Nancy Lau1,2, Arta Gharib Parsa1,3, Casey Walsh4,5, Joyce P Yi-Frazier1, Bryan J Weiner6, J Randall Curtis7,8, Elizabeth McCauley2,9, Abby R Rosenberg1,8,10, Krysta Barton1. 1. Palliative Care and Resilience Lab, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, Washington, USA. 2. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA. 3. UC Davis School of Medicine, Davis, California, USA. 4. Department of Health Services, University of Washington, Seattle, Washington, USA. 5. Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA. 6. Department of Global Health, University of Washington, Seattle, Washington, USA. 7. Division of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, Washington, USA. 8. Cambia Palliative Care Center of Excellence, University of Washington, Seattle, Washington, USA. 9. Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, Washington, USA. 10. Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington, USA.
Abstract
Purpose: Although targeted psychosocial programming for adolescents and young adults (AYAs) with advanced cancer is a well-described priority, how best to engage AYAs in that programming is less clear. We aimed to examine AYA perspectives on facilitators and barriers to utilization of psychosocial programs and preferred mode of delivery. Methods: In this nested cohort study, AYAs participated in semistructured 1:1 interviews on communication needs. The present analysis focused on questions regarding psychosocial program delivery. Data were analyzed using directed content analysis followed by thematic content analysis to further organize and refine identified global themes and organizational themes. Results: We interviewed 32 patients (Mage = 18, range 14-25, 41% female). Key facilitators to utilization of psychosocial services by AYAs were to (1) align in importance of coping skills, (2) emphasize AYA self-motivation and agency in approach and introduction to services, and (3) offer services to everyone and at multiple timepoints. Key AYA barriers included (1) considering themselves an exception to the rule when discussing the psychosocial needs of AYAs with cancer, (2) the challenge of starting something new, and (3) reluctance to share emotional problems with psychosocial clinicians. Regarding the mode of delivery, some preferred in-person delivery due to opportunities for developing a close relationship and therapeutic rapport-building. Mobile app-based delivery was universally appealing. Conclusion: We provide a potential framework to increase uptake of psychosocial services in the high needs population of AYAs with advanced cancer. Future research will explore implementation strategies for increasing AYA engagement in psychosocial intervention programs.
Purpose: Although targeted psychosocial programming for adolescents and young adults (AYAs) with advanced cancer is a well-described priority, how best to engage AYAs in that programming is less clear. We aimed to examine AYA perspectives on facilitators and barriers to utilization of psychosocial programs and preferred mode of delivery. Methods: In this nested cohort study, AYAs participated in semistructured 1:1 interviews on communication needs. The present analysis focused on questions regarding psychosocial program delivery. Data were analyzed using directed content analysis followed by thematic content analysis to further organize and refine identified global themes and organizational themes. Results: We interviewed 32 patients (Mage = 18, range 14-25, 41% female). Key facilitators to utilization of psychosocial services by AYAs were to (1) align in importance of coping skills, (2) emphasize AYA self-motivation and agency in approach and introduction to services, and (3) offer services to everyone and at multiple timepoints. Key AYA barriers included (1) considering themselves an exception to the rule when discussing the psychosocial needs of AYAs with cancer, (2) the challenge of starting something new, and (3) reluctance to share emotional problems with psychosocial clinicians. Regarding the mode of delivery, some preferred in-person delivery due to opportunities for developing a close relationship and therapeutic rapport-building. Mobile app-based delivery was universally appealing. Conclusion: We provide a potential framework to increase uptake of psychosocial services in the high needs population of AYAs with advanced cancer. Future research will explore implementation strategies for increasing AYA engagement in psychosocial intervention programs.
Authors: Emma Walker; Ana Martins; Susie Aldiss; Faith Gibson; Rachel M Taylor Journal: J Adolesc Young Adult Oncol Date: 2016-08-03 Impact factor: 2.223
Authors: Pamela S Hinds; Donna Drew; Linda L Oakes; Maryam Fouladi; Sheri L Spunt; Christopher Church; Wayne L Furman Journal: J Clin Oncol Date: 2005-09-19 Impact factor: 44.544
Authors: Abby R Rosenberg; Chuan Zhou; Miranda C Bradford; Krysta Barton; Courtney C Junkins; Mallory Taylor; Erin K Kross; J Randall Curtis; J Nicholas Dionne-Odom; Joyce P Yi-Frazier Journal: J Palliat Med Date: 2021-03-15 Impact factor: 2.947