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A Scoping Review of Food Insecurity and Related Factors among Cancer Survivors. Nutrients 2022; 14:nu14132723. [PMID: 35807902 PMCID: PMC9269347 DOI: 10.3390/nu14132723] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/24/2022] [Accepted: 06/27/2022] [Indexed: 02/05/2023] Open
Abstract
Despite growing awareness of the financial burden that a cancer diagnosis places on a household, there is limited understanding of the risk for food insecurity among this population. The current study reviewed literature focusing on the relationship between food insecurity, cancer, and related factors among cancer survivors and their caregivers. In total, 49 articles (across 45 studies) were reviewed and spanned topic areas: patient navigation/social worker role, caregiver role, psychosocial impacts, and food insecurity/financial toxicity. Patient navigation yielded positive impacts including perceptions of better quality of care and improved health related quality of life. Caregivers served multiple roles: managing medications, emotional support, and medical advocacy. Subsequently, caregivers experience financial burden with loss of employment and work productivity. Negative psychosocial impacts experienced by cancer survivors included: cognitive impairment, financial constraints, and lack of coping skills. Financial strain experienced by cancer survivors was reported to influence ratings of physical/mental health and symptom burden. These results highlight that fields of food insecurity, obesity, and cancer control have typically grappled with these issues in isolation and have not robustly studied these factors in conjunction. There is an urgent need for well-designed studies with appropriate methods to establish key determinants of food insecurity among cancer survivors with multidisciplinary collaborators.
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Marshall CA, Curran MA, Brownmiller G, Solarte A, Armin J, Hamann HA, Crist JD, Niemelä M, Badger TA, Weihs KL. Oregon's Familias en Acción replicates benefits for underserved cancer co-survivors through Un Abrazo Para la Familia. Psychooncology 2018; 27:2405-2411. [PMID: 30047167 DOI: 10.1002/pon.4841] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/12/2018] [Accepted: 07/15/2018] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Our goal in this study was to determine if we could replicate initial findings when providing the intervention, Un Abrazo Para La Familia ("Abrazo"). Abrazo is a community-focused psychoeducational preventive intervention addressing the cancer information and coping needs of low-income, underserved family members of cancer survivors, developed and first implemented in Tucson, Arizona. METHODS We used a preintervention and postintervention evaluation design to assess the effectiveness of replicating the Abrazo intervention with underserved Hispanic/Latino family members facing cancer as co-survivors. We describe lessons learned in an expansion of Abrazo from one region of the United States to another. RESULTS Portland promotoras demonstrated that when the Abrazo intervention is provided via a culturally congruent, accessible format, the significant gains in cancer knowledge and self-efficacy reported by underserved co-survivors can be replicated. This is important because Oregon represents a US region different from Abrazo's origins in the Southwest. CONCLUSION Our replication study provides a useful roadmap for others focusing on the psychosocial needs of Hispanic/Latino cosurviving family members of cancer. A manualized 12-hour training program based on the initial discovery and efficacy work was developed to train promotoras as a part of this study. The manual provides a clear protocol for others to replicate our intervention and evaluation procedures. Abrazo may be particularly important for family-centered care if the family does not have the cancer knowledge or self-confidence needed to fully participate.
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Affiliation(s)
- Catherine A Marshall
- Department of Disability and Psychoeducational Studies, The University of Arizona, Tucson, AZ, USA
| | - Melissa A Curran
- Department of Family Studies and Human Development, The University of Arizona, Tucson, AZ, USA
| | | | | | - Julie Armin
- Department of Family & Community Medicine, The University of Arizona, Tucson, AZ, USA
| | - Heidi A Hamann
- Departments of Psychology and Family & Community Medicine, The University of Arizona, Tucson, AZ, USA
| | - Janice D Crist
- College of Nursing, The University of Arizona, Tucson, AZ, USA
| | - Mika Niemelä
- Department of Psychiatry, Oulu University Hospital and Center for Life Course Health, Research, University of Oulu, Oulu, Finland
| | - Terry A Badger
- College of Nursing and Department of Psychiatry, The University of Arizona, Tucson, AZ, USA
| | - Karen L Weihs
- Department of Psychiatry, The University of Arizona, Tucson, AZ, USA
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Niemelä M, Marshall CA, Kroll T, Curran M, Koerner SS, Räsänen S, García F. Family-Focused Preventive Interventions With Cancer Cosurvivors: A Call to Action. Am J Public Health 2016; 106:1381-7. [PMID: 27196647 DOI: 10.2105/ajph.2016.303178] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Health promotion and preventive action in the context of public health interventions for highly prevalent, long-term conditions such as cancer are rarely geared toward the family as a whole. Yet family members, as cancer cosurvivors, must manage their own substantial stress and multiple caregiving responsibilities and often constitute a critical nexus between individual patients and clinicians. We drew on 2 examples of cancer cosurvivorship from 2 different health service contexts, the United States and Finland. A systemic approach in public health is needed to support family members who not only have to confront the meaning of long-term conditions such as cancer but also may have to manage concurrent social life challenges and stressors such as economic hardship.
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Affiliation(s)
- Mika Niemelä
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Catherine A Marshall
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Thilo Kroll
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Melissa Curran
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Susan Silverberg Koerner
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Sami Räsänen
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
| | - Francisco García
- Mika Niemelä is with the Child and Adolescent Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland. Catherine A. Marshall is with the Department of Disability and Psychoeducational Studies, University of Arizona, Tucson. Thilo Kroll is with the Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Dundee, Scotland, UK. Melissa Curran is with the Norton School of Family and Consumer Sciences, University of Arizona, Tucson. Susan Silverberg Koerner is with the Department of Human Development and Family Studies, University of Illinois, Urbana-Champaign. Sami Räsänen is with the Department of Psychiatry, Oulu University Hospital, Oulu, Finland. Francisco García is with the Pima County Health Department, Tucson, AZ. All authors are affiliated with the FRED (Family-Focused Research, Education and Development) network
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Marshall CA, Curran MA, Koerner SS, Kroll T, Hickman AC, García F. Un Abrazo Para La Familia: an evidenced-based rehabilitation approach in providing cancer education to low-SES Hispanic co-survivors. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2014; 29:626-33. [PMID: 24347436 PMCID: PMC4062619 DOI: 10.1007/s13187-013-0593-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We discuss Un Abrazo Para La Familia as an effective, rehabilitation-informed evidence-based model of education, information-sharing, and skill teaching for use with low-income Hispanic co-survivors of cancer. Over 2 years, 120 co-survivors participated in the intervention. The majority of participants (96 %) were women and all but one reported being Hispanic. Both in years 1 and 2, we followed the same pre- and post-intervention evaluation design. Based on pre- and post-intervention assessments of cancer-related knowledge and self-efficacy, the percentage of questions answered correctly about cancer significantly increased for co-survivors. Self-efficacy significantly increased as well. Using item analysis, we explored skill teaching as a mechanism for the effective delivery of Un Abrazo and recommend the use of promotoras in providing the intervention. Of the 12 cancer knowledge items resulting in statistically significant increases of cancer knowledge, 5 were taught via interactive skill teaching. Given the projected rise in the incidence of cancer in Hispanic populations, coupled with the fact that people from low-income backgrounds face unique challenges in cancer prevention and management, implications of the Un Abrazo model for future research and policy regarding cancer and families are considered.
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Affiliation(s)
| | - Melissa A. Curran
- Family Studies and Human Development University of Arizona 650 N. Park McClelland Park Tucson, AZ 85721-0078
| | - Susan Silverberg Koerner
- Department of Human & Community Development University of Illinois at Urbana-Champaign 226 Bevier Hall, M/C 180 Urbana, IL 61801
| | - Thilo Kroll
- Co-Director Social Dimensions of Health Institute (SDHI) University of Dundee and St Andrews School of Nursing & Midwifery University of Dundee
| | - Amy C. Hickman
- Rhetoric and Composition Department of English University of Arizona, Tucson, AZ 85721
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Marshall CA, Curran MA, Koerner SS, Weihs KL, Hickman AC, García FAR. Information and support for co-survivors during or after cancer treatment: Consideration of Un Abrazo Para la Familia as a model for family-focused intervention in cancer rehabilitation. Work 2013; 46:395-405. [PMID: 24004735 DOI: 10.3233/wor-131675] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The development and evaluation of Un Abrazo Para La Familia, [A Hug for the Family] is described. Un Abrazo is discussed as an effective model of education, information-sharing, and skill-building for use with low-income co-survivors of cancer. PARTICIPANTS Sixty co-survivors participated. The majority were women and all reported being Hispanic. METHODS Using quantitative data (N=60), the needs, concerns, and characteristics of the co-survivor population served through Un Abrazo are presented. Further, we offer three qualitative case studies (with one co-survivor, one survivor, and one non-participant) to illustrate the model and its impact. RESULTS The median level of education level of co-survivors was 12 years. The majority were unemployed and/or identified as homemakers, and indicated receipt of services indicating low-income status. Half reported not having health insurance. The top four cancer-related needs or concerns were: Information, Concern for another person, Cost/health insurance, and Fears. CONCLUSIONS Recognizing the centrality of the family in addressing cancer allows for a wider view of the disease and the needs that arise during and after treatment. Key rehabilitation strategies appropriate for intervening with co-survivors of cancer include assessing and building upon strengths and abilities and making culturally-respectful cancer-related information and support accessible.
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Affiliation(s)
- Catherine A Marshall
- Center of Excellence in Women's Health, and Department of Disability and Psychoeducational Studies, University of Arizona, Tucson, AZ, USA
| | - Melissa A Curran
- Family Studies and Human Development, University of Arizona, Tucson, AZ, USA
| | - Susan Silverberg Koerner
- Department of Human and Community Development, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Karen L Weihs
- Psychosocial Oncology Program, University of Arizona Medical Center, Tucson, AZ, USA
| | - Amy C Hickman
- Department of English, University of Arizona, Tucson, AZ, USA
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Marshall CA, Badger TA, Curran MA, Koerner SS, Larkey LK, Weihs KL, Verdugo L, García FAR. Un Abrazo Para La Familia: providing low-income Hispanics with education and skills in coping with breast cancer and caregiving. Psychooncology 2011; 22:470-4. [PMID: 22140003 DOI: 10.1002/pon.2108] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 11/02/2011] [Accepted: 11/03/2011] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Un Abrazo Para La Familia (A Hug for the Family) is an intervention designed to increase the accessibility of cancer information to low-income and medically underserved co-survivors of cancer. Co-survivors are family members or friends of an individual diagnosed with cancer. Our goal was to increase socio-emotional support for these co-survivors and improve skills in coping with cancer. The purpose of our pilot study was to explore the effectiveness of the intervention in increasing cancer knowledge and self-efficacy among co-survivors. METHODS Un Abrazo consisted of three one-hour sessions, in either Spanish or English. Sessions were delivered by a trained promotora (community health worker), in partnership with a counselor. Sixty participants completed measures of cancer knowledge and self-efficacy preceding (pre-test) and following the intervention (post-test). RESULTS From pre-test to post-test, the percentage of questions answered correctly about cancer knowledge increased (p < 0.001), as did ratings of self-efficacy (p < 0.001). Decreases were seen in 'Do not know' responses for cancer knowledge (p < 0.01), with a negative correlation between number of 'Do not knows' on cancer knowledge at pre-test and ratings of self-efficacy at pre-test (r = -0.47, p < 0.01). CONCLUSIONS When provided an accessible format, co-survivors of cancer from underserved populations increase their cancer knowledge and self-efficacy. This is notable because research indicates that family members and friends with increased cancer knowledge assume more active involvement in the cancer care of their loved ones.
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Affiliation(s)
- Catherine A Marshall
- Center of Excellence in Women's Health, and Frances McClelland Institute for Children, Youth and Families, Norton School of Family and Consumer Sciences, University of Arizona, Tucson, AZ, USA.
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