Dealing with the financial burden of cancer: perspectives of older breast cancer survivors

Purpose

Financial burden among cancer survivors is often overlooked in survivorship care planning. Cancer survivors with limited incomes may be particularly affected. Yet, little data are available to address financial issues among them. Eliciting the survivors’ perspectives on how to deal with this financial burden is a first crucial step to identifying the means to provide this supportive care.

Methods

In this pilot study, three nominal group technique (NGT) sessions were conducted with a convenience sample of 23 older breast cancer survivors (age 52 to 83) recruited from a county safety net hospital and a Comprehensive Cancer Center. One single NGT question was posed in these sessions, namely “What could help women deal with the financial burden that cancer brings to them and their families?” Survivors responded in an iterative fashion and then ranked the most relevant responses.

Results

The most relevant responses addressed the (1) need for affordable insurance; (2) need to have prompt information on treatment costs patients will face, insurance coverage, and agencies or programs that provide needed products and services; and (3) need to access social workers, navigators, support groups, or others knowledgeable about available resources. Survivors also suggested that physicians become aware of cancer costs and financial issues faced by patients and consider costs in their treatment plans.

Conclusions

Older survivors face financial challenges for which there are few available resources. They suggested several avenues to address cancer-related financial issues that may be considered in developing supportive interventions.     

Oral and dental late effects in survivors of childhood cancer: a Children’s Oncology Group report

Purpose

Multi-modality therapy has resulted in improved survival for childhood malignancies. The Children’s Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers provide practitioners with exposure- and risk-based recommendations for the surveillance and management of asymptomatic survivors who are at least 2 years from completion of therapy. This review outlines the pathophysiology and risks for oral and dental late effects in pediatric cancer survivors and the rationale for oral and dental screening recommended by the Children’s Oncology Group.

Methods

An English literature search for oral and dental complications of childhood cancer treatment was undertaken via MEDLINE and encompassed January 1975 to January 2013. Proposed guideline content based on the literature review was approved by a multi-disciplinary panel of survivorship experts and scored according to a modified version of the National Comprehensive Cancer Network “Categories of Consensus” system.

Results

The Children’s Oncology Group oral-dental panel selected 85 relevant citations. Childhood cancer therapy may impact tooth development, salivary function, craniofacial development, and temporomandibular joint function placing some childhood cancer survivors at an increased risk for poor oral and dental health. Additionally, head and neck radiation and hematopoietic stem cell transplantation increase the risk of subsequent malignant neoplasms in the oral cavity. Survivors require routine dental care to evaluate for potential side effects and initiate early treatment.

Conclusions

Certain childhood cancer survivors are at an increased risk for poor oral and dental health. Early identification of oral and dental morbidity and early interventions can optimize health and quality of life.     

Characteristics associated with the use of complementary health approaches among long-term cancer survivors

Purpose

This study aims to identify the prevalence and characteristics of long-term adult cancer survivors who use complementary health approaches (CHA).

Methods

Participants completed the Follow-up Care Use Among Survivors (FOCUS) Survey, a cross-sectional investigation of long-term cancer survivors. The use of CHA and reasons for use were assessed. A multivariable logistic regression model was applied to identify if predisposing, enabling, and need characteristics described in the Complementary and Alternative Medicine Healthcare Model were associated with CHA use in the past year.

Results

Long-term cancer survivors in the study (N?=?1,666) were predominately female (62 %) and older (mean age?=?69.5), with breast, prostate, colorectal, ovarian, and endometrial cancers. Thirty-three percent of survivors used CHA in the past year. Common reasons for CHA use were to relieve stress (28 %), treat or prevent cancer (21 %), relieve cancer-related symptoms (18 %), and deal with another condition (18 %). Predisposing (i.e., higher optimism) and need factors (i.e., experienced cancer-related symptoms, ever had depression/anxiety) were significantly associated with CHA (p-values?<?.05). Enabling factors (i.e., insurance coverage, financial resources) were not.

Conclusions

Cancer survivors continue to report a high prevalence of recent CHA use more than 5 years after initial diagnosis. Healthcare providers should be aware of increased use of CHA among subgroups of long-term cancer survivors in order to guide safe and optimal use.     

Issues of ovarian cancer survivors in the USA: a literature review

Purpose

As the number of ovarian cancer survivors increases, so does the need for appropriate intervention and care. A literature review was conducted to assess the issues affecting ovarian cancer survivors in the USA, including the needs of younger survivors.

Methods

Articles on six topics (finances/employment, reproductive and sexual health, treatment effects, information needs, genomics, and end-of-life/palliative care) among ovarian cancer survivors were identified through comprehensive database searches. Abstracts for all citations were reviewed to determine relevancy. Data from relevant articles, defined as including a sample size of ≥20, published in English, involving human subjects in the USA, and published between 2000 and 2010, were abstracted.

Results

Thirty-four articles were relevant. Common, but often unaddressed, treatment side effects included infertility and issues with sexual health. Survivors reported not receiving adequate information about their disease. Hereditary cancer can lead to concern for family members. End-of-life/palliative care was often not addressed by physicians. Most of the studies used a cross-sectional design and lacked control groups. Participants were primarily recruited from academic medical centers or clinical trials and tended to be White. Few studies specifically addressed young survivors; however, reproductive health issues are common.

Conclusions

Ovarian cancer has wide-ranging impacts. This review emphasizes the need for more research among ovarian cancer survivors, particularly related to finances, reproductive and sexual health, information, genomics, and end-of-life care. Issues specific to young survivors also deserve more attention. Direction for future research and clinical implications are discussed.     

Returning to work following curative chemotherapy: a qualitative study of return to work barriers and preferences for intervention

Purpose

This study aimed to explore barriers to return to work (RTW) and preferences for intervention and support for cancer patients treated with curative intent from the perspectives of cancer survivors and oncology health professionals.

Methods

Participants attended a focus group (N?=?24) or an individual interview (N?=?14). A topic guide and a semi-structured recorded interview format were used to gather data, which were later transcribed and analysed for global themes and subthemes.

Results

With regard to barriers, the global theme ‘work capacity’ captured an array of barriers encompassing financial pressure, preparedness for work, lack of confidence as well as other key physical, practical and psychosocial barriers. Participants expressed a preference for RTW models that focus on objective and structured assessment whilst allowing for flexibility to address individual needs.

Conclusions

Cancer survivors perceive multiple barriers when attempting to RTW. These barriers were perceived to impact upon work capacity, where ‘capacity’ was defined broadly to include practical, physical and psychosocial concerns. RTW is an important concern for cancer survivors and structured RTW interventions should be incorporated into the care of cancer survivors.     

Psychometric properties of cancer survivors�� unmet needs survey

Purpose

This study aims to develop a psychometrically rigorous instrument to measure the unmet needs of adult cancer survivors who are 1 to 5?years post-cancer diagnosis. ??Unmet needs?? distinguishes between problems which survivors experience and problems which they desire help in managing.

Methods

The survey was developed from a comprehensive literature review, qualitative analysis of the six most important unmet needs of 71 cancer survivors, review of the domains and items by survivors and experts, cognitive interviews and a pilot test of 100 survivors. A stratified random sample of 550 cancer survivors, selected from a population-based Cancer Registry, completed a mailed survey to establish reliability and validity.

Results

The final 89-item Survivors Unmet Needs Survey (SUNS) has high acceptability, item test?Cretest reliability and internal consistency (Chronbach??s alpha 0.990), face, content and construct validity. Five subscales measure Emotional Health needs (33 items, 19.4% of variance), Access and Continuity of Care (22 items, 15.1%), Relationships (15 items, 12.1%), Financial Concerns (11 items, 10.3%) and Information needs (eight items, 8.1% of the variance).

Conclusions

This instrument has strong psychometric properties and is useful for determining the prevalence and predictors of cancer survivors?? unmet needs across types of cancer, length of survivorship and socio-demographic characteristics. Use of the SUNS will enable more effective targeting of programmes and services and guide policy and health planning decisions.

Relevance

This study is an important step toward evidence-based planning and management of problems which the growing survivor population requires assistance in managing.     

Childhood cancer survivors’ primary care and follow-up experiences

Purpose

Although most childhood cancer survivors see a primary care provider (PCP), little is known about these encounters. We explored themes related to survivors’ (1) experiences with primary care, (2) communication with their PCPs about their cancer, and (3) their knowledge and impressions about follow-up care, including their interest in a survivor care plan (SCP).

Methods

From April to July 2012, we conducted in-depth, semi-structured telephone interviews with 53 adult survivors recruited from the Utah Cancer Surveillance, Epidemiology, and End Results (SEER) Registry. Participants were randomly selected from sex, age, and rural/urban strata and were younger than 21 years at the time of diagnosis. Participants were asked if they had a PCP and whether they discussed their cancer history with their provider and their interest in a SCP. Interviews were recorded, transcribed, and content-analyzed.

Results

The average age at interview was 39.1 years (SD?=?11.2). Most survivors had a current PCP (83.0 %). Almost half were not worried about their health despite having had cancer. Detailed discussions about cancer history with PCPs were generally rare. Few survivors had a follow-up care plan, but over half thought a SCP could empower their medical decision making. However, one-third of the survivors were skeptical about the usefulness of a SCP and some were worried about health-care costs.

Conclusions

Childhood cancer survivors need better care coordination. Of concern is that many do not discuss their cancer history with their current PCPs and most have no SCP.     

The use of cancer treatment summaries and care plans among Massachusetts physicians

Purpose

Cancer survivorship presents many challenges for affected individuals and their health care providers. Reports from The Institute of Medicine document these challenges and recommend the use of survivorship treatment summaries and care plans to improve communication and coordination of care for cancer survivors. The purpose of our study was to assess current use of treatment summaries and care plans in Massachusetts and identify obstacles to greater use.

Methods

A survey was mailed to cancer specialist physicians (CSPs) and primary care physicians (PCPs) in Massachusetts. The survey asked CSPs about their preparation of treatment summaries and care plans for their cancer survivor patients and perceived barriers to the provision of these documents. PCPs were asked about receipt and utility of treatment summaries and care plans and information they would like to see in these reports.

Results

One hundred eight CSPs and 400 PCPs answered the survey. Fifty-six percent of CSPs reported that they, or their staff, prepared treatment summaries for their cancer survivor patients; however, only 14% reported preparing care plans. Fifty-four percent of PCPs reported ever receiving a treatment summary, but only 16% ever received a care plan. CSPs cited lack of training, reimbursement, and templates as barriers to preparing care plans.

Conclusions

Interventions are needed to make treatment summaries and care plans a part of standard care for all cancer survivors. Increasing the use of treatment summaries and care plans will require specific training and reimbursement and may be facilitated by templates that capture automated data.     

Perceptions of risk among childhood and young adult cancer survivors who smoke

Purpose

Despite the fact that childhood and young adult cancer survivors are at increased risk for chronic health problems as a result of their cancer treatment, many use tobacco, thereby increasing their risks. Perceptions of risk related to tobacco use can be targeted for interventions aimed at improving health behaviors for childhood, adolescent, and young adult cancer survivors. Understanding the covariates of perceptions of health risks among young adult survivors who smoke will help to determine targets for intervention.

Method

Three hundred seventy-four participants who were diagnosed with cancer prior to age 35, currently between 18 and 55 years of age, and current smokers were recruited as part of a larger smoking cessation study, Partnership for Health-2 (PFH-2). Data were collected by telephone survey.

Results

Overall, women had the highest perception of risk for serious health problems, a second cancer, and heart problems. Additionally, those participants who were dependent on nicotine endorsed that they were at higher risk of serious health problems and second cancers, but not heart problems. Finally, Hodgkin lymphoma survivors reported that they were at increased risk for second cancers and heart problems compared to their “healthy” peers.

Conclusion

Young adult cancer survivors who smoke correctly perceived some of their increased health risks. Additional motivation and education is needed for those young adult cancer survivors who perceive their increased health risks yet continue to smoke. Further education is needed for young survivors so they have a fully appropriate sense of risk, especially as it relates to their tobacco use.     

Desire for children,difficulties achieving a pregnancy,and infertility distress 3 to 7 years after cancer diagnosis

Purpose

The aim was to investigate desire for children, difficulties achieving a pregnancy, and infertility distress among survivors 3 to 7 years after cancer treatment in reproductive age.

Methods

Cancer survivors were identified in national population-based cancer registries. Eligible subjects presented with selected cancer diagnoses between 2003 and 2007 between the ages of 18 to 45. A postal questionnaire including study-specific questions, the Short-Form 36 Health Survey and the Fertility Problem Inventory, was sent to 810 survivors, and 484 participated (60 % response).

Results

Most survivors who had a pretreatment desire for children still wanted children 3–7 years after treatment, and this group was characterized by young age and being childless at diagnosis. In addition, a substantial group of survivors (n?=?55, 17 %) that did not have a pretreatment desire for children had changed their mind about wanting children after treatment. About a third of the survivors with a desire to have children had experienced difficulties achieving a pregnancy after the cancer treatment, and an unfulfilled desire to have children was associated with worse mental health. Survivors presently facing difficulties achieving a pregnancy reported moderate levels of infertility distress and expressed low interest in using gamete donation.

Conclusions

Health professionals in cancer care need to be aware that patients’ plans for future children may change, particularly if they are young and childless. All patients of reproductive age should be provided with adequate information about the impact of cancer treatment on future fertility and fertility preservation.     

The dyadic effects of coping and resilience on psychological distress for cancer survivor couples

Purpose

This study aimed to examine the actor and partner effects of coping and resilience characteristics on psychological distress in cancer survivors and their spouses and to examine the mediating role of resilience characteristics in the relationship between coping and psychological distress.

Methods

A total of 91 breast, colorectal, and prostate cancer survivor-spouse dyads were recruited from the University Hospital Registry in Cleveland, Ohio. Standardized questionnaires that assessed psychological distress, reframing and acquiring social support coping, and resilience characteristics were used.

Results

The actor-partner interdependence mediation model demonstrated that the resilience of the survivors and spouses was a strong predictor of their personal psychological distress. Survivors’ and spouses’ own resilience mediated the association between their reframing coping and psychological distress. However, only the survivor model confirmed the mediating effect of resilience characteristics in the relationship between social support coping and psychological distress. In addition, spouse psychological distress was influenced by survivor resilience, indicating a spouse-partner effect in the relationship between resilience characteristics and psychological distress.

Conclusions

Our findings provide insight into the relationships between coping, resilience characteristics, and psychological distress at the individual and dyadic levels. Enhancing cancer survivors’ and their spouses’ positive thoughts and available external resources can improve resilience and, in turn, reduce their psychological distress of couples coping with cancer.     

Insomnia in adult survivors of childhood cancer: a report from project REACH

Purpose

Insomnia is a common problem affecting cancer survivors even years after completion of therapy. Childhood cancer survivors may be at particular risk due to vulnerability to the effects of treatment and medical late effects which impact normal sleep development. Using an indicator of clinically significant insomnia (sleep efficiency), we examined a group of adult survivors of childhood cancer to (1) describe clinical insomnia rates, (2) identify physical and psychological correlates of insomnia, and (3) investigate the frequency with which sleep issues were evaluated during a cancer survivorship medical visit.

Methods

A total of 122 adult survivors of childhood cancer completed standard measures of sleep, psychological distress, and health-related quality of life. Medical records of the 75 survivors with a survivorship medical visit on the day of self-report measure completion were reviewed for documentation of sleep-related issues.

Results

Twenty-eight percent of participants endorsed sleep efficiency below 85 %, indicating clinically significant insomnia. Insomnia was associated with poor physical health and anxiety but not with demographic or cancer treatment variables. Medical providers failed to document sleep in visit notes for 67 % of patients with self-reported insomnia.

Conclusions

A significant proportion of adult survivors of childhood cancer report insomnia, which is associated with physical and psychological health. Few survivors with insomnia discuss this issue with oncology providers during survivorship care. There is a clear need to screen for insomnia in this population. Patients and providers should take greater responsibility for discussing sleep issues and seeking out proper treatment referrals when it is identified.     

Mental health-care utilization in survivors of childhood cancer and siblings: the Swiss childhood cancer survivor study

Purpose

We aimed to (1) describe the utilization of mental health-care in survivors and siblings, the association with severity of distress, and visits to other professionals in distressed survivors not utilizing mental health-care; and (2) identify factors associated with utilization of mental health-care in distressed survivors.

Methods

Within the Swiss Childhood Cancer Survivor Study, we sent postal questionnaires to all participants aged <16 years at diagnosis (1976–2003), who survived ≥5 years after diagnosis and were aged ≥16 years at study. Survivors and siblings could indicate if they utilized mental health-care in the past year. Psychological distress was assessed with the Brief Symptom Inventory-18 (BSI-18). Participants with scores T?≥?57 on two of three scales or the Global Severity Index were considered distressed.

Results

We included 1,602 survivors and 703 siblings. Overall, 160 (10 %) and 53 (8 %), utilized mental health-care and 203 (14 %) and 127 (14 %) were considered distressed. Among these, 69 (34 %) survivors and 20 (24 %) siblings had utilized mental health-care. Participants with higher distress were more likely to utilize mental health-care. Distressed survivors not utilizing mental health-care were more likely to see a medical specialist than nondistressed. In the multivariable regression, factors associated with utilizing mental health-care were higher psychological distress and reporting late effects.

Conclusions

Our results underline the importance of developing interventional programs and implementing psychological screening in follow-up of survivors. It is also important to systematically address siblings' needs. In follow-up, patients at risk should be informed about existing possibilities or advised to visit mental health professionals.     

‘They’re survivors physically but we want them to survive mentally as well’: health care professionals’ views on providing potential late effect information

Purpose

The concept of providing personalised care plans for cancer survivors is receiving increasing attention; a recognised element of a care plan is to provide an indication of the risks and consequences of treatment. This paper reports health care professional (HCP) response to providing cancer survivors with information on potential late effects of their cancer treatment.

Methods

Eighteen HCPs from five cancer centres and three general practices in the UK completed semi-structured interviews which were digitally recorded, transcribed and qualitatively analysed using framework analysis.

Results

HCPs’ view of health care was that it is currently focused on acute care and needs are responded to as they may arise, including those which are late effects of cancer treatments. The concept of pre-empting a discussion of potential late effects during the survivorship phase was felt to be discordant with this approach and could impact on adjustment to life after cancer treatment.

Conclusion

Providing cancer survivors with information on potential late effects requires further consideration. Evidence for survivor preference for late effect information and the benefit afforded to survivors who receive it could inform the practice of HCPs. If a culture of proactivity is to be encouraged regarding discussions of future potential risk, HCPs may need support in considering ways of presenting survivors with reality whilst being mindful of their need to retain hope during the survivorship phase.     

Cancer caregivers’ perceptions of an exercise and nutrition program

Purpose

Little research has addressed exercise and nutrition-based interventions for cancer caregivers. This study explored cancer caregivers’ perceptions of participating in a structured exercise and nutrition program alongside cancer survivors for whom they provided care.

Methods

In-depth, semi-structured interviews were conducted by one interviewer with 12 cancer caregivers about their experiences participating in a structured, 12-week exercise and nutrition program designed for cancer survivors and caregivers to complete concurrently. Interviews were conducted until data saturation was reached.

Results

Inductive content analysis from individual interviews indicated three separate, but interrelated, themes: (1) the program was a positive mechanism through which caregivers shared and supported the cancer journey concurrently with survivors, (2) the program led to perceived physical and psychological benefits for both caregivers and survivors, and (3) participants perceived that participation in the program led to feeling increased social support in their caregiving duties.

Conclusions

Findings from this study suggest that participating in an exercise- and nutrition-based intervention is viewed positively by caregivers and that the outcomes are seen as beneficial to both caregivers and survivors. Interventions that address the health needs of both members of the caregiver–survivor dyad should continue to be encouraged by allied health professionals.     

A qualitative study exploring the experience of the partners of cancer survivors and their views on the role of primary care

Purpose

The partners of cancer survivors may experience distress, anxiety, fear and uncertainty whilst also caring for and supporting a partner who is ill. As they concentrate on the cancer survivor’s needs, their own needs may remain unaddressed. Primary care staff may be well placed to support partners as they are generally accessible and may have a better knowledge of the patient’s background and family relationships. However, their current involvement in the cancer survivor’s and partner’s cancer-related care is unclear. This study aimed to describe the experience of the partners of cancer survivors in dealing with cancer-related issues in the first 3?years post-diagnosis, their use of primary care services in relation to these issues and the barriers in doing so and their views on the role that primary care could potentially play in supporting them as carers during this period.

Methods

Semi-structured interviews with 22 partners of cancer survivors diagnosed within the last 3?years and recruited through six GP practices in the Thames Valley Region of the UK were analysed using the ‘framework’ approach to thematic analysis.

Results

Three issues were identified as of particular concern to partners: providing practical support, providing emotional support and managing their own health and well-being. Few partners had sought or received support from primary care specifically for cancer-related issues, indicating confidentiality, lack of knowledge of family relationships and the greater need of the cancer survivor as barriers. Most partners would welcome a proactive approach from primary care and felt that this would provide an opportunity to discuss issues they were concerned about.

Conclusions

Needs and concerns of the partners of cancer survivors in caring for patients are often not addressed. There is a scope for primary care to elicit these needs and provide greater support. Changes to clinical practice in primary care could lead to greater involvement of and to better outcomes for cancer survivors and their partners. A proactive approach to patients and their partners or other close family members at the time of diagnosis through an offer of support and the inclusion in a designated review appointment at the end of initial treatment would be useful.     

The importance of symptom surveillance during follow-up care of leukemia, bladder, and colorectal cancer survivors

Purpose

We examined cancer survivors’ experience of bothersome symptoms, association of symptom bother with health-related quality of life (HRQOL), survivors’ perception of symptom care, and their symptom-related information needs.

Methods

Using self-report survey measures, survivors of leukemia, bladder, or colorectal cancer who were 2–5 years post-diagnosis and received follow-up care in the past year (N?=?623) provided information about the presence of bothersome symptoms, symptom-related information needs, adequacy of symptom-related care, and their physical and mental HRQOL. Multivariable statistical analyses were conducted to identify correlates of symptom bother, inadequate care, and symptom information needs and to examine the association between symptom bother and HRQOL.

Results

Twenty-eight percent of the 606 respondents experienced symptom bother in the past year (46 % of leukemia, 24 % of bladder, and 26 % of colorectal cancer survivors). Younger survivors, those of Hispanic ethnicity, with low income, those with recurrent cancer, and chemotherapy recipients were more likely to report symptom bother (all p?<?0.05). Symptom bother was associated with lower physical and mental HRQOL (p?<?0.001). While 92 % of survivors with symptoms discussed them with their follow-up care physician, 52 % of these reported receiving inadequate symptom care. Survivors reporting inadequate symptom care were 2.5 times as likely to identify symptom information needs compared to those who received adequate care (p?<?0.05).

Conclusions

One in four cancer survivors report symptoms 2–5 years post-diagnosis, and only half of these survivors receive adequate care to address those symptoms. Research that refines and tests symptom care interventions for this population is warranted.     

Sport participation in colorectal cancer survivors: an unexplored approach to promoting physical activity

Purpose

Physical activity improves health outcomes in colorectal cancer (CRC) survivors, but participation rates are low. One understudied strategy for increasing physical activity in CRC survivors may be sport participation. Here, we report the sport participation rate, sport preferences, and correlates of sport participation among CRC survivors.

Methods

A provincial, population-based mailed survey of CRC survivors in Alberta, Canada was performed and included measures of sport participation, sport preferences, sport benefits and barriers, and medical and demographic variables.

Results

A total of 600 CRC survivors completed the survey (34?% response rate). Almost a quarter (23.0?%) of CRC survivors reported participating in a sport in the past month, with the most common sport being golf (58.7?%). In multivariate regression analysis, 33.0?% (p?=?0.001) of the variance in sport participation was explained by being male (???=?0.12; p?=?0.006), in better general health (???=?0.12; p?=?0.006), and ???5?years post-diagnosis (???=?0.09; p?=?0.031). The most common barriers to sport participation were time, age/agility, and no interest/dislike of sports. The most common anticipated benefits of sport participation were improved physical fitness, meeting people, and improved health. Over half (57.2?%) of CRC survivors were possibly interested in learning about sport participation opportunities.

Conclusions

Promotion of sport participation may be a potentially fruitful strategy for increasing physical activity in CRC survivors.     

Health media use among childhood and young adult cancer survivors who smoke

Purpose

Promoting healthy behaviors may reduce the risk of co-morbidities among childhood and young adult (CYA) cancer survivors. Although behavioral interventions are one way to encourage such activities, there is increasing evidence that health media use—particularly health information seeking—also may influence health knowledge, beliefs, and behaviors. The current study explores patterns of health media use among survivors of CYA cancer. Our focus is on survivors who smoke and thus are at even greater risk of co-morbidities.

Methods

We analyzed data from the Partnership for Health-2 study, a web-based smoking cessation intervention, to examine the prevalence of and factors associated with health media use (N?=?329).

Results

Nearly two thirds (65.3 %) of CYA survivors who smoke reported infrequent or no online health information seeking. Many reported never reading health sections of newspapers or general magazines (46.2 %) or watching health segments on local television news (32.3 %). Factors associated with health media use include education and employment, cancer-related distress, and smoking quit attempts.

Conclusions

Health information engagement is low among CYA survivors who smoke, particularly active seeking of health information online. Population subgroups differ in their media use patterns; some of these differences reflect communication inequalities, which have the potential to exacerbate health disparities. Clinicians have an opportunity to guide CYA survivors towards useful and reliable information sources. This guidance could help survivors fulfill their unmet information and support needs and may be particularly important for less educated survivors and other underserved populations.