PURPOSE/ OBJECTIVES: To identify factors that predict or modify substance use in childhood cancer survivors and to describe how a risk-counseling intervention reduced young survivors' substance use. DESIGN: Secondary analysis of clinical trial data and primary analysis of medical record data. SETTING: Outpatient clinic. SAMPLE: 149 females and 118 males 12-18 years of age whose cancer had been in remission for at least two years were randomly assigned to intervention (n = 132) and standard care (n = 135) groups. METHODS: Self-report questionnaires, abstracted medical record data, confirmatory factor analysis, and structural equation modeling. MAIN RESEARCH VARIABLES: Smoking, alcohol consumption, knowledge, risk perceptions, motivation, and worry about cancer and treatment effects. FINDINGS: Three factors directly predicted substance use at baseline: being in a higher grade in school (independent of age), feelings of being more susceptible to late effects of cancer therapy, and worrying more about cancer and its treatment. At follow-up a year later, grade in school and worry predicted increased substance use. In addition, a desire to change health behavior, influenced by the intervention and gender, predicted decreased substance use. The mechanism of influence of the intervention was evident: The intervention led to a need to change, which precipitated a desire to change and ultimately resulted in decreased substance use. CONCLUSIONS: Young survivors' worries and concerns about their cancer and treatment-related late effects are a new intervention target. Motivation is sensitive to behavioral change interventions and positively affects risk reduction. IMPLICATIONS FOR NURSING: Two new intervention strategies to address the impact of survivors' concerns about their cancer and its treatment are implied: (a) Replace substance use with new coping methods to reduce fear and anxiety, and (b) tailor motivation-based interventions to age and gender to communicate graphically and realistically to survivors the personal importance of behavioral change in modifying the risks of late effects.
RCT Entities:
PURPOSE/ OBJECTIVES: To identify factors that predict or modify substance use in childhood cancer survivors and to describe how a risk-counseling intervention reduced young survivors' substance use. DESIGN: Secondary analysis of clinical trial data and primary analysis of medical record data. SETTING:Outpatient clinic. SAMPLE: 149 females and 118 males 12-18 years of age whose cancer had been in remission for at least two years were randomly assigned to intervention (n = 132) and standard care (n = 135) groups. METHODS: Self-report questionnaires, abstracted medical record data, confirmatory factor analysis, and structural equation modeling. MAIN RESEARCH VARIABLES: Smoking, alcohol consumption, knowledge, risk perceptions, motivation, and worry about cancer and treatment effects. FINDINGS: Three factors directly predicted substance use at baseline: being in a higher grade in school (independent of age), feelings of being more susceptible to late effects of cancer therapy, and worrying more about cancer and its treatment. At follow-up a year later, grade in school and worry predicted increased substance use. In addition, a desire to change health behavior, influenced by the intervention and gender, predicted decreased substance use. The mechanism of influence of the intervention was evident: The intervention led to a need to change, which precipitated a desire to change and ultimately resulted in decreased substance use. CONCLUSIONS: Young survivors' worries and concerns about their cancer and treatment-related late effects are a new intervention target. Motivation is sensitive to behavioral change interventions and positively affects risk reduction. IMPLICATIONS FOR NURSING: Two new intervention strategies to address the impact of survivors' concerns about their cancer and its treatment are implied: (a) Replace substance use with new coping methods to reduce fear and anxiety, and (b) tailor motivation-based interventions to age and gender to communicate graphically and realistically to survivors the personal importance of behavioral change in modifying the risks of late effects.
Authors: Christine Eiser; Kate Absolom; Diana Greenfield; John Snowden; Robert Coleman; Barry Hancock; Helena Davies Journal: J Cancer Surviv Date: 2007-03 Impact factor: 4.442
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Authors: Cheryl L Cox; Liang Zhu; Lorna Finnegan; Brenda D Steen; Melissa M Hudson; Leslie L Robison; Kevin C Oeffinger Journal: Psychooncology Date: 2011-03-06 Impact factor: 3.894
Authors: Glynnis A McDonnell; Christina G Salley; Marie Barnett; Antonio P DeRosa; Rachel S Werk; Allison Hourani; Alyssa B Hoekstra; Jennifer S Ford Journal: J Adolesc Health Date: 2017-07-17 Impact factor: 5.012
Authors: Cheryl L Cox; Melissa M Hudson; Ann Mertens; Kevin Oeffinger; John Whitton; Michele Montgomery; Leslie L Robison Journal: Arch Intern Med Date: 2009-03-09
Authors: Cheryl L Cox; Liang Zhu; Melissa M Hudson; Brenda D Steen; Leslie L Robison; Kevin C Oeffinger Journal: Psychooncology Date: 2012-09-11 Impact factor: 3.894
Authors: Cheryl L Cox; Michele Montgomery; Kevin C Oeffinger; Wendy Leisenring; Lonnie Zeltzer; John A Whitton; Ann C Mertens; Melissa M Hudson; Leslie L Robison Journal: Cancer Date: 2009-02-01 Impact factor: 6.860
Authors: Jennifer Allen; Victoria W Willard; James L Klosky; Chenghong Li; D Kumar Srivastava; Leslie L Robison; Melissa M Hudson; Sean Phipps Journal: J Cancer Surviv Date: 2017-11-03 Impact factor: 4.442