Multiple risk behaviors among smokers in the childhood cancer survivors study cohort. A Video Game Improves Behavioral Outcomes in Adolescents and Young Adults With Cancer: A Randomized Trial Smoking among participants in the childhood cancer survivors cohort: the Partnership for Health Study. Social Cognitive Predictors of Sun Protection Intention and Behavior Preparing patients for threatening medical treatments: effects of a chemotherapy educational DVD on anxiety, unmet needs, and self-efficacy Multi-component behavioral intervention to promote health protective behaviors in childhood cancer survivors: the protect study. Factors influencing long-term follow-up clinic attendance among survivors of childhood cancer Development and evaluation of an educational interactive CD-ROM for teens with cancer.
The literature on health behaviors of young adult cancer survivors is very limited , and thus little is known about preventable risk factors in this population . This paper describes the prevalence of five behavioral risk factors among 541 young adult survivors of childhood cancers from the CCSS cohort who were identified as smokers and enrolled in a r and omized controlled trial of a smoking cessation intervention .  The relationship between presence of multiple risk factors and a number of smoking-related factors was examined . About 31 % of the sample engaged in zero or one health-risk behavior in addition to smoking ; 63 % engaged in 2 or 3 , and 6 % engaged in 4 or 5 . There were positive linear relationships between number of risk factors and smoking rate and nicotine dependence . Number of risk factors was not associated with self-efficacy for quitting , but was related to readiness to quit . This study demonstrated that childhood cancer survivors who smoke have a number of other risk factors for the development of preventable disease and the presence of these risks was associated with factors that decrease the likelihood of quitting smoking . Attention to other health behaviors may be an important strategy for helping smokers quit . In particular , helping childhood cancer survivors who smoke to reduce other risk behaviors might also encourage them to quit smoking OBJECTIVE . Suboptimal adherence to self-administered medications is a common problem . The purpose of this study was to determine the effectiveness of a video-game intervention for improving adherence and other behavioral outcomes for adolescents and young adults with malignancies including acute leukemia , lymphoma , and soft-tissue sarcoma . METHODS . A r and omized trial with baseline and 1- and 3-month assessment s was conducted from 2004 to 2005 at 34 medical centers in the United States , Canada , and Australia . A total of 375 male and female patients who were 13 to 29 years old , had an initial or relapse diagnosis of a malignancy , and currently undergoing treatment and expected to continue treatment for at least 4 months from baseline assessment were r and omly assigned to the intervention or control group . The intervention was a video game that addressed issues of cancer treatment and care for teenagers and young adults . Outcome measures included adherence , self-efficacy , knowledge , control , stress , and quality of life . For patients who were prescribed prophylactic antibiotics  , adherence to trimethoprim-sulfamethoxazole was tracked by electronic pill-monitoring devices ( n = 200 ) . Adherence to 6-mercaptopurine was assessed through serum metabolite assays ( n = 54 ) . RESULTS . Adherence to trimethoprim-sulfamethoxazole and 6-mercaptopurine was greater in the intervention group . Self-efficacy and knowledge also increased in the intervention group compared with the control group . The intervention did not affect self-report measures of adherence , stress , control , or quality of life . CONCLUSIONS . The video-game intervention significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy . The findings support current efforts to develop effective video-game interventions for education and training in health care PURPOSE This article describes baseline data collection and the intervention design of Partnership for Health , a smoking cessation intervention for smokers in the Childhood Cancer Survivors Study . The purpose of this article is to evaluate demographic , psychosocial , and cancer-related factors that are associated with smoking behavior and mediators of smoking cessation . PATIENTS AND METHODS This study includes 796 smokers from the Childhood Cancer Survivors Study data base who were diagnosed with cancer before the age of 21 , had survived at least 5 years , and were at least 18 years of age at the time of the baseline survey . Correlates of smoking behaviors included smoking rate , number of recent quit attempts , and nicotine dependence ; two key mediators of smoking cessation , readiness to quit smoking and self-efficacy , were also assessed . RESULTS Participants smoked , on average , 14 cigarettes/day ; 53.2 % were nicotine dependent , and 58 % had made at least one quit attempt in the past year . Smoking behaviors were primarily associated with demographic variables ; mediators of cessation were primarily associated with age at cancer diagnosis and perceived vulnerability to smoking-related illnesses . Severity of psychologic symptoms was associated with increased smoking rate , high nicotine dependence , and low self-efficacy . Support for quitting was related to smoking rate , number of quit attempts , readiness to quit smoking , and self-efficacy . CONCLUSION These findings indicate that many cancer survivors who smoke are receptive to smoking cessation interventions . Factors related to mediators of smoking cessation might be particularly good targets for intervention The authors investigated sunbathing behavior and intention prospect ively using the Theory of Planned Behavior ( TPB ) . Before summer , 85 young adults who intended to sunbathe completed a TPB question naire . After summer , 46 of them completed a second question naire about their summertime sunbathing behavior . The proposed model was successful in predicting both behavior and intention to use sun protection , with 45 % of the variance of self-reported sunscreen use and 32 % of the variance in intention explained by the TPB . Items design ed to measure self-efficacy and perceived control loaded onto different factors and demonstrated discriminant validity . Self-efficacy predicted both intention and behavior ( after controlling for all other TPB variables ) , but perceived behavioral control did not . The authors discuss the implication s of the findings for potential interventions to improve sun protection behavior Goals of workBased on meta-analyses regarding the preparation of patients for potentially threatening medical procedures , a DVD , incorporating behavioral role modelling , was developed to prepare patients for chemotherapy and assist them to self-manage side effects . It was hypothesized that patients who watched the DVD ( vs those who did not ) would report ( 1 ) lower anxiety ; ( 2 ) higher self-efficacy related to coping with treatment side effects ; ( 3 ) fewer supportive care needs ; and ( 4 ) higher satisfaction with information received . It was further hypothesized that these effects would be stronger in those perceiving their treatment intent to be curative rather than palliative . Material s and methods Quasi-experimental design using a historical control group was employed . Participants were scheduled to receive their first ever chemotherapy treatment . Group 1 ( usual care ; n = 50 ) was prospect ively recruited before the release of the DVD and group 2 ( DVD plus usual care ; n = 50 ) after the release . Before commencing chemotherapy , all patients completed reliable and valid measures of self-efficacy , anxiety , and supportive care needs . Data was stratified according to perceived treatment intent . Independent sample t tests were performed for each group ( curative vs palliative).Main results Significant differences were found between the usual care and intervention groups : for self-perceived curative patients in relation to self-efficacy for seeking social support ( p = 0.044 ) , with increased confidence in those watching the DVD , and for self-perceived palliative patients in relation to their satisfaction with information about side effects ( p = 0.026 ) , with increased satisfaction in those watching the DVD . Overall , significant differences were found between self-perceived curative vs palliative patients on measures of self-efficacy and supportive care needs , with self-perceived curative patients reporting more confidence and fewer needs . Conclusions The educational DVD was considered highly acceptable by patients and was found to increase self-efficacy and reduce supportive care needs . Hence , it is appropriate to give to patients before face-to-face chemotherapy education . Additional pretreatment education is recommended , particularly for self-perceived palliative patients , to reduce their pretreatment anxiety and enhance their confidence in coping with treatment 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 Introduction Attendance at long-term follow-up clinic is necessary for survivors of childhood cancer to facilitate education about cancer-related health risks , early detection of treatment-related morbidity , and implementation of health-promoting interventions . Despite the need for continued care , barriers to clinic attendance exist . The purpose of this prospect i ve study was to identify the demographic , medical , and logistic factors impacting clinic attendance and long-term follow-up care among survivors of childhood cancer . Methods  Adherence to clinic attendance  was monitored among 941 long-term childhood cancer survivors scheduled for evaluation . Patients were classified as “ attenders ” or “ non-attenders ” based on the outcome of their first scheduled clinic appointment over a one year period . Social work staff contacted non-attenders by telephone to determine reasons for missed appointments . Results Nearly 15 % of survivors were classified as non-attenders . Univariate findings revealed that older age , lower SES , being non-white , less medically insured , traveling by car , living shorter distance from clinic , having a scheduled social work consultation , and entering or exiting survivorship clinic were associated with clinic non-attendance ( all p values < 0.05 ) . The final multivariate model indicated that non-whites ( OR = 1.88 , 95 % CI = 1.19–2.97 ) , patients without insurance ( OR = 2.36 , 95 % CI = 1.98–3.79 ) , those traveling by car ( OR = 12.74 , 95 % CI = 3.97–40.86 ) , and those who have not experienced secondary cancer events ( OR = 1.76 , 95 % CI = 0.94–3.28 ) were more likely to be non-attenders . Work or school conflicts were the primary reasons cited for missed appointments . Discussion / conclusions Despite mechanisms design ed to reduce financial burdens associated with attending survivorship clinic at our institution , demographic , medical , and logistic barriers exist which impact participation in long-term follow-up . Implication s for cancer survivors and providersThese results highlight the importance of developing tailored outreach strategies for survivors of childhood cancer at-risk for clinic non-attendance , particularly among underserved population BACKGROUND Cancer is the number one disease killer of children and adolescents in North America . For adolescents , this diagnosis comes at a particularly vulnerable stage . Educating adolescents with cancer from diagnosis through treatment teaches and empowers them . Increasing evidence shows that these adolescents want more information . Few educational tools exist for young cancer patients ; none are interactive ; therefore , a CD-ROM was developed to meet this need . PROCEDURE Animation , voiceover , music , videos , and games were combined to develop a comprehensive multimedia CD-ROM to teach 12- to 18-year-olds with solid tumors about their disease , treatment , coping skills , and late effects in an interactive and non-threatening way . The CD-ROM was evaluated in a pre-post design with 65 subjects recruited from four pediatric oncology centers r and omized to the CD-ROM or a " H and book " containing analogous information .  Pre-post question naires measured coping strategies , health locus of control , quality of life , cancer knowledge , and self-efficacy ; post-test variables also included acceptability and use by teens , their families , and healthcare professionals . RESULTS Teens receiving the CD-ROM were significantly more likely to increase their internal locus of control scores ; however , no significant differences were observed on other measures , attributable in part to the study sample size . Among teens , acceptability was higher in the CD-ROM versus the H and book group , but not different between the two parent groups . Pediatric oncology healthcare providers gave positive feedback on the CD-ROM . CONCLUSIONS This CD-ROM is an innovative and engaging educational tool -- the first portable interactive product with access on dem and for adolescents with solid tumors
Objective : The primary objective of this review was to summarize the literature regarding factors associated with self-efficacy for disease management ( SEDM )  in cross-sectional studies and the efficacy/effectiveness of psychosocial interventions that are design ed to improve SEDM in adolescent and young adult ( AYA ) cancer survivors .
The secondary aim was to assess the quality of included studies .