative data on African American men's information seeking through an analysis of focus group data. Three research questions are addressed: (a) What health-information concerns and needs do African American men have? (b) How do African American men describe their efforts to obtain health information? and (c) What factors facilitate or inhibit health-information seeking by African American men? The implications of the data and suggestions for future research are provided.

Cancer-related information sought by the general public: evidence from the National Cancer Institute's Cancer Information Service, 2002-2003

BACKGROUND

We examined the main topics of inquiry (Subjects of Interaction-SOI) of calls made by the general public to the National Cancer Institute's Cancer Information Service's (CIS) 1-800-4-CANCER telephone information service.

METHODS

We analyzed data from 37,620 callers to the CIS between September 2002 and August 2003. We conducted frequencies, chi-squares, and logistic regressions to ascertain sample characteristics and sociodemographic correlates of each SOI. Results. We found differences in discussion of the 7 main SOI by age, sex, ethnicity, race, and education.

CONCLUSIONS

Findings inform the CIS' and other organizations' efforts to develop and disseminate cancer information.

Cancer-related information seeking: hints from the 2003 Health Information National Trends Survey (HINTS)

Few nationally representative surveys have assessed the cancer-related information seeking behavior of the American public. Data for our analysis were from the 2003 Health Information National Trends Survey (HINTS). The goals of our analysis were to characterize cancer information seekers (3,011) and nonseekers (3,348) in terms of sociodemographic, health care access, and health status variables, and to describe the nature of the cancer-related information being sought by information seekers. Significant and independent associations with seeking status were identified for gender, age, race, income, education, personal and family history of cancer, and having a usual source of health care. Information seekers were less likely to be male (OR = .51); aged 65 or older (OR = .40); Hispanic (OR = .60); to have a usual source of health care (OR = .70); and more likely to have incomes greater than $50,000 (OR = 1.50), some college (OR = 1.87) or a college degree (OR = 2.95), a prior cancer diagnosis (OR = 3.57), or a family history of cancer (OR = 2.17). Among cancer information seekers, the most frequently searched topic was cancer site-specific information (50.2%). Individuals who reported searching for cancer site-specific information were most frequently looking for information about breast cancer (23.8%), prostate cancer (11.5%), and skin cancer (11.3%). The HINTS survey provides a unique opportunity to explore the characteristics of information seekers and nonseekers and the content of information being sought by the public in a nationally representative sample; understanding gained from this effort provides generalizable and policy-relevant information about the American public's information needs.

The National Cancer Institute's cancer information service: a new generation of service and research to the nation

The National Cancer Institute (NCI), the nation's leading agency for cancer information and research, mandated by the U.S. Congress to provide accurate, up-to-date information about cancer to all segments of the U.S. population, established the Cancer Information Service (CIS) on July 1, 1975. Using a two-pronged approach, the telephone information service and education programs for the public and health professionals, the CIS was designed to maximize its reach. In 1982, the CIS implemented three tools: the Call Record Form to record data about each call to the service, a national user survey, and a system of national test calls. These resulted in a rich data source and an infrastructure that allowed collaborative health communications research with the CIS to emerge later in the decade. As the CIS embarks on a new generation of service to the nation, it is now characterized by three vital components that advance the NCI's overall mission of cancer prevention and control: a Partnership Program, Multichannel Contact Centers, and a Health Communications Research Program.

Meeting the public's cancer information needs: characteristics of callers to the National Cancer Information Center of the American Cancer Society

BACKGROUND

In this study, we describe the characteristics of the callers of the American Cancer Society's National Cancer Information Center (NCIC), why they called, how they learned about NCIC, and their satisfaction.

METHODS

A random sample of callers (N = 19,487) completed a telephone survey.

RESULTS

The majority were female, White, 45 to 74 years old, had incomes greater than 35,001 dollars, and were college educated. They learned about the NCIC through TV advertisements and requested information about specific cancers, local programs, or making donations.

CONCLUSIONS

These findings validate the usefulness of the NCIC and are helpful in identifying and targeting persons who do not routinely use this service.

Risk communication strategies: state of the art and effectiveness in the context of cancer genetic services

The objective of this paper is first to describe the different strategies used to communicate risks to patients in the field of cancer or genetics, to review their effectiveness, and to summarise the state of the art of this practice in particular, in cancer genetics. The target audience is health care professionals involved in the communication of cancer risks, and genetic risks of breast/ovarian or colorectal cancer in particular. The methods include a review of the literature (Medline, Pascal, PsycInfo, Embase) by a panel of researchers and clinicians (cancer geneticists, epidemiologists, health psychologists, sociologists) in the context of a European Project on risk communication. We highlight practices that have been shown to be effective in the context of health psychology research and those being still under consideration for use in routine practice. In conclusion, this paper adds clinical relevance to the research evidence. We propose specific steps that could be integrated in standard clinical practice based on current evidence for their usefulness/effectiveness.

Evaluation of the American Cancer Society's breast cancer-related documents by cancer survivors

BACKGROUND

In an attempt to address the informational needs of female breast cancer survivors, the American Cancer Society (ACS) develops and distributes written documents. Although this educational effort has been well received, little attention has been given to the suitability of the materials themselves.

METHODS

A random sample of 812 survivors was derived from callers to the ACS National Cancer Information Center (NCIC) from July to December of 2000. The participants then rated the three most commonly distributed breast cancer information documents on five dimensions 1). presentation, 2). satisfaction, 3). understanding, 4). anxiety, and 5). impact.

RESULTS

. Participants responded favorably to four of the five rating categories. Conclusions. The evidence suggests that the three materials had positive health outcomes and were well received by the survivors.

Telephone counseling in psychosocial oncology: a report from the Cancer Information and Counseling Line

Providing psychosocial counseling services to cancer patients and their significant others by telephone is emerging as an alternative to traditional (in-person) counseling programs in psychooncology. In this paper, data are reported describing the clients of such a program that has been in continuous operation since 1981: the Cancer Information and Counseling Line (CICL) of the AMC Cancer Research Center. An examination of call record forms completed between 1 June 1998 and 30 May 1999 (N = 1627) revealed that the vast majority of callers were female (77%), non-Hispanic White (77%), with at least some college education (62%). Only 27% were cancer patients/survivors, compared to 43% who were spouses, other relatives and friends of cancer patients/survivors, and 16% who were symptomatic callers. Breast cancer was by far the most frequently mentioned cancer site (30%). Although initial topics of inquiry were dominated by requests for medical information (77%), with only a small percentage of callers initially requesting psychosocial support and counseling (12%), by the time, the call was completed, 67% had received some form of psychosocial support and/or counseling. Recommendations for future research are discussed within the context of this review.

Evaluating the Cancer Information Service: a model for health communications. Part 1

The Cancer Information Service (CIS) was established in 1975 by the National Cancer Institute (NCI) to meet the information needs of cancer patients, their families, health professionals, and the public. As the nation's foremost source for cancer information, the CIS applies a unique health communications model to bring the latest research findings on cancer prevention, detection, treatment, and supportive care to the nation. It does this through two main program components: a toll-free telephone service (1-800-4-CANCER) and an outreach program that focuses on providing technical assistance, specifically to partners reaching minority and underserved audiences. During its 22-year history, more than 7.5 million callers have reached the CIS telephone service. In addition, 100,000 requests are received each year from 4,500 organizations nationwide seeking cancer-related outreach expertise. This overview describes the CIS model for health communications, describes the program's impact in broad terms, and defines the critical role evaluation plays in each program component. The overview describes two customer satisfaction and impact surveys performed by an independent survey research firm in 1996 to evaluate the CIS model: (a) the telephone service user survey, a random sample of 2,489 persons representing major caller groups who were interviewed 3 to 6 weeks after their initial call to the CIS; and (b) the outreach partner survey, a random sample of 867 partner organizations, the majority of which reach minority and underserved audiences with information and programs, surveyed within a few months after a contact with the CIS outreach program. Impact data for both program areas were favorable: Approximately 8 out of 10 CIS callers reported that the information they received had a positive impact (either in eliciting a positive action [56%] or in reassurance of decisions made [22%]) and two-thirds of CIS partners said the CIS has an important impact on their programs.

The value and impact of the Cancer Information Service telephone service. Part 4

The Cancer Information Service (CIS) of the National Cancer Institute (NCI) is a health communications program that disseminates information through two channels: to individuals through a toll-free telephone service and to organizations (serving primarily underserved populations) through an outreach program. People call the 1-800-4-CANCER line to meet a variety of information needs. The information specialists who respond to these calls are prepared to answer questions ranging from cancer prevention to early detection, treatment, and survivorship. In a 1996 random sample survey, 2,489 callers were asked why they called, how they valued the information, and what health-related actions they took or decisions they made since their call. Results show the CIS is highly valued by its users, with satisfaction high across gender, age, education, and racial/ethnic groups. While differences in satisfaction were observed by caller type and subject of inquiry, nearly all respondents reported that contact with the CIS increased knowledge, provided reassurance, and influenced decisionmaking and health behavior. Overall, 95% were satisfied with CIS information, 98% trusted the information, 92% reported an increase in knowledge, 69% felt reassured, and 73% said the information helped them to better cope with their concerns. Eight out of 10 callers reported the information they received had a positive impact, with 56% reporting taking a positive health action. Results demonstrate that health communications programs like the CIS can fill information gaps consumers must bridge to make informed health care decisions and can play an important public health role in motivating people to take actions to reduce risks and/or make decisions that lead to improved health status.