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The Internet is a promising format for engaging young cancer survivors who seek information about fertility and cancer. Future studies can evaluate FCP effectiveness in delivering education and support interventions.

Health care provider knowledge and awareness of limited health literacy continues to be a challenge. Educational programs developed for providers and patients are needed to address the health literacy crisis. Improving health literacy will improve health outcomes while reducing the use of unnecessary health care services.

Professional development activities focusing on higher level leadership competencies could assist managers to be more successful in this challenging, but critical, role.

Preliminary evidence shows that young breast cancer survivors derive improved mood and knowledge benefit from FCP participation. Internet-based approach may be a viable format for engaging this population of cancer survivors.

Disparities in cancer survivorship exist among specific populations of breast cancer survivors, specifically rural African American breast cancer survivors (AA-BCS). While effective survivorship interventions are available to address and improve quality of life, interventions must be culturally tailored for relevance to survivors. Here, we report the results of our formative research using focus groups and in-depth interview to better understand unique rural AA-BCS survivorship experiences and needs in the Alabama Black Belt. Surveys were used to gather sociodemographic and cancer treatment data. Fifteen rural AA-BCS shared their experiences and concerns about keeping their cancer a secret, lack of knowledge about survivorship, lingering symptoms, religion and spirituality, cancer surveillance, and general lack of survivorship education and support. Rural AA-BCS were unwilling to share their cancer diagnosis, preferring to keep it a secret to protect family and friends. Quality-of-life issues like lymphedema body image and sexuality were not well understood. They viewed spirituality and religion as essential in coping and accepting cancer. Participants also discussed the importance of and barriers to maintaining health through regular check-ups. They needed social support from family and friends and health care providers. Overall, rural AA-BCS expressed their need for knowledge about survivorship self-management by providing a vivid picture of the realities of cancer survival based on shared concerns for survivorship support and education within the context of culture.

To ensure an adequate supply of knowledgeable and skillful rural health care professionals, continuing education specific to the delivery of care in rural settings is necessary. Once developed, the continuing education must be delivered in a manner that is acceptable and accessible to isolated rural providers.

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