Feasibility and Preliminary Outcomes From a Pilot Study of Coping Skills Training for Adolescent—Young Adult Survivors of Childhood Cancer and Their Parents Efficacy of the Survivor Health and Resilience Education (SHARE) Program to Improve Bone Health Behaviors Among Adolescent Survivors of Childhood Cancer Peer-delivered smoking counseling for childhood cancer survivors increases rate of cessation: the partnership for health study. The Effects of Physical Activity on Health and Quality of Life in Adolescent Cancer Survivors: A Systematic Review Intervention to reduce intentions to use tobacco among pediatric cancer survivors. Efficacy of an internet-based cognitive-behavioral intervention for long-term survivors of pediatric cancer: a pilot study Internet-Based Physical Activity Intervention Targeting Young Adult Cancer Survivors. Multi-component behavioral intervention to promote health protective behaviors in childhood cancer survivors: the protect study. Testing the effects of a decision-making and risk-reduction program for cancer-surviving adolescents. A randomized controlled pilot trial of a Web-based resource to improve cancer knowledge in adolescent and young adult survivors of childhood cancer. A Substance Use Decision Aid for Medically at-Risk Adolescents: Results of a Randomized Controlled Trial for Cancer-Surviving Adolescents Effect of Internet peer-support groups on psychosocial adjustment to cancer: a randomised study A randomized trial of a Facebook-based physical activity intervention for young adult cancer survivors Increasing rates of breast cancer and cardiac surveillance among high-risk survivors of childhood Hodgkin lymphoma following a mailed, one-page survivorship care plan. A pilot intervention to enhance psychosexual development in adolescents and young adults with cancer. Randomized Trial of a Physical Activity and Meditation Intervention for Young Adult Cancer Survivors.
Uncertainty is a central feature of long-term childhood cancer survivorship during which time it principally has to do with late effects . Therefore , the purpose s of this article are ( a ) to assess feasibility of a r and omized clinical trial of a telephone-delivered coping skills training ( CST ) intervention in terms of recruitment , retention , and timeline , as well as the performance of the study measures ; and ( b ) to demonstrate trends in change on outcomes within the context of a small pilot study . The results of this pilot study suggest that HEROS PLUS CST has clinical relevance and that in-person long-term follow-up plus telephone-delivered psychosocial care is a practical way to deliver integrated care to adolescent — young adult childhood cancer survivors and their parents Purpose The purpose of this study is to test the efficacy of the Survivor Health and Resilience Education Program intervention — a manualized , behavioral intervention focusing on bone health behaviors among adolescent survivors of childhood cancer . Methods Participants were 75 teens aged 11–21 years , one or more years post-treatment , and currently cancer-free . Teens were r and omized to a group-based intervention focusing on bone health or a wait-list control .  Bone health behaviors were assessed at baseline and 1-month post-intervention . Results Controlling for baseline outcome measures and theoretical predictors , milk consumption frequency ( p = 0.03 ) , past month calcium supplementation ( p < 0.001 ) , days in the past month with calcium supplementation ( p < 0.001 ) , and dietary calcium intake ( p = 0.04 ) were significantly greater at 1-month follow-up among intervention participants compared with control participants . Conclusions The intervention had a significant short-term impact on self-reported bone health behaviors among adolescent survivors of childhood cancer . Research examining long-term intervention effectiveness is warranted PURPOSE Cancer survivors smoke at rates that are only slightly lower than the general population . This article reports on the final outcomes of Partnership for Health , a smoking cessation intervention for smokers in the Childhood Cancer Survivors Study ( CCSS ) . METHODS This study is a r and omized control trial with follow-up at 8 and 12 months that involved smokers ( n = 796 ) enrolled onto the CCSS cohort . Participants were r and omly assigned to either a self-help or a peer-counseling program that included up to six telephone calls from a trained childhood cancer survivor , tailored and targeted material s , and free nicotine replacement therapy . The intervention was delivered by telephone and postal service mail . RESULTS The quit rate was significantly higher in the counseling group compared with the self-help group at both the 8-month ( 16.8 % v 8.5 % ; P < .01 ) and 12-month follow-ups ( 15 % v 9 % ; P < or = .01 ) . Controlling for baseline self-efficacy and readiness to change , the intervention group was twice as likely to quit smoking , compared with the self-help group . Smoking cessation rate increased with an increase in the number of counseling calls . The cost of delivering the intervention was approximately 300 dollars per participant . The incremental cost-effectiveness of the intervention compared with controls was 5,371 dollars per additional quit . CONCLUSION Interventions to prevent future illnesses are of critical importance to childhood cancer survivors . The Partnership for Health intervention result ed in a doubling of smoking cessation quit rates . Because of the seriousness of smoking among childhood cancer survivors , this intervention model may be appropriate as a multicomponent treatment program for survivors who smoke Background There are numerous published controlled trials assessing the safety and the benefits of physical activity ( PA ) for child and adult cancer survivors . However , trials exclusively comprised of adolescent cancer survivors aged 13 - 19 years , who may experience different health and quality of life ( QOL ) effects as a function of their developmental status , are lacking . Rather , some trials have included both adolescent and child cancer survivors together . Objective The aim of this systematic review was to synthesize the findings from r and omized controlled trails ( RCTs ) and controlled clinical trials ( CCTs ) investigating the effects of PA on health and QOL outcomes in sample s comprised of > 50 % adolescent cancer survivors to summarize the current state of evidence , identify knowledge gaps , and highlight areas in need of additional research within this population . Methods Using a search strategy developed for this review , 10 electronic data bases were search ed for RCTs and CCTs that reported on the effects of PA on at least 1 health and /or QOL outcome in sample s comprised of > 50 % adolescent cancer survivors . Results From the 2249 articles identified , 2 CCTs met the predetermined eligibility criteria and were included in this review . Combined , 28 adolescents ( of 41 participants ) who were receiving active treatment participated in the 2 studies review ed . A total of 4 health and QOL outcomes ( ie , bone mass , fatigue , grip strength , QOL ) were assessed pre- and post-PA intervention . Conclusions On the basis of the 2 studies review ed , PA appears to be safe and feasible .  PA also shows promise to mitigate reductions in bone mass and might be a viable strategy to improve fatigue , grip strength , and QOL . High- quality controlled trials with larger sample s exclusively comprised of adolescent cancer survivors that assess a wide range of outcomes are needed to determine the effects of PA on health and QOL outcomes in this population PURPOSE In this r and omized controlled trial , we sought to determine whether a risk counseling intervention would increase knowledge and perceived vulnerability to tobacco-related health risks and decrease future intentions to use tobacco among preadolescents and adolescents previously treated for cancer . PATIENT AND METHODS Participants included 103 cancer survivors between the ages of 10 and 18 years who were r and omly assigned to either a  st and ard care control ( SCC ) group or a tobacco intervention ( TI ) group .  Patients in the SCC group received st and ard advice about the risks of tobacco use . Patients in the TI group received more intensive late effects risk counseling in addition to an educational video , goal setting , written physician feedback , smoking literature , and follow-up telephone counseling . The effect of our intervention was assessed by self-reported knowledge , perceived vulnerability , and intentions at baseline , 6 , and 12 months . RESULTS Compared with the SCC group , patients who received our intervention had significantly higher knowledge scores , higher perceived vulnerability scores , and lower intention scores at 12 months . No significant differences between the SCC and TI groups at 6 months , across all measures , were found . CONCLUSION Pediatric survivors '  knowledge , perceived vulnerability to health risks , and intentions to use tobacco can be modified by a risk counseling intervention . The delayed effect of our intervention indicates that these changes may evolve over time . Implication s for health care providers who engage in tobacco counseling with young cancer survivors are discussed . Additional longitudinal studies are needed to determine definitive long-term intervention effects on actual tobacco use in this high-risk population Purpose Long-term survivors of pediatric cancer have an increased risk of post-traumatic stress symptoms ( PTSS ) and dysfunctional anxiety . However , there is a lack of evidence -based psychotherapy tailored to the needs of this target group . In this single-arm pilot study , an Internet-based psychological intervention ( “ Onco-STEP ” ) for adolescent and young adult survivors was developed , and its efficacy in reducing PTSS and anxiety was evaluated . Methods Former patients of pediatric cancer older than 15 years manifesting clinical ly relevant PTSS or anxiety were eligible . The cognitive-behavioral treatment consists of ten writing sessions and comprises two modules : the first aim ing to reprocess the traumatic cancer-related experiences and the second aim ing to build coping strategies with current cancer-related fears . Treatment was delivered via written messages on a secure Internet platform . Outcomes were assessed by the Post-traumatic Stress Diagnostic Scale , the Hospital Anxiety and Depression Scale , and the Fear of Progression/Relapse Question naire . Results A total of 20 participants completed the intervention ( mean age 27.3 ± 4.8 years at study ; 13.8 ± 4.7 years since diagnosis ; 70 % female )  . PTSS , anxiety , and fear of progression/relapse significantly declined at the end of the intervention , with pre – post effect sizes of 0.63 , 0.74 , and 0.48 . In addition , we found a significant decrease in symptoms of depression . Except for the improvement in depression , all effects were sustained 3 months after the end of treatment . Conclusions The results show that the intervention is efficacious in reducing symptoms of post-traumatic stress and anxiety . Onco-STEP is a promising new way to treat young adult long-term survivors of pediatric cancer with late psychological effects . Future efforts need to focus on investigating specific evidence of the intervention in a r and omized controlled trial Purpose : Young adults who have been treated for cancer face several health and psychosocial risks . To minimize these risks , is it imperative that they address any modifiable risk factors , such as sedentary lifestyle . Unfortunately , more than half of young adult cancer survivors remain sedentary . To facilitate the adoption of physical activity ( PA ) in this population -potentially reducing health and psychosocial risks-we developed and pilot tested an internet-based PA intervention for young survivors . Patients and methods : Eighteen young adults , aged 18 to 39 , who had been diagnosed with cancer in the past 10 years were recruited . Participants were r and omized to receive access to the PA website for 12 weeks or information about other cancer-related websites . Intervention feasibility and acceptability was assessed only among those in the PA website group ; PA and psychosocial outcomes ( mood , fatigue ) were assessed in both groups . Results : Findings revealed that 86 % of participants in the PA website group would recommend the intervention to others and most ( 71 % ) were " satisfied " or " very satisfied " with it . Further , 100 % rated getting onto the website as " very easy " and 86 % rated the information on the site as " very easy " to underst and . The logging feature , followed by the goal - setting feature , were most often accessed by participants . Participants also rated the graphing and stage-matched manual features as helpful . Estimates of effect sizes for between-group differences at 12 weeks were medium for PA outcomes and large for psychosocial outcomes . Conclusions : This internet-based PA intervention targeting young adult cancer survivors is feasible and acceptable and may benefit this population BACKGROUND Improved cure rates for childhood cancer have produced a growing population of survivors at risk for late toxicities of chemotherapy and radiation therapy . Healthy behaviors can modify these risks . We initiated a controlled prospect i ve trial to determine if a multi-component behavioral intervention could induce change in childhood cancer survivors ' health knowledge , health perceptions , and practice of health-protective behaviors . PROCEDURE Adolescent cancer survivors attending a long-term follow-up clinic were r and omized to receive st and ard follow-up care or st and ard care plus the educational intervention . Baseline measures were obtained at r and omization ( T(0 ) ) and repeated 1 year ( T(1 ) ) later during the survivors ' annual check-up . RESULTS Of 272 patients enrolled and r and omized , 251 are evaluable at both time points . Treatment and control groups were similar in regards to diagnosis , gender , race , and age . The change in outcome measures over the year ( T(1)-T(0 ) ) was not significantly different between the two groups as assessed by a two- sample pooled t test . However , additional exploratory analyses indicated a significant gender difference in knowledge with female survivors in the intervention group having higher scores . In addition , patients who choose certain individual health goals , such as breast/testicular self-examination , showed improved practice of the health behavior . In addition , in a very exploratory analysis , a gender difference in response to the intervention was noted , with females exhibiting a greater improvement in knowledge scores than did males . CONCLUSIONS Although the multi-behavioral educational intervention did not induce change in health knowledge , perceptions , and behaviors of childhood cancer survivors for the treatment group as a whole , gender differences and specific health goal differences were found . These findings suggest that future interventions should be tailored to reflect gender differences and the nature of the health goal under assessment PURPOSE / OBJECTIVES To test the effects of a  decision-making and risk-reduction program  for cancer-surviving adolescents . DESIGN Prospect i ve clinical trial using a quasi-experimental pretest/post-test design with repeated measures . SETTING Two survivor follow-up clinics and a camp for children and adolescents with cancer located in upstate New York . SAMPLE A convenience sample of 64 survivors ( 13 - 21 years of age ) . The intervention group consisted of  21 survivors who attended a workshop  , and the comparison group consisted of 43 survivors who did not attend the workshop .  METHODS Intervention-integrated information specific to survivorship , decision-making skills , risk behaviors , and social support from peers and healthcare professionals . The educational component of the program lasted one day ( five one-hour units ) , and the social component lasted overnight . A single , semistructured interview at the time of the previous yearly evaluation visit was used for baseline data . Testing was conducted during home visits at 1 , 6 , and 12 months . MAIN RESEARCH VARIABLES Decision making , risk motivation , and risk behaviors ( i.e. , smoking , alcohol use , and illicit drug use ) . FINDINGS The effect of the intervention for improving decision making was significant at 1-month postintervention , marginally significant at 6-months postintervention , and highly significant at 12-months postintervention . The effect of the intervention for motivation toward alcohol use was significant at 1-month postintervention and marginally significant at 6-months postintervention ; however , the intervention had no effect on smoking motivation at any of the three time intervals . The effect of the intervention for improving smoking behavior was marginally significant at 6-months postintervention and was marginally significant at 12-months postintervention for alcohol use . CONCLUSIONS The intervention had a dampening effect on the upward trajectory of substance use , a path that is well-known to increase with age for both genders in the general population . This short , five-hour program for improving decision making and affecting substance use of teen survivors shows promise ; however , a larger sample is needed to enhance findings . IMPLICATION S FOR NURSING PRACTICE Besides tailoring risk-behavior information based on actual or potential late effects of treatment to each teen survivor during follow-up visits , oncology professionals need to provide booster programs to refine decision-making skills within meaningful decision context for teen survivors as a means of reducing risk behaviors OBJECTIVE This study examined cancer  knowledge in adolescent and young adult ( AYA ) survivors and pilot tested a Web-based re source to provide individually tailored information regarding cancer treatment history , late effects risk , and re sources . METHODS Fifty-two survivors ( 15 - 28 years old ) who completed cancer treatment were recruited from the University of Minnesota oncology clinics . Participants were r and omly assigned to receive access to personalized health history , late effects information , and re sources via a password-protected Web portal or to st and ard of care ( physician counseling ) only . Participants completed surveys measuring cancer knowledge , health locus of control , and psychosocial well-being prior to r and omization and approximately 1 year later . RESULTS Overall , few participants accurately reported their chemotherapy history with detail ( 19 % at baseline and 33 % at follow-up ) , and many did not recognize that previous cancer treatments could impact future health ( 60 % at baseline and 54 % at follow-up ) . Among those r and omized to the receive access to the website , utilization was very low , making it difficult to draw conclusions about efficacy . Nonetheless , these data suggest that offering tailored information through the Web was not more effective than st and ard of care at improving cancer knowledge . Anxiety and health beliefs were associated with cancer knowledge , including knowledge of steps survivors could take to mitigate late effects risks ( p < 01 ) . CONCLUSIONS Knowledge gaps exist among AYA survivors regarding important aspects of their treatment histories and ongoing health risks . Offering purely educational information ( either in person by providers or via the Web ) does not appear to be enough to close this gap . Copyright © 2015 John Wiley & Sons , Background : Adolescent survivors of childhood cancer engage in risky behaviors . Objective : This study tested a decision aid for cancer-surviving adolescents aim ed at difficult decisions related to engaging in substance use behaviors . Methods : This r and omized controlled trial recruited 243 teen survivors at 3 cancer centers . The cognitive-behavioral skills program focused on decision making and substance use within the context of past treatment . Effects at 6 and 12 months were examined for decision making , risk motivation , and substance use behaviors using linear regression models . Results : The majority of the teen cancer survivors ( 90 % ) rated the program as positive . There was an intermediate effect at 6 months for change in risk motivation for low riskers , but this effect was not sustained at 12 months . For quality decision making , there was no significant effect between treatment groups for either time point . Conclusions : The overall program effects were modest . Once teen survivors are in the program and learn what quality decision making is , their written reports indicated adjustment in their perception of their decision-making ability ; thus , a more diagnostic baseline decision-making measure and a more intensive intervention are needed in the last 6 months . With 2 of 3 teen participants dealing with cognitive difficulties , the data suggest that this type of intervention will continue to be challenging , especially when 90 % of their household members and 56 % of their close friends model substance use . Implication s for Practice : This effectiveness trial using late-effects clinics provides recommendations for further program development for medically at-risk adolescents , particularly ones with cognitive difficulties Background : We conducted a r and omised study to investigate whether providing a self-guided Internet support group to cancer patients affected mood disturbance and adjustment to cancer . Methods : Baseline and 1- , 6- and 12-month assessment s were conducted from 2004 to 2006 at a national rehabilitation centre in Denmark . A total of 58 rehabilitation course weeks including 921 survivors of various cancers were r and omly assigned to a control or an intervention group by cluster r and omisation . The intervention was a lecture on the use of the Internet for support and information followed by participation in an Internet support group . Outcome measures included self-reported mood disturbance , adjustment to cancer and self-rated health . Differences in scores were compared between the control group and the intervention group . Results : The effect of the intervention on mood disturbance and adjustment to cancer showed a transient difference at the 6-month follow-up , where the intervention group reported less reduction in anxious preoccupation ( P=0.04 ) , helplessness ( P=0.002 ) , confusion ( P=0.001 ) and depression ( P=0.04 ) . Otherwise no significant effects were observed . Conclusion : We conclude that use of Internet-based support groups in cancer patients still needs to confirm long-lasting psychological effects Purpose Over half of young adult cancer survivors do not meet physical activity ( PA ) guidelines . PA interventions can enhance health and quality of life among young adult cancer survivors . However , few exercise interventions have been design ed and tested in this population . This study evaluated the feasibility and preliminary efficacy of a 12-week , Facebook-based intervention ( FITNET ) aim ed at increasing moderate-to-vigorous intensity PA  compared with a Facebook-based self-help comparison ( SC ) condition . Methods Young adult cancer survivors ( n = 86 ) were r and omly assigned to the FITNET or SC group . All participants were asked to complete self-administered online question naires at baseline and after 12 weeks . Results Seventy-seven percent of participants completed postintervention assessment s , and most participants reported using intervention components as intended . Participants in both groups would recommend the program to other young adult cancer survivors ( FITNET , 46.9 vs. SC , 61.8 % ; p = 0.225 ) . Over 12 weeks , both groups increased self-reported weekly minutes of moderate-to-vigorous PA ( FITNET , 67 min/week ( p = 0.009 ) vs. SC , 46 min/week ( p = 0.045 ) ) , with no significant difference between groups . Increases in light PA were 135 min/week greater in the FITNET group relative to the SC group ( p = 0.032 ) , and the FITNET group reported significant weight loss over time ( −2.1 kg , p = 0.004 ; p = 0.083 between groups ) . Conclusion Facebook-based intervention approaches demonstrated potential for increasing PA in young adult cancer survivors . Implication s for Cancer SurvivorsSocial networking sites may be a feasible way for young adult cancer survivors to receive health information and support to promote PA and healthy behaviors BACKGROUND Hodgkin lymphoma ( HL ) survivors face substantially elevated risks of breast cancer and cardiovascular disease . They and their physicians are often unaware of these risks and surveillance recommendations . PROCEDURE A prospect i ve one-arm study was conducted among a r and om sample of 72 HL survivors , ages 27 - 55 years , participating in the Childhood Cancer Survivor Study ( CCSS ) who were at increased risk for breast cancer and /or cardiomyopathy and had not had a screening mammogram or echocardiogram , respectively , within the prior 2 years . A one-page survivorship care plan with recommendations for surveillance was mailed to participants . In addition , survivors ' primary physicians were contacted and provided patient-specific information and a web-based Virtual Information Center was made available for both survivors and physicians . Outcomes were assessed by telephone 6 months after the intervention . RESULTS The survivor participation ( 62/72 ; 86 % ) and 6-month retention ( 56/61 ; 92 % ) rates were high . Tension and anxiety , measured by the Profile of Mood States , did not increase following risk notification ; 91 % of survivors described their reactions to receiving the information in positive terms . At 6 months , 41 % of survivors reported having completed the recommended mammogram ; 20 % reported having an echocardiogram ( females 30 % , males 10 % ) . Only 29 % of survivors visited the website . Nine physicians enrolled , and none used the study re sources . CONCLUSION A mailed , personalized survivorship care plan was effective in communicating risk and increasing compliance with recommended medical surveillance . Internet- and telephone-based strategies to communicate risk were not utilized by survivors or physicians BACKGROUND Evidence suggests that cancer diagnosed during adolescence and young adulthood may present considerable challenges to what would otherwise be a relatively smooth developmental trajectory , particularly in areas related to reproductive health . We created and pilot tested a two-session , individually-delivered , counseling intervention to enhance psychosexual development in this unique population . PROCEDURES A total of 21 patients , aged 15 to 25 years and treated for cancer within the past 5 years , completed the counseling intervention .  Patients were adaptively r and omized to begin the intervention immediately , or to be placed on a 3-month waitlist , after which time , they were reassessed and began the intervention . The content of the intervention included education , dialog , and support regarding cancer and such issues as sexual development and function , body image , fertility , prevention of sexually transmitted disease and unwanted pregnancy , and romantic relationships ( e.g. , dating , sexual communication ) . A 1-month follow-up booster call followed the intervention . Question naires were completed at baseline , post-waitlist ( for half the sample ) , post-treatment , and at 3-month follow-up . RESULTS Participation in the intervention increased cancer-specific knowledge regarding sexual issues ; improved body image ; lessened anxiety about sexual and romantic relationships ; and decreased overall level of psychological distress . Gains were maintained through the 3-month follow-up . CONCLUSIONS Addressing issues of reproductive health in the adolescent/young adult with cancer can and should be offered as a part of comprehensive pediatric cancer care PURPOSE Young adult cancer survivors have a number of increased health and psychosocial risks . To minimize these risks , they must address any modifiable risk factors , for example increase their physical activity ( PA ) and reduce stress . Unfortunately , more than half of young survivors remain sedentary , and few participate in a structured form of relaxation . This study evaluated the feasibility , acceptability , and effects of a theory-based PA and meditation intervention for young survivors . METHODS Young adult cancer survivors ( age 18 - 39 years ) were r and omized to receive the 12-week " RElaxation aNd Exercise for Wellness " ( RENEW ) intervention right away ( intervention group ) or after a 12-week wait ( control group ) . Participants were assessed at baseline , 12 weeks , and 24 weeks . RESULTS Thirty-five survivors were enrolled and r and omized . Results indicate that 89 % of intervention calls were delivered , and most participants felt that intervention goals and the number and duration of intervention calls were appropriate . Satisfaction ratings indicate that the intervention was acceptable , and 100 % of participants would recommend it to others . Comparison of the intervention and control groups at the 12-week assessment ( i.e. , before controls received the intervention ) revealed that the intervention group was performing more minutes of at least moderate intensity PA/week ( p = 0.002 ; M = 113.8 , SE = 23.5 vs. M = -8.7 , SE = 27.1 ) and outperformed controls on a test of cardiovascular fitness ( p = 0.008 ; M = -1.76 , SE = 0.41 vs. M = -0.03 , SE = 0.45 ) . When data from the intervention and control groups were pooled , pre- to post-intervention analyses indicated a trend toward improved mood . CONCLUSION This theory-based intervention for young adult cancer survivors was feasible and acceptable , and may have helped survivors increase PA , improve fitness , and enhance mood
BACKGROUND The effects of cancer and treatment have severe and long lasting negative impacts on quality of life .
Adolescents and Young Adults ( AYA ) have high survival rates but may not reach their full life potential because of these consequences .
This review aims to identify , appraise and synthesis e the effects of health promotion and psychological interventions for AYA after cancer treatment .