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Cho D, Roth M, Peterson SK, Jennings K, Kim S, Weathers SP, Ahmed S, Livingston JA, Barcenas C, You YN, Milbury K. Associations Between Stress, Health Behaviors, and Quality of Life in Young Couples During the Transition to Survivorship: Protocol for a Measurement Burst Study. JMIR Res Protoc 2024; 13:e53307. [PMID: 38652520 PMCID: PMC11077407 DOI: 10.2196/53307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Cancer is a life-threatening, stressful event, particularly for young adults due to delays and disruptions in their developmental transitions. Cancer treatment can also cause adverse long-term effects, chronic conditions, psychological issues, and decreased quality of life (QoL) among young adults. Despite numerous health benefits of health behaviors (eg, physical activity, healthy eating, no smoking, no alcohol use, and quality sleep), young adult cancer survivors report poor health behavior profiles. Determining the associations of stress (either cancer-specific or day-to-day stress), health behaviors, and QoL as young adult survivors transition to survivorship is key to understanding and enhancing these survivors' health. It is also crucial to note that the effects of stress on health behaviors and QoL may manifest on a shorter time scale (eg, daily within-person level). Moreover, given that stress spills over into romantic relationships, it is important to identify the role of spouses or partners (hereafter partners) in these survivors' health behaviors and QoL. OBJECTIVE This study aims to investigate associations between stress, health behaviors, and QoL at both within- and between-person levels during the transition to survivorship in young adult cancer survivors and their partners, to identify the extent to which young adult survivors' and their partners' stress facilitates or hinders their own and each other's health behaviors and QoL. METHODS We aim to enroll 150 young adults (aged 25-39 years at the time of cancer diagnosis) who have recently completed cancer treatment, along with their partners. We will conduct a prospective longitudinal study using a measurement burst design. Participants (ie, survivors and their partners) will complete a daily web-based survey for 7 consecutive days (a "burst") 9 times over 2 years, with the bursts spaced 3 months apart. Participants will self-report their stress, health behaviors, and QoL. Additionally, participants will be asked to wear an accelerometer to assess their physical activity and sleep during the burst period. Finally, dietary intake (24-hour diet recalls) will be assessed during each burst via telephone by research staff. RESULTS Participant enrollment began in January 2022. Recruitment and data collection are expected to conclude by December 2024 and December 2026, respectively. CONCLUSIONS To the best of our knowledge, this will be the first study that determines the interdependence of health behaviors and QoL of young adult cancer survivors and their partners at both within- and between-person levels. This study is unique in its focus on the transition to cancer survivorship and its use of a measurement burst design. Results will guide the creation of a developmentally appropriate dyadic psychosocial or behavioral intervention that improves both young adult survivors' and their partners' health behaviors and QoL and potentially their physical health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/53307.
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Affiliation(s)
- Dalnim Cho
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Michael Roth
- Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Susan K Peterson
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kristofer Jennings
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Seokhun Kim
- The Center for Clinical Research and Evidence-Based Medicine, The University of Texas McGovern Medical School, Houston, TX, United States
| | - Shiao-Pei Weathers
- Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Sairah Ahmed
- Department of Lymphoma-Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - J Andrew Livingston
- Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Carlos Barcenas
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Y Nancy You
- Department of Colon & Rectal Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Kathrin Milbury
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States
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Klobodu C, Vitolins MZ, Deutsch JM, Fisher K, Nasser JA, Stott D, Murray MJ, Curtis L, Milliron BJ. Examining the Role of Nutrition in Cancer Survivorship and Female Fertility: A Narrative Review. Curr Dev Nutr 2024; 8:102134. [PMID: 38584676 PMCID: PMC10997918 DOI: 10.1016/j.cdnut.2024.102134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/26/2024] [Accepted: 03/07/2024] [Indexed: 04/09/2024] Open
Abstract
Female cancer survivors have a higher chance of experiencing infertility than females without a history of cancer diagnosis. This risk remains high despite advances in fertility treatments. There is a need to augment fertility treatments with cost-effective methods such as nutritional guidance to improve fertility chances. The aim of this review article is to connect the current literature on cancer survivorship nutrition and fertility nutrition, focusing on the importance of integrating nutritional guidance into fertility counseling, assessment, and treatment for female cancer survivors. Consuming a healthful diet comprising whole grains, soy, fruits, vegetables, seafood, and unsaturated fats has improved both female fertility and cancer survivorship. Similarly, maintaining a healthy body weight also improves female fertility and cancer survivorship. Therefore, dietary interventions to support female cancer survivors with fertility challenges are of immense importance. The period of follow-up fertility counseling and assessment after cancer treatment may provide a unique opportunity for implementing nutritional guidance for female cancer survivors. Dietary interventions are a promising strategy to improve pregnancy chances and overall quality of life among female cancer survivors; thus, researchers should investigate perceptions regarding fertility, barriers, and challenges to changing nutrition-related behaviors, and preferences for nutritional guidance to support fertility treatments in this population.
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Affiliation(s)
- Cynthia Klobodu
- Department of Nutrition and Food Science, California State University, Chico, College of Natural Sciences, CA, United States
| | - Mara Z Vitolins
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Jonathan M Deutsch
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Kathleen Fisher
- Department of Nursing, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Jennifer A Nasser
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Dahlia Stott
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
| | - Michael J Murray
- Northern California Fertility Medical Center, Sacramento, CA, United States
| | - Laura Curtis
- Department of Nutrition and Food Science, California State University, Chico, College of Natural Sciences, CA, United States
| | - Brandy-Joe Milliron
- Department of Health Sciences, College of Nursing and Health Professions, Drexel University, Philadelphia, PA, United States
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Din HN, Strong D, Singh-Carlson S, Corliss HL, Hartman SJ, Madanat H, Su HI. The effect of changing pregnancy intentions on preconception health behaviors: a prospective cohort study. J Cancer Surviv 2023; 17:1660-1668. [PMID: 36289184 PMCID: PMC10539193 DOI: 10.1007/s11764-022-01281-1] [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: 07/30/2022] [Accepted: 10/18/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Pregnancy intentions are associated with preconception health behaviors but are understudied among female adolescent and young adult (AYA) cancer survivors. Preconception health is critical for survivors because they face unique risks to fertility and pregnancy from late effects of cancer treatments. This study prospectively assessed the effect of pregnancy intention on physical activity (PA) and smoking behaviors among female AYA survivors. METHODS A cohort of 1049 female AYA survivors were recruited between 2013 and 2017. Participants were 18-39 years and had completed primary cancer treatment. Longitudinal mixed effects analysis was conducted on participants who completed at least 2 of 4 questionnaires over 1.5 years. Two measures were used to capture multiple dimensions of pregnancy intention. The pregnancy intention score (PIS) captured wanting and planning dimensions and represented a scaled response of low to high intention. The trying dimension captured urgent intention and ranged from not trying, ambivalent (neither attempting nor avoiding pregnancy), and trying now. Intention change was assessed between each consecutive time points. Final analysis was conducted with multiple imputations. RESULTS Survivors with increased intention measured by trying was associated with increased PA over time (adjusted B [95%CI]: 0.3 [0.01, 0.5]) compared to survivors with no changes or decreased trying intention. PIS was not significantly associated with preconception behaviors. No measure of intention was associated with smoking behavior. CONCLUSIONS Increasingly urgent pregnancy intention (trying dimension) was associated with higher preconception PA. IMPLICATIONS FOR CANCER SURVIVORS Screening for immediate intentions can identify AYA survivors in need of early preconception health promotion.
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Affiliation(s)
- Hena Naz Din
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA.
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA.
| | - David Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Dr., La Jolla, CA, 92037, USA
| | - Savitri Singh-Carlson
- School of Nursing, San Diego State University, 5500 Campanile Mall, San Diego, CA, 92182, USA
| | - Heather L Corliss
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
- Center for Research On Sexuality and Sexual Health, Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA
| | - Sheri J Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
- Moores Cancer Center, University of California San Diego, 3855 Health Sciences Dr., La Jolla, CA, 92037, USA
| | - Hala Madanat
- School of Public Health, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
- Division of Research & Innovation, San Diego State University, 5500 Campanile Dr., San Diego, CA, 92182, USA
- Institute for Behavioral and Community Health, San Diego State University, 9245 Sky Park Court, Suite 221, San Diego, CA, 92123, USA
| | - H Irene Su
- Division of Reproductive Endocrinology and Infertility, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, USA
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Bertuzzi AF, Grimaudo MS, Laffi A, Giordano L, Gennaro N, Cariboni U, Siracusano LV, Quagliuolo V, Colombo P, Federico D, Renne SL, Specchia C, Cananzi F, Marrari A, Navarria P, Daolio PA, Bastoni S, Santoro A. Multidisciplinary management of adolescents and young adults (AYA) sarcoma: A successful effort of an adult high-volume cancer center. Cancer Med 2023; 12:16254-16263. [PMID: 37366268 PMCID: PMC10469812 DOI: 10.1002/cam4.6289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 05/13/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023] Open
Abstract
INTRODUCTION The aim of this retrospective study was to investigate the clinicopathological characteristics of AYA sarcomas and their clinical outcomes at a high-volume single center. METHODS Demographic, clinicopathological data on the diagnosis, treatment and follow-up of all sarcoma patients aged 16-39 years (ys) observed at our Institute between January 2010 and December 2021 were retrospectively collected, including diagnostic (TTD) and treatment delay(TTT), clinical outcomes (OS and PFS), and late-treatment effects. RESULTS We identified 228 AYA patients, median age 30 years, 29% ≤ 25 years, 57% males, 88% soft tissue sarcomas (STS), and 12% bone sarcomas (BS). Among STSs, 13% were small round cell tumors (SRCT), 52% intermediate-high-grade, 24% low-grade STSs. Among BS, 32% were high-grade. Median TTD and TTT were 120 (0-8255) and 7 days (0-83), respectively. Surgery was performed in 83%, radiotherapy in 29%, and systemic therapy in 27%. Median follow-up was 72.9 months(1.6-145), 5-year and 10-year OS were 78.5% and 62%, respectively. Kaplan-Meyer analysis showed a significantly better 5-year OS and PFS for patients with >92 days of TTD (OS 85.7% vs. 66.7%, p = 0.001, PFS 50.2% vs. 24.9%, p = 0.009). According to age (≤25 years vs. > 25 years), 5-year OS was 69.8% versus 82.2%, respectively (p = 0.047). CONCLUSION Our analysis confirmed previous data on sarcoma AYA patients followed in a referral center. Unexpectedly, diagnostic delay was not associated with poor OS and PFS. Patients <25 years showed a poorer prognosis due to the higher incidence of SRCT.
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Affiliation(s)
| | | | - Alice Laffi
- Department of Oncology & HematologyIRCCS Humanitas Research HospitalRozzanoItaly
| | - Laura Giordano
- Biostatistic UnitIRCCS Humanitas Research HospitalRozzanoItaly
| | - Nicolò Gennaro
- Feinberg School of MedicineNorthwestern UniversityChicagoUSA
| | - Umberto Cariboni
- Department of SurgeryIRCCS Humanitas Research HospitalRozzanoItaly
| | | | | | - Piergiuseppe Colombo
- Department of Biomedical SciencesHumanitas UniversityItaly
- Department of PathologyIRCCS Humanitas Research HospitalRozzanoItaly
| | - D’Orazio Federico
- Department of RadiologyIRCCS Humanitas Research HospitalRozzanoItaly
| | - Salvatore Lorenzo Renne
- Department of Biomedical SciencesHumanitas UniversityItaly
- Department of PathologyIRCCS Humanitas Research HospitalRozzanoItaly
| | - Cristina Specchia
- Department of GynecologyIRCCS Humanitas Research HospitalRozzanoItaly
| | - Ferdinando Cananzi
- Department of Biomedical SciencesHumanitas UniversityItaly
- Department of SurgeryIRCCS Humanitas Research HospitalRozzanoItaly
| | - Andrea Marrari
- Department of OncologyIstituto Ortopedico RizzoliBolognaItaly
| | - Pierina Navarria
- Department of Radiotherapy and RadiosurgeryIRCCS Humanitas Research HospitalRozzanoItaly
| | | | | | - Armando Santoro
- Department of Oncology & HematologyIRCCS Humanitas Research HospitalRozzanoItaly
- Department of Biomedical SciencesHumanitas UniversityItaly
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Buro AW, Sauls R, Stern M, Carson TL. A qualitative study of stress experiences, health behaviors, and intervention preferences in young adult cancer survivors. Support Care Cancer 2023; 31:295. [PMID: 37093353 PMCID: PMC10123481 DOI: 10.1007/s00520-023-07756-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/13/2023] [Indexed: 04/25/2023]
Abstract
PURPOSE To inform behavioral intervention development, this study examined experiences and unmet needs related to stress, diet, and physical activity in young adult (YA) cancer survivors. METHODS Twenty-three semi-structured interviews were conducted with a purposive sample of YA cancer survivors (n = 12 aged 18-29 years; n = 11 aged 30-39 years; 57% racial or ethnic minority) between May and July 2022 via Zoom. Data were analyzed using a coding reliability approach to thematic analysis. RESULTS Stressor-related themes included health and health care, economic stability, social and community context, and balancing responsibilities. Transition to independent adulthood was discussed among younger participants (18-29 years). Coping-related themes included letting go, keeping anchored in faith, and distraction. Older participants (30-39 years) reported more diverse coping strategies. Routine and consistency and the impact of stress were themes aligning with health behaviors. Control was a cross-cutting theme regarding stressors, coping, and health behaviors. Themes related to intervention preferences included individualized approach, expert-based content, peer support, integrative self-care, and manageability. Younger participants preferred multiple intervention formats (e.g., website, tracking logs). CONCLUSIONS Findings highlighted unmet needs regarding social and environmental stressors in YA cancer survivors and a preference for individualized, expert-based content and peer support in stress management-enhanced behavioral interventions. Such interventions may be tailored for specific age groups to account for differences in stress experiences and intervention preferences.
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Affiliation(s)
- Acadia W Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
| | - Rachel Sauls
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- College of Public Health, University of South Florida, Tampa, FL, USA
| | - Marilyn Stern
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Tiffany L Carson
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
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Reported Mental Health, Diet, and Physical Activity in Young Adult Cancer Survivors. Nutrients 2023; 15:nu15041005. [PMID: 36839363 PMCID: PMC9961696 DOI: 10.3390/nu15041005] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/14/2023] [Accepted: 02/16/2023] [Indexed: 02/19/2023] Open
Abstract
Young adult (YA) cancer survivors are at increased risk for chronic diseases and face age-dependent stressors that may hinder their ability to maintain healthy lifestyle behaviors. This study examined associations between reported mental health, eating beliefs, and health behaviors in YA cancer survivors. YA cancer survivors aged 18-39 years (n = 225) completed a self-administered REDCap® survey, including the Perceived Stress Scale 10, PROMIS® Anxiety and Depression, Eating Beliefs Questionnaire, National Health and Nutrition Examination Survey Dietary Screener Questionnaire, Godin-Shephard Leisure-Time Physical Activity Questionnaire, and demographic and diagnosis-related questions. Descriptive statistics, bivariate analyses, and multiple linear regression were performed. Participants were mean 31.3 years old and 3.7 years post-treatment; 77.3% were women. Most participants reported White (78%) or Black or African American (11.2%) race and non-Hispanic ethnicity (84%). Adjusting for covariates, perceived stress, anxiety, and depression were associated with increased added sugar intake (p < 0.001) and eating beliefs (p < 0.001). Perceived stress and depression were associated with reduced vegetable intake (p < 0.05). There were no associations with fruit intake or physical activity in the adjusted models. Health behavior interventions for this population may address psychosocial needs by including a stress management or mind-body component. Further research including direct measures of health behaviors is warranted.
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Klobodu C, Deutsch J, Vitolins MZ, Fisher K, Nasser JA, Stott D, Milliron BJ. Optimizing Fertility Treatment With Nutrition Guidance: Exploring Barriers and Facilitators to Healthful Nutrition Among Female Cancer Survivors With Fertility Challenges. Integr Cancer Ther 2023; 22:15347354231191984. [PMID: 37559460 PMCID: PMC10416655 DOI: 10.1177/15347354231191984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 07/14/2023] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION Young women diagnosed with cancer are at an increased risk for infertility compared to women without a cancer diagnosis. Consuming a healthful diet comprised of whole grains, fruits, vegetables, and unsaturated fats has been found to improve both fertility and cancer survivorship. Given this reason, dietary interventions tailored to support female cancer survivors with fertility challenges are of immense importance. Therefore, the aim of this study was to explore barriers and facilitators to healthful nutrition among female cancer survivors with fertility challenges, to inform the development of dietary interventions for this population. METHODS Using a formative research design, interview, survey, and dietary intake data were collected from 20 female cancer survivors of reproductive age. Participant-check focus group discussions were conducted to validate findings. All interviews were recorded and transcribed verbatim. Transcripts were coded and analyzed using a thematic analysis approach. Quantitative data were analyzed using means, standard deviations, ranges, frequencies, and percentages. RESULTS The average age of respondents was 31.47 ± 3.5 years and the average BMI was 24.78 ± 4.1 kg/m2. All participants were college educated, 45% identified as White, 50% as Black, and 10% as Hispanic or Latinx. Cancer diagnoses included breast, thyroid, ovarian, leukemia, and gastrointestinal cancers. The following themes were identified: (1) Lack of nutrition-related resources and detailed guidance, (2) Work-life balance, (3) Perceived rigidity of dietary guidance, (4) Treatment-related fatigue, (5) Having trust in healthcare providers, (6) Higher motivation to change nutrition behavior, and (7) Recognizing the additional benefits of nutrition. CONCLUSION These findings indicate a sought-after yet unmet need for post-cancer treatment fertility nutrition recommendations. Interventions should be tailored to women's needs and focus on improving their self-efficacy to make healthful dietary choices.
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Affiliation(s)
- Cynthia Klobodu
- Drexel University, Philadelphia, PA, USA
- California State University Chico, Chico, CA, USA
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Shrivastava SP, Elhence A, Jinwala P, Bansal S, Chitalkar P, Bhatnagar S, Patidar R, Asati V, Reddy PK. Assessment of Psychological Distress Among Indian Adolescents and Young Adults with Solid Cancer Using the National Comprehensive Cancer Network Distress Thermometer. South Asian J Cancer 2022. [DOI: 10.1055/s-0042-1756184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose The incidence of cancer has increased in India with a visible impact on the young population (aged 15–39 years). The present study aims to evaluate psychological distress among Indian adolescents and young adults (AYAs) with solid cancer using the National Comprehensive Cancer Network (NCCN) distress thermometer.
Methods The demographic and clinical characteristics of AYAs patients (age 15–39 years) with cancer were recorded. Assessment of psychological distress of patients using the NCCN distress thermometer was performed at three time points over a period of 3 months. Distress thermometer scale and a self-administered questionnaire in English and Hindi languages was handed over to participants at three time points: at treatment commencement (T1), at 1 month, and 3 months (T2 and T3, respectively) into therapy.
Results Of the 259 patients, 63% were women and 37% men; the median age was 34 years. In total, 71 (27%) were ≤ 24 years old and 188 (73%) were>24 years old. Bone sarcoma (39%) was common cancer in AYA patients aged ≤ 24 years and breast cancer (21%) in >24 years of age. The distress scores in both the groups were the highest at diagnosis (T1) followed by that measured at 1 (T2) and 3 months (T3) after diagnosis. The distress score in the age ≤ 24 years was the highest (6.7) at T1, followed by those measured at T2 (2.6) and T3 (1.1) and among age>24 years was the highest (6.6) at T1, followed by those measured at T2 (2.6) and T3 (1.2). Among AYA patients>24 years old, worry, nervousness, sadness, transportation, and sleep were the top five identified problems and in ≤ 24 years old, the top identified problems were worry, financial support, sleep, nervousness, and sadness.
Conclusion Adolescents and young adults experience some level of distress associated with the cancer diagnosis, effects of the disease, treatment regardless of the stage and various transitions throughout the trajectory of the disease. The distress thermometer is an easy and useful tool for the assessment of psychological distress in AYA cancers. Early identification of distress burden with the distress thermometer leads to effective interventions in patients with cancer which could improve outcomes including survival in AYAs with cancer in India.
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Affiliation(s)
- Shiv Prasad Shrivastava
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Aditya Elhence
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prutha Jinwala
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shashank Bansal
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prakash Chitalkar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shweta Bhatnagar
- Department of Radiology, CHL Hospital, Indore, Madhya Pradesh, India
| | - Rajesh Patidar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Vikas Asati
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Pradeep Kumar Reddy
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Ji X, Hu X, Brock KE, Mertens AC, Cummings JR, Effinger KE. Early Posttherapy Opioid Prescription, Potential Misuse, and Substance Use Disorder Among Pediatric Cancer Survivors. J Natl Cancer Inst 2022; 114:895-906. [PMID: 35262708 PMCID: PMC9194632 DOI: 10.1093/jnci/djac049] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/22/2022] [Accepted: 03/02/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pediatric cancer survivors often have pain, which may be managed with opioids. We examined the prevalence of opioid prescriptions, potential misuse, and substance use disorders (SUDs) among pediatric cancer survivors during the first year posttherapy. METHODS Using MarketScan Commercial Database, we identified 8969 survivors (aged 21 years or younger at diagnosis) who completed cancer therapy in 2009-2018 and remained continuously enrolled for at least 1 year posttherapy and 44 845 age-, sex-, and region-matched enrollees without cancer as a comparison group. Outcomes included opioid prescriptions, any indicator of potential prescription opioid misuse, and SUDs within 1 year posttherapy. Outcomes were compared between survivors and noncancer peers in bivariate and adjusted analyses, stratified by off-therapy age (children: 0-11 years; adolescents: 12-17 years; young adults: 18-28 years). All statistical tests were 2-sided. RESULTS A higher proportion of survivors than noncancer peers filled opioid prescriptions (children: 12.7% vs 2.0%; adolescents: 22.9% vs 7.7%; young adults: 26.0% vs 11.9%). In models adjusting for sociodemographic factors and health status, survivors remained 74.4%-404.8% more likely than noncancer peer to fill opioid prescriptions (P < .001). The prevalence of potential misuse or SUDs was low, with 1.4% of child, 4.7% of adolescent, and 9.4% of young adult survivors fulfilling at least 1 criterion; however, it was higher than noncancer peers (0.1%, 1.4%, and 4.3%, respectively). In adjusted models, the likelihood of potential misuse among survivors remained at least 2 times higher than that among noncancer peers (P < .001), and the difference in SUDs became nonstatistically significant. CONCLUSION Statistically significantly higher rates of opioid prescriptions and potential misuse were found among pediatric cancer survivors within 1 year posttherapy as compared with peers without cancer.
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Affiliation(s)
- Xu Ji
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Xin Hu
- Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Katharine E Brock
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Ann C Mertens
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.,Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Janet R Cummings
- Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - Karen E Effinger
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
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10
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Din HN, Strong D, Singh-Carlson S, Corliss HL, Hartman SJ, Madanat H, Su HI. Association between pregnancy intention and preconception health behaviors. Cancer 2022; 128:615-623. [PMID: 34634132 PMCID: PMC9546522 DOI: 10.1002/cncr.33958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 08/02/2021] [Accepted: 09/07/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Female adolescent and young adult (AYA) cancer survivors face higher infertility and pregnancy risks than peers with no cancer history. Preconception health behaviors such as physical activity (PA), tobacco smoking, and alcohol intake influence reproductive outcomes. In general populations, pregnancy intention is positively associated with healthy preconception behaviors, but it has not been studied among AYA survivors. The authors hypothesized that higher pregnancy intention would be associated with healthier behaviors, especially among AYA survivors with perceived infertility risk. METHODS A cross-sectional analysis was conducted with data collected between 2013 and 2017 from 1071 female AYA survivors aged 18 to 39 years who had completed their primary cancer treatment and enrolled in an ovarian function study. Self-reported intention dimensions were measured as a pregnancy intention score (PIS) and trying now to become pregnant. Multivariable linear (PA), binary (smoking), and ordinal (alcohol use) logistic regressions were used to estimate associations between intentions and preconception behaviors, with adjustments made for demographic and cancer characteristics. Effect modification by perceived infertility risk was assessed. RESULTS The mean PIS was 1.1 (SD, 0.77) on a 0 to 2 scale (2 = high intention), and 8.9% were attempting pregnancy now. A higher PIS was associated with increased PA (β, 0.08; 95% CI, 0.11-1.04), whereas ambivalence in pregnancy intention was associated with lower alcohol consumption (odds ratio, 0.72; 95% CI, 0.55-0.95). Pregnancy intentions were not associated with smoking. Perceived infertility risk strengthened the relationship between PIS and PA (P < .05). CONCLUSIONS Pregnancy intentions were associated with some healthier preconception behaviors in AYA survivors. Medical professionals caring for AYA survivors may consider pregnancy intention screening to guide conversations on preconception health.
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Affiliation(s)
- Hena Naz Din
- School of Public Health, San Diego State University, San Diego, California
| | - David Strong
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California
- Moores Cancer Center, University of California San Diego, La Jolla, California
| | | | - Heather L. Corliss
- School of Public Health, San Diego State University, San Diego, California
- Center for Research on Sexuality and Sexual Health, Institute for Behavioral and Community Health, San Diego State University, San Diego, California
| | - Sheri J. Hartman
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California
- Moores Cancer Center, University of California San Diego, La Jolla, California
| | - Hala Madanat
- School of Public Health, San Diego State University, San Diego, California
- Division of Research & Innovation, San Diego State University, San Diego, California
- Institute for Behavioral and Community Health, San Diego State University, San Diego, California
| | - H. Irene Su
- Division of Reproductive Endocrinology and Infertility, University of California San Diego, San Diego, California
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11
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Ishiki H, Hirayama T, Horiguchi S, Iida I, Kurimoto T, Asanabe M, Nakajima M, Sugisawa A, Mori A, Kojima Y, Udagawa R, Tsuchiya H, Oki M, Shimizu M, Yanai Y, Touma S, Nozawa K, Kojima R, Inamura N, Maehara A, Suzuki T, Satomi E. A Support System for Adolescent and Young Adult Patients with Cancer at a Comprehensive Cancer Center. JMA J 2022; 5:44-54. [PMID: 35224259 PMCID: PMC8827278 DOI: 10.31662/jmaj.2021-0106] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/05/2021] [Indexed: 01/08/2023] Open
Abstract
Cancer patients in adolescents and young adults (AYA) generation aged 15-39 years have various psychosocial needs during their treatment course such as school enrollment, finding employment, marriage, and fertility. It is difficult for medical professionals to gain experience related to providing medical care and consultation support to these kinds of AYA generation cancer patients. There is a need to provide information and establish both support and medical care systems that are able to meet the diverse needs unique to this generation. This review will explain how to launch an AYA support team (AST). We have worked and established the AST since 2016, which is medical care teams that provide support according to the life stage of each individual patient and build a multidisciplinary AYA generation patient support system. The team-building process consisted of two main projects: building and enlarging multidisciplinary team and establishing screening process of psychosocial needs of AYA generation patients. Multidisciplinary healthcare professionals got involved in the AST with already-existing patient support functions in our center: the patient support center, which is an outpatient department and the palliative care team, which is an inpatient interdepartmental team. The AST systematically finds patients in need of assistance and offers them support as a multidisciplinary team. The AST also established a procedure that systematically gathers information about the needs of patients by using a screening tool. In addition, the AST provides the following specialized services: reproductive medicine, supporting cancer patients with children, employment support, and peer support. The AST has been established and sophisticatedly worked. It can flexibly provide various psychosocial support services. This review will explain how to launch an AST.
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Affiliation(s)
- Hiroto Ishiki
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Takatoshi Hirayama
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Saki Horiguchi
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Ikumi Iida
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Tamae Kurimoto
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Mihoko Asanabe
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Miho Nakajima
- Department of Pediatric Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Akiko Sugisawa
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Ayako Mori
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Yuki Kojima
- Department of Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Ryoko Udagawa
- Department of Pharmacy, National Cancer Center Hospital, Tokyo, Japan
| | - Hayato Tsuchiya
- Nutrition Management Office, National Cancer Center Hospital, Tokyo, Japan
| | - Mami Oki
- Department of Rehabilitation, National Cancer Center Hospital, Tokyo, Japan
| | - Mariko Shimizu
- Center for Physician Referral and Medical Social Service, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Yanai
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Shoko Touma
- Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan
| | - Keiko Nozawa
- Appearance Support Center, National Cancer Center Hospital, Tokyo, Japan
| | - Rebekah Kojima
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan
| | - Naoko Inamura
- Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Asami Maehara
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Department of Nursing, National Cancer Center Hospital, Tokyo, Japan
| | - Tatsuya Suzuki
- Department of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan.,Center for Physician Referral and Medical Social Service, National Cancer Center Hospital, Tokyo, Japan
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12
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Stroske I, Geue K, Friedrich M, Sender A, Schmidt R, Richter D, Leuteritz K. Health Behavior and Associated Factors in Young Adult Cancer Patients. Front Psychol 2021; 12:697096. [PMID: 34539494 PMCID: PMC8440830 DOI: 10.3389/fpsyg.2021.697096] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/09/2021] [Indexed: 11/15/2022] Open
Abstract
Objectives: Having cancer in young adulthood increases the risk of adverse long-term health effects. These risks can be influenced by one's health behavior (HB). The aim of this study is therefore to investigate the presence of health behavior in adolescents and young adults (AYAs) and to identify associated factors. Design: Young cancer patients (18-39 years old at time of diagnosis) were surveyed at baseline and 12 months later via online or as a paper-pencil version. Methods: A spectrum of indicators for HB was assessed via seven items from the Questionnaire of Multiple Health Behavior (MHB). Multiple linear regression analyses were conducted to determine factors associated with patients' HB indicators. Results: Five-hundred and fourteen AYAs (75% women) reported the highest level of health-conscious behavior for "avoidance of consumption of nicotine," "follow medical recommendations," and "being considerate in road traffic." Less health-conscious behavior was reported for "keeping an appropriate and balanced diet" and "physical activity." Significant improvements from baseline to the follow-up were observed for "regularly attending health screening" (Hedges' g = 0.44). The analyzed factors explained up to 10% of the HB indicators. Women reported significantly more health-conscious behavior than men in four out of seven HB indicators. Higher quality of life (QoL) was associated with more health behavior in three out of seven HB indicators. Conclusion: Findings show a predominantly health-conscious lifestyle in AYA cancer patients, though we also found harmful behavior which needs to be better approached-e.g., through improving AYAs' health education. AYA men should be particularly targeted in specific prevention and health promotion measures. Future work should identify other factors associated with HB to evaluate targets for intervention.
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Affiliation(s)
- Isabelle Stroske
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Kristina Geue
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Michael Friedrich
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Annekathrin Sender
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Ricarda Schmidt
- Clinic and Polyclinic for Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - Diana Richter
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Katja Leuteritz
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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13
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Schulte FSM, Chalifour K, Eaton G, Garland SN. Quality of life among survivors of adolescent and young adult cancer in Canada: A Young Adults With Cancer in Their Prime (YACPRIME) study. Cancer 2020; 127:1325-1333. [PMID: 33332603 DOI: 10.1002/cncr.33372] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 11/13/2020] [Accepted: 11/16/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The quality of life (QoL) among survivors of adolescent and young adult (AYA) cancer may be compromised compared with that in the general population. In this study, the authors: 1) assessed for differences in QoL among a national study of AYA cancer survivors compared with the Canadian population and 2) explored the factors associated with poorer QoL in AYA cancer survivors. METHODS For the current research, data from the Young Adults With Cancer in Their Prime study were used. QoL was measured using physical and mental component scores from a 12-item short-form health status measure. A comparison group was derived from the Canadian Community Health Survey. RESULTS AYAs (n = 195; 17.8% male; mean ± SD: 35.62 ± 6.89 years on study, 6.48 ± 5.73 years from treatment) were compared with a comparison sample (n = 665; 21.2% male). Among survivors, 31.8% reported poor physical health, and 49.7% reported poor mental health. Compared with the general population, AYAs had significantly lower physical health (F[1,818] = 52.80; P = .00) and mental health (F[1,818] = 83.54; P = .00), controlling for sex and age. Multivariable logistic regression analyses revealed that an annual income level <$40,000 (adjusted odds ratio [AOR], 8.32; 95% CI, 2.85-24.30), poor sleep quality (AOR, 1.19; 95% CI, 1.06-1.33), worse body image (AOR, 1.08; 95% CI, 1.02-1.14), and higher social support (AOR, 1.02; 95% CI, 1.00-1.05) were significantly associated with poor physical health. Poor sleep quality (AOR, 1.22; 95% CI, 1.08-1.38), body image (AOR, 1.06; 95% CI, 1.01-1.12), fear of cancer recurrence (AOR, 1.13; 95% CI, 1.06-1.21) were associated with poor mental health. CONCLUSIONS The QoL of AYAs requires urgent attention. Sleep, body image, and social support may be important modifiable targets for intervention to improve their QoL.
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Affiliation(s)
- Fiona S M Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.,Department of Hematology, Oncology, and Transplant program, Alberta Children's Hospital, Calgary, Alberta, Canada
| | | | - Geoff Eaton
- Young Adult Cancer Canada, St John's, Newfoundland, Canada
| | - Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University of Newfoundland, St John's, Newfoundland, Canada
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14
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Kosir U, Bowes L, Taylor RM, Gerrand C, Windsor R, Onasanya M, Martins A. Psychological adaptation and recovery in youth with sarcoma: a qualitative study with practical implications for clinical care and research. BMJ Open 2020; 10:e038799. [PMID: 33234628 PMCID: PMC7684813 DOI: 10.1136/bmjopen-2020-038799] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES This study explored factors that play a role in psychological adaptation and recovery of young people with sarcoma. DESIGN Qualitative study. SETTING National Health Service hospitals in the UK. METHODS Using purposive sampling, participants were recruited for semistructured interviews over the telephone or face to face in order to answer questions about how cancer impacted various domains of their life. Data were analysed using a framework approach. RESULTS Thirty participants, aged 15-39 years with primary sarcoma diagnosis provided in-depth accounts of their experience. Emerging themes from the interviews were grouped into two overarching themes that relate to one's adaptation to illness: individual level and environmental level. The qualitative nature of our study sheds light on meaningful connections between various factors and their role in one's psychological adaptation to sarcoma. We devised a visual matrix to illustrate how risk and protective factors in adaptation vary between and within individuals. CONCLUSIONS This study demonstrates that young people with sarcoma report an array of both positive and negative factors related to their illness experience. The route to recovery is a multifactorial process and a one-size-fits-all approach to psychosocial care proves inadequate. We propose that moving beyond the latent constructs of resilience and psychopathology towards a dynamic model of psychological adaptation and recovery in this population can result in optimisation of care. We offer some recommendations for professionals working with young people with sarcoma in clinic and research.
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Affiliation(s)
- Urska Kosir
- Department of Experimental Psychology, Oxford University, Oxford, Oxfordshire, UK
| | - Lucy Bowes
- Department of Experimental Psychology, Oxford University, Oxford, Oxfordshire, UK
| | - Rachel M Taylor
- Cancer Clinical Trials, University College Hospitals NHS Foundation Trust, London, UK
- Centre for Nurse, Midwife and AHP Led Research (CNMAR), University College London Hospitals NHS Foundation Trust, London, UK
| | - Craig Gerrand
- Sarcoma Service, Royal National Orthopaedic Hospital NHS Trust, Stanmore, UK
| | - Rachael Windsor
- Paediatric & Adolescent Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Maria Onasanya
- Paediatric & Adolescent Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Ana Martins
- Paediatric & Adolescent Division, University College London Hospitals NHS Foundation Trust, London, UK
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15
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Fuemmeler BF, Holzwarth E, Sheng Y, Do EK, Miller CA, Blatt J, Rosoff PM, Østbye T. Mila Blooms: A Mobile Phone Application and Behavioral Intervention for Promoting Physical Activity and a Healthy Diet Among Adolescent Survivors of Childhood Cancer. Games Health J 2020; 9:279-289. [PMID: 32391734 DOI: 10.1089/g4h.2019.0060] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Objectives: Smartphone applications ("apps") can be used to promote health behavior change and expand the reach of behavioral interventions. To date, only a few existing apps have been developed for health promotion among adolescent survivors of childhood cancer. To address this gap, we developed an app-based intervention, using game design characteristics, theory-based behavioral strategies, and assistance from a health coach to motivate health behavior change for adolescent survivors of childhood cancer. This article describes the development and initial feasibility evaluation of the intervention. Methods: Using a theoretical framework and an extensive formative process, we developed an app-based game ("Mila Blooms") that promotes healthy eating and physical activity among adolescent survivors of childhood cancer. A single-arm 8-week intervention, using this app-based game, with assistance from a health coach, was conducted among a sample of pediatric cancer survivors (n = 15) to evaluate its initial feasibility for promoting health behavior change. Results: Results from the feasibility evaluation were encouraging. The majority of enrolled participants were retained throughout the 8-week intervention (93.8%). Participant satisfaction feedback indicated positive experiences, related to ease of use and enjoyment of the app. Although there was little evidence for behavior change attributable to the app in this first stage of development, there was a solid demonstration of the viability and appeal of the game features, and there were no adverse side effects. Conclusions: Results provide insights into how gamification can be used to promote health behaviors through an app-based intervention. Mila Blooms holds promise for promoting health behavior change. Lessons learned from our experiences could be useful for the future development and implementation of app-based adolescent health interventions.
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Affiliation(s)
- Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | | | - Yaou Sheng
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Elizabeth K Do
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Carrie A Miller
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, Virginia
| | - Julie Blatt
- Department of Pediatric Hematology Oncology Program, University of North Carolina, Chapel Hill, Chapel Hill, North Carolina
| | - Philip M Rosoff
- Department of Pediatrics and Medicine, Duke University, Durham, North Carolina
| | - Truls Østbye
- Department of Family Medicine and Community Health, Duke University, Durham, North Carolina
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16
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Asvat Y, King AC, Smith LJ, Lin X, Hedeker D, Henderson TO. Substance use behaviors in adolescent and young adult cancer patients: Associations with mental and physical health. Psychooncology 2020; 29:1068-1076. [PMID: 32154963 DOI: 10.1002/pon.5378] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 02/25/2020] [Accepted: 03/03/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Cancer diagnosis in adolescents and young adults (AYAs) coincides with the developmental initiation of substance use and emergence of affective disturbance. We examined substance use behaviors and risk-stratified associations with mental and physical health, as well as objective indicators of tobacco and cannabis use and concordance with self-report and medical records. METHODS AYAs were 15 to 39 years at cancer diagnosis and ≥18 years and ≥6 months postdiagnosis at study enrollment. Risk-stratified groups included nonsmoker/nondrinker, nonsmoker/drinker, smoker/drinker. Assessments included demographics, past year tobacco, alcohol, and cannabis use, depression, anxiety, sleep, and physical activity. Urine analysis provided biochemical verification of tobacco and cannabis use. RESULTS Participants included 100 AYAs (60% male) with primarily hematological cancers (88%). Past year alcohol, tobacco, and cannabis use prevalence rates were 80%, 15%, and 33%, respectively. A minority (non-users) refrained from both alcohol and tobacco (20%), while most were exclusively alcohol users (65%) or alcohol and tobacco co-users (15%). Relative to other sub-groups, co-users reported more depressive and anxious symptoms, while non-users reported more physical activity. More frequent tobacco and cannabis use were associated with more depressive and anxious symptoms, while more frequent alcohol use was associated with lower physical activity. There were no group differences or associations with sleep quality. There was considerable discordance between tobacco use self-report, biochemical verification, and medical record documentation. CONCLUSIONS Substance use among AYAs is common and detrimental to mental and physical health, especially among more frequent users and co-users, highlighting the need for early assessment and intervention.
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Affiliation(s)
- Yasmin Asvat
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Andrea C King
- Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Lia J Smith
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Xiaolei Lin
- School of Data Science, Fudan University, Shanghai, China, USA
| | - Donald Hedeker
- Department of Public Health Sciences and College, University of Chicago, Chicago, Illinois, USA
| | - Tara O Henderson
- Department of Pediatrics, University of Chicago, Chicago, Illinois, USA
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17
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Perez GK, Salsman JM, Fladeboe K, Kirchhoff AC, Park ER, Rosenberg AR. Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship. Am Soc Clin Oncol Educ Book 2020; 40:1-15. [PMID: 32324424 PMCID: PMC7328818 DOI: 10.1200/edbk_279787] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Research on adolescents and young adults (AYAs) with cancer has flourished over the past decade, underscoring the unique medical and psychosocial needs of this vulnerable group. A cancer diagnosis during adolescence and young adulthood intersects with the developmental trajectory of AYAs, derailing critical physical, social, and emotional development. AYAs face these abrupt life changes needing age-appropriate information and resources to offset these challenges. Greater attention is needed to address AYA-specific concerns on reproductive and sexual health, financial security and independence, emotional well-being, social support, and end-of-life care. If these unique needs are unaddressed, this can adversely affect AYAs' health care engagement and overall quality of life, increasing their risk for cancer-related morbidity and early mortality. In particular, health care decisions made during treatment have important implications for AYA patients' future health. Oncology clinicians are well positioned to address AYA patients' concerns by anticipating and addressing the challenges this age group is likely to face. In this paper, we explore several core topics that affect AYAs' quality of life and that can be challenging to address. Starting from the moment of diagnosis, through cancer treatment and post-treatment survivorship, and into end of life, each section highlights critical developmental-centric life domains that are affected by the cancer experience. Specifically, we discuss resources, tools, and strategies to navigate these challenging conversations. Taking a risk-reduction approach that invites two-way communication and facilitates referral to age-appropriate resources would help destigmatize these experiences and, in turn, would support the provision of compassionate and effective age-concordant care to this vulnerable group.
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Affiliation(s)
- Giselle K. Perez
- Harvard Medical School/Massachusetts General Hospital, Boston, MA
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, MA
| | - John M. Salsman
- Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Kaitlyn Fladeboe
- Seattle Children’s Research Institute, University of Washington, Seattle, WA
| | - Anne C. Kirchhoff
- Huntsman Cancer Institute and Department of Pediatrics, University of Utah, Salt Lake City, UT
| | - Elyse R. Park
- Harvard Medical School/Massachusetts General Hospital, Boston, MA
- Mongan Institute Health Policy Research Center, Massachusetts General Hospital, Boston, MA
| | - Abby R. Rosenberg
- Seattle Children’s Research Institute, University of Washington, Seattle, WA
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18
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Pugh G, Hough R, Gravestock H, Fisher A. The health behaviour status of teenage and young adult cancer patients and survivors in the United Kingdom. Support Care Cancer 2020; 28:767-777. [PMID: 31144171 PMCID: PMC6954124 DOI: 10.1007/s00520-019-04719-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 02/26/2019] [Indexed: 01/21/2023]
Abstract
PURPOSE The primary aim of this study was to investigate the health behaviour status of teenage and young adult (TYA) cancer patients and survivors; the secondary aim was to determine if TYA cancer patients and survivors health behaviour differs to general population controls. METHODS Two hundred sixty-seven young people with cancer (n =83 cancer patients receiving active treatment: n =174 cancer survivors, 57.1% >1 year since treatment completion) and 321 controls completed a health and lifestyle questionnaire which included validated measures of physical activity (PA) (Godin Leisure Time Exercise Questionnaire), diet (Dietary Instrument for Nutrition Education, DINE), smoking status, and alcohol consumption (AUDIT-C). RESULTS General population controls and cancer survivors were more likely to meet current (PA) recommendations (p <0.001) than TYA cancer patients undergoing treatment (54.8% vs 52.3% vs 30.1%, respectively). Less than 40% of young people with cancer and controls met fat intake, sugar intake, fibre intake or current fruit and vegetable recommendations. TYA cancer survivors were more likely to report binge drinking than controls (OR=3.26, 95% CI 2.12-5.02, p <0.001). Very few young people with in the study were current smokers. The majority of TYA cancer patients and survivors reported a desire to make positive changes to their health behaviour. CONCLUSION Consideration should be given to whether existing health behaviour change interventions which have demonstrated positive effects among the general TYA population could be adapted for young people with cancer.
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Affiliation(s)
- G. Pugh
- Centre for Sports & Exercise Medicine, William Harvey Research Institute, Queen Mary University of London, Mile End Hospital, Bancroft Road, London, E1 4DG UK
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
| | - R. Hough
- Department of Haematology, University College London Hospital, London, UK
| | - H. Gravestock
- CLIC Sargent, No.1 Farriers Yard, L77-85 Fulham Palace Road, London, W6 8JA UK
| | - A. Fisher
- Department of Behavioural Science & Health, University College London, 1-19 Torrington Place, London, WC1E 6BT UK
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19
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Garrido Casas J, Menéndez Llaneza C, Pico Gómez-Pavón P, Cal López MÁDL, Bozalongo S, Torrado Val E. Hospital care for adolescents with cancer in Spain: Needs, resources and organisational model. ENFERMERÍA CLÍNICA (ENGLISH EDITION) 2019; 31:227-233. [PMID: 34243910 DOI: 10.1016/j.enfcle.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 07/21/2019] [Indexed: 11/17/2022]
Abstract
In Spain, adolescents with cancer are treated in Pediatric Onco-Hematology Units or in Adult Oncology Units. For this reason, the Spanish Federation of Parents of Children with Cancer carried out two surveys in 2013 and 2014 to know the differences in provision of psico-social services to the patients and their relatives among both types of Units. Twenty eight Pediatric and 18 Adult Units provided information. The results showed that the Pediatric Units were better adapted to the needs of the adolescent and family patients and to Spanish Health Authorities recommendations: more appropriate environment, resources for education and leisure, facilities to parents and relatives. Specialized Psycosocial care by psychologists and social workers is insufficient in both cases and the compliance with national and international recommendations is weak. However, specific adolescents' Units are starting to be created in Spain, following the experiences in other countries that define the new role of nurse as an essential linchpin in the care team.
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Affiliation(s)
| | | | | | | | - Silvia Bozalongo
- Asociación Riojana de Familiares y Amigos de Niños con Cáncer, Logroño, La Rioja, Spain
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20
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Garrido Casas J, Menéndez Llaneza C, Pico Gómez-Pavón P, de la Cal López MÁ, Bozalongo S, Torrado Val E. Hospital care for adolescents with cancer in Spain: Needs, resources and organisational model. ENFERMERIA CLINICA 2019; 31:S1130-8621(19)30288-8. [PMID: 31445823 DOI: 10.1016/j.enfcli.2019.07.004] [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: 04/18/2018] [Revised: 05/17/2019] [Accepted: 07/21/2019] [Indexed: 11/23/2022]
Abstract
In Spain, adolescents with cancer are treated in paediatric onco-haematology units or in adult oncologyunits. For this reason, the Spanish Federation of Parents of Children with Cancer carried out 2 surveys, one in 2013 and other in 2014, to determine the differences in provision of psycho-social services to the patients and their relatives between the 2 types of units. Twenty-eight paediatric and 18 adult units provided information. The results showed that the paediatric units were better adapted to the needs of the adolescent and family patients and to Spanish health authority recommendations: more appropriate environment, resources for education and leisure, facilities for parents and relatives. Specialised psycho-social care from psychologists and social workers is insufficient in both cases and the compliance with national and international recommendations is weak. However, specific units for adolescents are starting to be created in Spain, following the experiences in other countries that define the new role of the nurse as an essential linchpin in the care team.
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Affiliation(s)
| | | | | | | | - Silvia Bozalongo
- Asociación Riojana de Familiares y Amigos de Niños con Cáncer, Logroño, La Rioja, España
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21
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Physical Activity and Quality of Life of Healthy Children and Patients with Hematological Cancers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16152776. [PMID: 31382561 PMCID: PMC6696059 DOI: 10.3390/ijerph16152776] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 07/13/2019] [Accepted: 08/01/2019] [Indexed: 01/23/2023]
Abstract
The aim was to assess the level of physical activity and the quality of life of children undergoing cancer treatment, during and after the completion of the treatment. Eighty-eight children aged 11–15 were enrolled. Three groups of children were assessed, i.e., children undergoing cancer treatment (n = 30), children after cancer treatment (n = 28), and healthy children (n = 30). The level of physical activity in children was assessed using the questions from the Health Behavior in School-Aged Children (HBSC) questionnaire. The assessment of children’s quality of life was conducted using the KIDSCREEN-10 Index. The chi-square test was used to assess the statistical significance of the differences in the results between the study groups in the case of both HBSC and KIDSCREEN-10 questionnaires. Children undergoing cancer treatment did not perform any physical activity of at least 60 min (in total) per day, during the week. Therefore, they did not meet the recommendations related to the appropriate level of daily physical activity (Moderate-to-Vigorous Physical Activity; MVPA). Children after cancer treatment and healthy children significantly more frequently undertook physical activity. The quality of life of children with cancer is significantly lower and different from the quality of life of healthy children.
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23
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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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24
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Yurkiewicz IR, Simon P, Liedtke M, Dahl G, Dunn T. Effect of Fitbit and iPad Wearable Technology in Health-Related Quality of Life in Adolescent and Young Adult Cancer Patients. J Adolesc Young Adult Oncol 2018; 7:579-583. [PMID: 29924668 DOI: 10.1089/jayao.2018.0022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Adolescent and young adult (AYA) patients with cancer face significant challenges with regard to fatigue, reduced physical activity, and social isolation, which may negatively impact quality of life. This study investigated whether the use of digital wearable technology (Fitbits, along with synced iPads) can affect health-related quality of life (HRQOL) in AYA aged patients with cancer. MATERIALS AND METHODS This was a prospective cohort study that offered Fitbits and iPads to all AYA patients aged 15 to 29 at an academic medical center at the time of cancer diagnosis. Patients completed the Short Form Health Survey developed by RAND (RAND-36) assessing eight dimensions of HRQOL on entering the study and at the time of their 6-month follow-up or the end of treatment, whichever occurred first. At the time of follow-up, patients also completed a questionnaire that assessed user experience, including frequency of wearable device use, enjoyment, challenges, and participation, in online communities. RESULTS Thirty-three patients participated in the study. Most patients reported enjoying the digital technology and using the devices to track multiple aspects of their health (85%). Most also reported a subjective increase in physical activity (79%). After the intervention, participants demonstrated significant improvements across all eight dimensions of HRQOL measured by the RAND-36 (p < 0.00 to 0.01). CONCLUSION Distributing wearable technology at the time of diagnosis may provide an avenue for improving HRQOL in adolescents and young adults with cancer.
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Affiliation(s)
- Ilana R Yurkiewicz
- 1 Division of Hematology, Department of Medicine, Stanford University School of Medicine , Palo Alto, California
| | - Pamela Simon
- 2 Department of Pediatric Hematology-Oncology, Lucille Packard Children's Hospital Stanford , Palo Alto, California
| | - Michaela Liedtke
- 1 Division of Hematology, Department of Medicine, Stanford University School of Medicine , Palo Alto, California
| | - Gary Dahl
- 2 Department of Pediatric Hematology-Oncology, Lucille Packard Children's Hospital Stanford , Palo Alto, California
| | - Tamara Dunn
- 1 Division of Hematology, Department of Medicine, Stanford University School of Medicine , Palo Alto, California
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25
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Chan A, Poon E, Goh WL, Gan Y, Tan CJ, Yeo K, Chua A, Chee M, Law YC, Somasundaram N, Kanesvaran R, Ng QS, Tham CK, Toh CK, Lim ST, Tao M, Tang T, Quek R, Farid M. Assessment of psychological distress among Asian adolescents and young adults (AYA) cancer patients using the distress thermometer: a prospective, longitudinal study. Support Care Cancer 2018; 26:3257-3266. [DOI: 10.1007/s00520-018-4189-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 03/28/2018] [Indexed: 11/30/2022]
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26
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A New Lease on Life: Preliminary Needs Assessment for the Development of a Survivorship Program for Young Adult Survivors of Cancer in South Texas. J Pediatr Hematol Oncol 2018; 40:e154-e158. [PMID: 28991132 PMCID: PMC5866154 DOI: 10.1097/mph.0000000000000990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Priorities for young adult survivorship care from the survivors' perspective are not well documented. To address this within our patient population, we conducted a multimethod needs assessment of young adult survivors of pediatric, adolescent, and young adult cancer in South Texas to get a better understanding of the ongoing challenges and priorities for their survivorship needs and related services. Participants were 18 to 39 years at the time of the needs assessment and predominately Hispanic. In an online survey, survivors most commonly cited being concerned about their physical and mental health, long-term treatment effects, recurrence, and health insurance issues. Participants stated that they received critical support from family, friends, and medical staff, but they would like to receive additional support from other cancer survivors through peer mentorship opportunities and survivor retreats/social events.
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27
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Valle CG, Tate DF. Engagement of young adult cancer survivors within a Facebook-based physical activity intervention. Transl Behav Med 2017; 7:667-679. [PMID: 28374211 PMCID: PMC5684071 DOI: 10.1007/s13142-017-0483-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
Few studies have examined how young adult cancer survivors use online social media. The objective of this study was to characterize Facebook engagement by young adult cancer survivors in the context of a physical activity (PA) intervention program. Young adult cancer survivors participated in one of two Facebook groups as part of a 12-week randomized trial of a PA intervention (FITNET) compared to a self-help comparison (SC) condition. A moderator actively prompted group discussions in the FITNET Facebook group, while social interaction was unprompted in the SC group. We examined factors related to engagement, differences in engagement by group format and types of Facebook posts, and the relationship between Facebook engagement and PA outcomes. There were no group differences in the number of Facebook comments posted over 12 weeks (FITNET, 153 vs. SC, 188 p = 0.85) or the proportion of participants that reported engaging within Facebook group discussions at least 1-2 days/week. The proportion of participants that made any posts decreased over time in both groups. SC participants were more likely than FITNET participants to agree that group discussions caused them to become physically active (p = 0.040) and that group members were supportive (p = 0.028). Participant-initiated posts elicited significantly more comments and likes than moderator-initiated posts. Responses posted on Facebook were significantly associated with light PA at 12 weeks (β = 11.77, t(85) = 1.996, p = 0.049) across groups. Engagement within Facebook groups was variable and may be associated with PA among young adult cancer survivors. Future research should explore how to promote sustained engagement in online social networks. ClinicalTrials.gov identifier: NCT01349153.
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Affiliation(s)
- Carmina G Valle
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
| | - Deborah F Tate
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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28
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Reed DR, Oshrine B, Pratt C, Fridgen O, Elstner C, Wilson L, Soliman H, Lee MC, McLeod HL, Shah B, Donovan KA, Pabbathi S, Turney M, Binitie O, Healy C, Nieder M, Shaw PH, Galligan A, Letson GD, Stern M, Quinn GP, Davies S. Sink or Collaborate: How the Immersive Model Has Helped Address Typical Adolescent and Young Adult Barriers at a Single Institution and Kept the Adolescent and Young Adult Program Afloat. J Adolesc Young Adult Oncol 2017; 6:503-511. [PMID: 28777007 PMCID: PMC5725631 DOI: 10.1089/jayao.2017.0051] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Damon R Reed
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida.,5 Department of Individualized Cancer Management, Personalized Medicine Institute , Moffitt Cancer Center, Tampa, Florida
| | - Benjamin Oshrine
- 3 Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital , St. Petersburg, Florida
| | - Christie Pratt
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida
| | - Olivia Fridgen
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida
| | - Cathy Elstner
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida
| | - Leila Wilson
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida
| | - Hatem Soliman
- 4 Breast Oncology, Moffitt Cancer Center , Tampa, Florida
| | - Marie C Lee
- 4 Breast Oncology, Moffitt Cancer Center , Tampa, Florida
| | - Howard L McLeod
- 5 Department of Individualized Cancer Management, Personalized Medicine Institute , Moffitt Cancer Center, Tampa, Florida
| | - Bijal Shah
- 6 Malignant Hematology, Moffitt Cancer Center , Tampa, Florida
| | | | - Smitha Pabbathi
- 8 Internal Medicine Department and Survivorship Program, Moffitt Cancer Center , Tampa, Florida
| | - Mary Turney
- 9 Patient and Family Services, Moffitt Cancer Center , Tampa, Florida
| | - Odion Binitie
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,2 Sarcoma Department, Moffitt Cancer Center , Tampa, Florida
| | - Christine Healy
- 9 Patient and Family Services, Moffitt Cancer Center , Tampa, Florida
| | | | - Peter H Shaw
- 3 Cancer and Blood Disorders Institute, Johns Hopkins All Children's Hospital , St. Petersburg, Florida
| | - Andrew Galligan
- 11 Department of Pediatrics, University of South Florida , Tampa, Florida
| | | | - Marilyn Stern
- 12 Department of Child and Family Studies, University of South Florida , Tampa, Florida.,13 Health Outcomes and Behavior Program, Moffitt Cancer Center , Tampa, Florida
| | - Gwendolyn P Quinn
- 1 Adolescent and Young Adult Oncology Program, Moffitt Cancer Center , Tampa, Florida.,13 Health Outcomes and Behavior Program, Moffitt Cancer Center , Tampa, Florida
| | - Simon Davies
- 14 Teen Cancer America , Los Angeles, California
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Pugh G, Hough R, Gravestock H, Williams K, Fisher A. Lifestyle advice provision to teenage and young adult cancer patients: the perspective of health professionals in the UK. Support Care Cancer 2017; 25:3823-3832. [PMID: 28726067 DOI: 10.1007/s00520-017-3814-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 07/03/2017] [Indexed: 01/22/2023]
Abstract
PURPOSE Health professionals are an important source of information for teenage and young adult (TYA) cancer patients. However, little is known about health professionals' provision of lifestyle advice to young people with cancer who are in their care. METHODS An online survey was distributed to health professionals within the UK who identified themselves as working with TYA cancer patients. Health professional awareness of lifestyle guidance, provision of lifestyle advice to young people and views on lifestyle information format and delivery were explored. RESULTS Ninety-five health professionals (44% nurses; 28% allied health professionals; 17% physicians) completed the survey. The majority (72%) of respondents were aware of some lifestyle guidance for cancer patients. However, less than half of TYA health professionals (46%) were able to successfully recall the source of the guidelines and less than a third reported proving specific advice to the majority of their patients on weight management, smoking, alcohol consumption and sun safety. Many health professionals (38%) felt that they were not the right person to provide advice and cited lack of resources as a key barrier to advice provision. The majority (95%) reported being interested in a resource containing relevant lifestyle information that could be given to young people with cancer. CONCLUSIONS TYA health professionals' awareness of lifestyle guidance and provision of advice regarding health behaviour is sub-optimal. Clear and comprehensive guidance written specifically for TYA health professionals could overcome the reported barriers and improve professionals' confidence in addressing and providing advice on lifestyle to young people with cancer.
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Affiliation(s)
- Gemma Pugh
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Rachael Hough
- University College Hospital's NHS Foundation Trust, 235 Euston Rd, London, NW1 2BU, UK
| | - Helen Gravestock
- CLIC Sargent, No. 1 Farriers Yard, Assembly London, 77-85 Fulham Palace Road, London, W6 8JA, UK
| | - Kate Williams
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK
| | - Abigail Fisher
- Health Behaviour Research Centre, University College London, 1-19 Torrington Place, London, WC1E 6BT, UK.
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Viola A, Mitchell HR, Salner A, Gillan E, Rotatori J, Cartmel B, Santacroce S, Ma X, Kadan-Lottick N. Survivorship Care Preferences: A Pilot Study of Young Adults With Cancer. Clin J Oncol Nurs 2017; 21:E71-E78. [PMID: 29658261 DOI: 10.1188/17.cjon.e71-e78] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Adolescents and young adults (AYAs) face increased risk for physical, social, and cognitive late complications of cancer therapy. Strategies are needed to better engage AYAs in survivorship research. Objectives This study aimed to determine the feasibility of enrolling AYAs within six months of diagnosis to a survivorship study and assess their health concerns and survivorship care preferences. Methods Patients aged 15–34 years who were diagnosed with leukemia, lymphoma, or sarcoma at three Connecticut hospitals from 2008–2011 were identified and recruited by mail. Participants and their physicians received a survivorship care plan. Participants completed surveys at 6 months and 18 months after diagnosis. Findings Recruiting AYAs to survivorship research remains challenging, even when approaching them soon after diagnosis. Novel strategies are needed for nurses and other healthcare team members to engage AYAs in survivorship care and research.
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Vollmer Dahlke D, Fair K, Hong YA, Kellstedt D, Ory MG. Adolescent and Young Adult Cancer Survivorship Educational Programming: A Qualitative Evaluation. JMIR Cancer 2017; 3:e3. [PMID: 28410172 PMCID: PMC5392208 DOI: 10.2196/cancer.5821] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Revised: 11/29/2016] [Accepted: 01/05/2017] [Indexed: 01/17/2023] Open
Abstract
Background This program evaluation considers the need for increased professional and patient education for adolescent and young adult (AYA) cancer survivorship. Due to the high incidence of late effects of cancer treatment among AYA cancer survivors, knowledge sharing and communications are needed throughout the transition from cancer care into community care. AYA survivors are likely to need developmentally appropriate psychosocial care as well as extensive follow-on surveillance by physicians who are educated and aware of the likely chronic conditions and late effects that may occur in these patients. Objective The objective of this study was to evaluate the outcomes of the After Cancer Care Ends, Survivorship Starts for Adolescent and Young Adults (ACCESS AYA) programming. The intent of the ACCESS AYA program was to build health literacy around AYA survivorship issues and to stimulate improved communications between survivors and health care providers. This paper addresses the central research question of “How did the ACCESS AYA program increase health literacy, communications, and understanding among AYA survivors and providers?” Methods The primarily qualitative evaluation included a brief introductory survey of participant awareness and effectiveness of the ACCESS AYA project serving as a recruitment tool. Survey respondents were invited to participate in in-depth interviews based on interview guides tailored to the different stakeholder groups. The evaluation used the Atlas Ti qualitative database and software for coding and key word analyses. Interrater reliability analyses were assessed using Cohen kappa analysis with Stata 12.1 (StataCorp LLC) software. Results The key themes, which included survivor wellbeing, health care professional education, cancer advocates role and education, hospital and community-based resources, and the role of societal support, are presented in a concept map. The interrater reliability scores (ranging from 1 to minus 1) were .893 for first cycle coding and .784 for the second cycle. In the brief quantitative survey based on a scale of 1 to 5 with 5 as high, the 22 respondents rated their level of awareness of the project with a mean 3.2 (CI 3.02-3.45) and project effectiveness with a mean of 4 (CI 3.72-4.27). Conclusions This study contributes to understanding of the ACCESS AYA survivor community in central Texas and the health care professionals and advocates who aid them in their efforts to a new normal life and wellbeing in their survivorship. The results of the evaluation highlight the need to continue to build both survivor and professional resources to address the unique impact of cancer on AYA cancer survivors.
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Affiliation(s)
- Deborah Vollmer Dahlke
- Texas A&M School of Public Health, Health Promotion and Community Health Sciences, Texas A&M University, Austin, TX, United States
| | - Kayla Fair
- TX A&M School of Public Health, Health Promotion and Community Health Sciences, Texas A&M University, College Station, TX, United States
| | - Yan Alicia Hong
- TX A&M School of Public Health, Health Promotion and Community Health Sciences, Texas A&M University, College Station, TX, United States
| | - Debra Kellstedt
- TX A&M School of Public Health, Health Promotion and Community Health Sciences, Texas A&M University, College Station, TX, United States
| | - Marcia G Ory
- TX A&M School of Public Health, Health Promotion and Community Health Sciences, Texas A&M University, College Station, TX, United States
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32
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Pugh G, Hough RE, Gravestock HL, Jackson SE, Fisher A. The Health Behavior Information Needs and Preferences of Teenage and Young Adult Cancer Survivors. J Adolesc Young Adult Oncol 2017; 6:318-326. [PMID: 28165844 DOI: 10.1089/jayao.2016.0089] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE This study aimed to establish teenage and young adult cancer survivors (TYACS') specific interest in receiving information on physical activity, diet, smoking, and alcohol consumption and their preferences regarding the delivery, format, and timing of such health behavior information. METHODS TYACS aged 13-25 years were invited to complete a questionnaire assessing the advice they had received in the past and their preferences on when and how health behavior information should be delivered. RESULTS A total of 216 TYACS (mean age: 20 years; mean age at diagnosis: 16 years) completed the questionnaire. Approximately 40% of TYACS received no advice on physical activity and diet, and more than half (54%) received no advice on weight management. The majority (>70%) reported receiving no advice on smoking or alcohol consumption. Interest in receiving lifestyle advice was high overall (71%) but varied across behaviors, with TYACS reporting a greater level of interest in receiving advice on health protective behaviors (physical activity and diet) than health risk behaviors (smoking and alcohol consumption) (∼85% vs. ∼15%, respectively). TYACS reported seeking health behavior information from health professionals and were most interested in information delivered online or in the form of a mobile app. Similar proportions (18%-29%) felt health behavior information should first be provided before, during, immediately after, and post-treatment. CONCLUSIONS It is evident that there is a need to develop lifestyle interventions in a range of formats available to TYACS throughout the care pathway to address the health behavior information needs of young people with cancer.
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Affiliation(s)
- Gemma Pugh
- 1 Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London , London, United Kingdom
| | - Rachael E Hough
- 2 Department of Haematology, University College London Hospital , London, United Kingdom
| | | | - Sarah E Jackson
- 1 Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London , London, United Kingdom
| | - Abigail Fisher
- 1 Department of Epidemiology and Public Health, Health Behaviour Research Centre, University College London , London, United Kingdom
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M Russell A, Galvin KM, Harper MM, Clayman ML. A comparison of heterosexual and LGBTQ cancer survivors' outlooks on relationships, family building, possible infertility, and patient-doctor fertility risk communication. J Cancer Surviv 2016; 10:935-42. [PMID: 26887847 DOI: 10.1007/s11764-016-0524-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Accepted: 02/04/2016] [Indexed: 12/31/2022]
Abstract
PURPOSE Little research about cancer-related infertility has examined the experiences and needs of lesbian, gay, bisexual, transgender, or queer (LGBTQ) cancer survivors. This research seeks to understand how LGBTQ survivors are similar to or different from heterosexual survivors with respect to cancer treatments' effects on relationships, plans for parenthood, and fertility preservation decision making. METHODS Semi-structured telephone interviews conducted with adolescent or young adult (AYA) cancer survivors (n = 56) were coded for themes. Interviews consisted of questions about pre- and post-diagnosis thoughts about relationships, parenthood, possible infertility, and how information about fertility risks was received. RESULTS While LGBTQ (n = 22) and heterosexual (n = 34) survivors reported similar challenges when dating post-diagnosis, heterosexual survivors were more likely to report fertility concerns as affecting romantic relationships (p < .05). LGBTQ survivors seemed more open to raising non-biological children or not becoming a parent than heterosexual survivors. LGBTQ survivors generally reported being satisfied with or indifferent to the information that they were given regarding fertility loss, despite reporting receiving similar amounts of information as compared to heterosexual patients (p < .10). CONCLUSIONS LGBTQ patients' views on relationships, parenthood, and family building seemed to result in less distress when faced with infertility. However, interventions facilitating information exchange about dating, fertility risks, and family building options may be valuable to LGBTQ and heterosexual cancer survivors. IMPLICATIONS FOR CANCER SURVIVORS LGBTQ cancer survivors may display more adaptive coping with respect to relationships and fertility loss. Oncology professionals may want to proactively introduce positive coping strategies to reduce distress among AYA cancer survivors at risk for infertility.
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Affiliation(s)
- Andrea M Russell
- Division of General Internal Medicine, Feinberg School of Medicine, Northwestern University, Evanston, IL, USA
| | - Kathleen M Galvin
- Department of Communication Studies, Northwestern University, Evanston, IL, USA
| | - Maya M Harper
- Biomedical and Health Information Sciences, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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