Childhood Cancer Survivors’ Adherence to Healthcare Recommendations Made Through a Distance-Delivered Survivorship Program

Alchin, Joseph Elliot; Signorelli, Christina; McLoone, Jordana K.; Wakefield, Claire E.; Fardell, Joanna E.; Johnston, Karen; Cohn, Richard J.

doi:10.2147/jmdh.s363653

Cited by 4 publications

(6 citation statements)

References 85 publications

(139 reference statements)

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“…Additionally, these reinforce the utility of structured web-based curriculums, like the HEAL initiative, in providing widereaching, dedicated, and cost-effective lifestyle guidance and education to parents of CCS (69). The availability and scope of long-term survivorship care after childhood cancer is highly variable and depends on factors such as geographic location, treating institution, and local/regional resources (62,70). Infrequent clinic visits, limited time, and insufficient resources are several systemic factors that limit healthcare providers' ability to provide ongoing, comprehensive education/counseling and meaningful lifestyle interventions (63).…”

Section: Current Intervention Recommendations and Strategiesmentioning

confidence: 89%

“…Nevertheless, Touyz et al found that both adolescents and their parents preferred face-to-face intervention to a web-based one ( 68 ). The lack of consensus regarding an optimal intervention approach is compounded by studies like that of Alchin et al, who found that AYA survivors exhibit limited recall and poor adherence to healthcare recommendations despite the use of a variety of communication modalities for education delivery ( 70 ). In an effort to overcome some of these unique hurdles contemporary investigations are incorporating novel approaches alongside more conventional strategies, such as creating a CCS-directed cookbook and providing guided lifestyle coaching sessions ( 71 , 76 ).…”

Section: Current Intervention Recommendations and Strategiesmentioning

confidence: 99%

“…The availability and scope of long-term survivorship care after childhood cancer is highly variable and depends on factors such as geographic location, treating institution, and local/regional resources ( 62 , 70 ). Infrequent clinic visits, limited time, and insufficient resources are several systemic factors that limit healthcare providers’ ability to provide ongoing, comprehensive education/counseling and meaningful lifestyle interventions ( 63 ).…”

Section: Current Intervention Recommendations and Strategiesmentioning

confidence: 99%

“…It has been suggested that CCS, and AYAs in particular, could significantly benefit from such technology-based programs (62). In fact, in recent years CCS studies have increasingly opted for remote (telephone, mobile application, telehealth) intervention strategies as these are typically more cost-effective, accessible to those living in rural and/or remote areas, and preferred among younger groups (60,(68)(69)(70)(71). Nevertheless, Touyz et al found that both adolescents and their parents preferred face-to-face intervention to a web-based one (68).…”

Section: Current Intervention Recommendations and Strategiesmentioning

confidence: 99%

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Nutritional assessment and dietary intervention among survivors of childhood cancer: current landscape and a look to the future

Feit,

Beals,

Dandekar

et al. 2024

Front. Nutr.

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Over 85% of childhood cancer patients become long-term survivors. Still, cancer and its therapies are associated with a myriad of long-term complications such that childhood cancer survivors (CCS) endure excess disease burden, morbidity, and mortality throughout their lifetimes. Existing literature suggests that CCS maintain poor dietary intake and nutritional status. Thus, as childhood cancer cure rates continue to improve, the role of diet and nutrition in mitigating many of the most common adverse long-term health outcomes among CCS has gained significant interest. Herein we present an in-depth review of existing scientific literature evaluating dietary intake and nutrition status among CCS and its impact on treatment-related health complications; as well as contemporary intervention strategies aimed at overcoming distinctive barriers and improving deleterious lifestyle behaviors in this heterogeneous, at-risk population. Patient-specific, clinical, and systemic factors act as barriers to the timely conduct of comprehensive dietary/nutritional assessments and provision of tailored, risk-based recommendations. This Mini Review discusses the current state of the science, persisting research gaps, and opportunities for advancement of assessment and intervention strategies to address the unique needs of CCS.Search Strategy: We searched PubMed for peer-reviewed articles with the search terms “pediatric cancer,” “pediatric malignancy,” “pediatric oncology,” “childhood cancer,” “survivorship,” “cancer late effects,” “long-term follow-up,” “body mass index,” “nutritional status,” “malnutrition,” “body weight,” “body weight changes,” “body composition,” “obesity,” “overweight “, “Mediterranean diet,” “DASH diet,” “processed foods,” “micronutrients,” “antioxidants,” “vitamin D,” “calcium,” “selenium,” “zinc,” “metabolic syndrome,” “heart disease,” “cardiovascular disease,” “cardiometabolic disease,” “hypertension,” “hyperlipidemia,” “HDL,” “LDL,” and “small dense LDL” from January 1, 1995, to July 21, 2023. We also selected relevant articles from our personal files and from reference lists of identified papers. We prioritized publications after 2013; however, commonly cited and highly regarded (defined by high citation count and journal impact factor) older publications were also included. Randomized controlled trials, observational studies, retrospective studies, meta-analysis, editorials, and review articles were included, whereas conference abstracts and case reports were excluded. We only searched for articles published in English, or those translated into English.

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Section: Current Intervention Recommendations and Strategiesmentioning

confidence: 89%

Section: Current Intervention Recommendations and Strategiesmentioning

confidence: 99%

Section: Current Intervention Recommendations and Strategiesmentioning

confidence: 99%

Section: Current Intervention Recommendations and Strategiesmentioning

confidence: 99%

See 2 more Smart Citations

Nutritional assessment and dietary intervention among survivors of childhood cancer: current landscape and a look to the future

Feit,

Beals,

Dandekar

et al. 2024

Front. Nutr.

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“… 38 The relationship between worry about cancer-related health problems and its influence on survivorship care engagement appears to be complex. 39 , 40 Adequately educating survivors about their risk of late effects, and the appropriate level of risk-based surveillance needed (eg, GP-led survivorship care vs specialist-led care), without raising their anxiety remains a significant challenge. 40 However, this is important to overcome as risk-stratified models of care become increasingly important to alleviate the pressures of the growing number of survivors on limited services and resources that are available.…”

Section: Discussionmentioning

confidence: 99%

Childhood Cancer Survivors’ Reported Late Effects, Motivations for Seeking Survivorship Care, and Patterns of Attendance

et al. 2023

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Background Childhood cancer survivors are vulnerable to long-term treatment-related health conditions, which can lead to poor quality of life. Little data exist on the overall health of long-term Australian and New Zealand childhood cancer survivors or on survivors’ motivations for attending survivorship clinics. Methods This study administers a cross-sectional questionnaire to long-term survivors ≥5 years from their primary diagnosis. We compared participant-reported number of late effects by a cancer diagnosis, and identified clinical (eg, treatment) and demographic (eg, age) factors that were associated with late effects burden and engagement in cancer survivorship care. Results A total of 634 participants completed questionnaires (48% male, mean age = 21.7 years). Most participants (79%) reported at least one cancer-related late effect, most commonly fatigue (40%) and memory/learning difficulties (34%). Brain tumor survivors reported a higher total number of late effects than survivors with other diagnoses (mean = 5.7 vs. 3.2, P < .001). Participants’ most commonly reported motivators for engaging in care were to understand problems that may occur later in life because of their cancer and/or treatment (98.5%) and to get reassurance about one’s health (97.4%). The proportion of survivors endorsing each motivating factor was similar across cancer diagnoses, with the exception of learning more about insurance and pensions (highest in brain tumor survivors = 80%). In multivariable analyses, survivors were more likely to report being engaged in survivorship care if they were younger (P < .001), less time had elapsed since their diagnosis (P < .001), or they reported a higher number of motivating factors (P = .016). Conclusion Survivors report a range of health problems decades after treatment completion. Understanding the burden of late effects, and motivators for seeking survivorship care to manage these health problems, is important for ensuring that tailored interventions or services are available to meet the needs of this growing population and to design effective models of survivorship care.

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Childhood cancer models of survivorship care: a scoping review of elements of care and reported outcomes

Bradford,

Chan,

Skrabal Ross

et al. 2024

J Cancer Surviv

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Purpose This study aimed to systematically map elements of care and respective outcomes described in the literature for different models of post-treatment care for survivors of childhood cancer. Methods MEDLINE, CINAHL, and Embase were searched with combinations of free text terms, synonyms, and MeSH terms using Boolean operators and are current to January 2024. We included studies that described post-treatment cancer survivorship models of care and reported patient or service level elements of care or outcomes, which we mapped to the Quality of Cancer Survivorship Care Framework domains. Results Thirty-eight studies with diverse designs were included representing 6101 childhood cancer survivors (or their parent/caregiver) and 14 healthcare professionals. A diverse range of models of care were reported, including paediatric oncologist-led long-term follow-up, multi-disciplinary survivorship clinics, shared-care, and primary care-led follow-up. Elements of care at the individual level most commonly included surveillance for cancer recurrence as well as assessment of physical and psychological effects. At the service level, satisfaction with care was frequently reported but few studies reported how treatment-related-late effects were managed. The evidence does not support one model of care over another. Conclusions Gaps in evidence exist regarding distal outcomes such as costs, health care utilization, and mortality, as well as understanding outcomes of managing chronic disease and physical or psychological effects. The findings synthesized in this review provide a valuable reference point for future service planning and evaluation. Implications for Cancer Survivors Decades of research highlight the importance of survivorship care for childhood cancer survivors who are at risk of serious treatment-related late effects. This review emphasizes there is no single, ‘one-size fits all’ approach for delivering such care to this vulnerable population.

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Childhood Cancer Survivors’ Adherence to Healthcare Recommendations Made Through a Distance-Delivered Survivorship Program

Cited by 4 publications

References 85 publications

Nutritional assessment and dietary intervention among survivors of childhood cancer: current landscape and a look to the future

Nutritional assessment and dietary intervention among survivors of childhood cancer: current landscape and a look to the future

Childhood Cancer Survivors’ Reported Late Effects, Motivations for Seeking Survivorship Care, and Patterns of Attendance

Childhood cancer models of survivorship care: a scoping review of elements of care and reported outcomes

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