scholarly journals Digital Interventions to Support Adolescents and Young Adults With Cancer: Systematic Review

JMIR Cancer ◽  
10.2196/12071 ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e12071 ◽  
Author(s):  
Lisa McCann ◽  
Kathryn Anne McMillan ◽  
Gemma Pugh
Keyword(s):  
Young Adults ◽  
Cancer Diagnosis ◽  
Subjective Experience ◽  
Emotional Health ◽  
Digital Health ◽  
Health Interventions ◽  
Adolescents And Young Adults ◽  
Research Papers ◽  
Digital Interventions ◽  
Diagnosis Of Cancer

Background The last decade has seen an increase in the number of digital health interventions designed to support adolescents and young adults (AYAs) with cancer. Objective The objective of this review was to identify, characterize, and fully assess the quality, feasibility, and efficacy of existing digital health interventions developed specifically for AYAs, aged between 13 and 39 years, living with or beyond a cancer diagnosis. Methods Searches were performed in PubMed, EMBASE, and Web of Science to identify digital health interventions designed specifically for AYA living with or beyond a cancer diagnosis. Data on the characteristics and outcomes of each intervention were synthesized. Results A total of 4731 intervention studies were identified through the searches; 38 interventions (43 research papers) met the inclusion criteria. Most (20/38, 53%) were website-based interventions. Most studies focused on symptom management and medication adherence (15, 39%), behavior change (15, 39%), self-care (8, 21%), and emotional health (7, 18%). Most digital health interventions included multiple automated and communicative functions such as enriched information environments, automated follow-up messages, and access to peer support. Where reported (20, 53% of studies), AYAs’ subjective experience of using the digital platform was typically positive. The overall quality of the studies was found to be good (mean Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields scores >68%). Some studies reported feasibility outcomes (uptake, acceptability, and attrition) but were not sufficiently powered to comment on intervention effects. Conclusions Numerous digital interventions have been developed and designed to support young people living with and beyond a diagnosis of cancer. However, many of these interventions have yet to be deployed, implemented, and evaluated at scale.

scholarly journals A Tutorial on the Challenges and Solutions for Developing Tailored Video Interventions that Integrate Multiple Digital Assets to Promote Engagement and Improve Health Outcomes: The Positive Health Check Example (Preprint)

2020 ◽  
Author(s):  
Camilla Harshbarger ◽  
Olivia Burrus ◽  
Sivakumar Rangarajan ◽  
John Bollenbacher ◽  
Brittany Zulkiewicz ◽  
...  
Keyword(s):  
Digital Health ◽  
Health Interventions ◽  
Health Check ◽  
Multidisciplinary Teams ◽  
Positive Health ◽  
Counseling Intervention ◽  
Video Clips ◽  
Tailored Messages ◽  
Digital Interventions ◽  
Digital Assets

UNSTRUCTURED Video is a versatile and popular medium for digital health interventions and as the technology behind mobile devices and applications advances, video-based interventions may become increasingly common. Though a complex and busy environment, clinic waiting rooms offer the opportunity for implementing digital interventions to patients waiting to see their providers. However, to increase efficient ways of working in public health, to leverage the scalability and low cost of implementing digital interventions, and to keep up with rapidly advancing technology and user needs, more guidance is needed on the design and development of video-based tailored interventions. Here we provide a tutorial for digital intervention researchers and developers who wish to efficiently design and develop video-based, tailored, digital health interventions by describing our challenges and solutions encountered with Positive Health Check (PHC). PHC, a hybrid app, is a brief, interactive, individually- tailored video-based digital HIV behavioral counseling intervention. Hybrid applications are available from an Internet URL or can be downloaded from Google Play and the Apple Store. PHC uses video clips, and multimedia digital assets to deliver intervention content. These include interactive, tailored messages and graphics, a repurposed animated video and patient and provider handouts generated in real-time by PHC. This tutorial addresses numerous challenges and solutions for (1) using video as a medium to enhance user engagement through “video doctors”, full screen video, storyboards and streamlined scripts; (2) navigating the complexity of linking a database of video clips with other digital assets through script coding and flow diagrams of algorithms for delivering a tailored user experience; and, (3) identifying main steps to building an app that will seamlessly deliver to users individually-tailored messages, graphics and handouts. These steps include using keyframes to design integration of video and digital assets, using agile development methods to gather iterative feedback from multidisciplinary teams, and creating an intelligent data-driven backend solution that will tailor message delivery to individual users. Although PHC focuses on promoting health and well-being among persons with HIV, the challenges and solutions presented here are transferable to video-based digital health interventions focused on other areas of health.

scholarly journals Effectiveness of digital health interventions for diabetes: systematic review of systematic reviews

2021 ◽  
Author(s):  
Bonkana Maiga ◽  
Cheick O Bagayoko ◽  
Mohamed Ali Ag Ahmed ◽  
Abdrahamane Anne ◽  
Marie-Pierre Gagnon ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Digital Health ◽  
Scientific Evidence ◽  
Relevant Information ◽  
Health Interventions ◽  
Care Utilization ◽  
Clinical Indicators ◽  
Health Technologies ◽  
Digital Interventions ◽  
Effective Interventions

Abstract Background The use of digital health technologies to tackle diabetes has been particularly flourishing in recent years. Previous studies have shown to varying degrees that these technologies can have an impact on diabetes prevention and management. Objective The aim of this review is to summarize the best evidence regarding the effectiveness of digital health interventions to improve one or more diabetes indicators. Methods We included all types of interventions aimed at evaluating the effect of digital health on diabetes. We considered at all types of digital interventions (mobile health, teleconsultations, tele-expertise, electronic health records, decision support systems, e-learning, etc.). We included systematic reviews published in English or French over the last 29 years, from January 1991 to December 2019, that met the inclusion criteria. Two reviewers independently reviewed the titles and abstracts of the studies to assess their eligibility, and extracted relevant information according to a predetermined grid. Any disagreement was resolved by discussion and consensus between the two reviewers, or involved a third author as referee. Results In total in our review of journals, we included 10 reviews. The outcomes of interest were clinical indicators of diabetes that could be influenced by digital interventions. These outcomes had to be objectively measurable indicators related to diabetes surveillance and management that are generally accepted by diabetes experts. Six of the ten reviews showed moderate to large significant reductions in glycated hemoglobin (HBA1c) levels compared to controls. Most reviews reported overall positive results and found that digital health interventions improved health care utilization, behaviours, attitudes, knowledge and skills. Conclusion Based on a large corpus of scientific evidence on digital health interventions, this overview could help identify the most effective interventions to improve diabetes indicators.

scholarly journals Telemental Health For Youth With Chronic Illnesses: Systematic Review (Preprint)

2021 ◽  
Author(s):  
Nancy Lau ◽  
Susannah F Colt ◽  
Shayna Waldbaum ◽  
Alison O'Daffer ◽  
Kaitlyn Fladeboe ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Young Adults ◽  
Mental Health Problems ◽  
Health Problems ◽  
Small Sample ◽  
Chronic Illnesses ◽  
Health Interventions ◽  
Adolescents And Young Adults ◽  
Telemental Health

BACKGROUND Children, adolescents, and young adults with chronic conditions experience difficulties coping with disease-related stressors, comorbid mental health problems, and decreased quality of life. The COVID-19 pandemic has led to a global mental health crisis, and telemental health has necessarily displaced in-person care. However, it remains unknown whether such remote interventions are feasible or efficacious. We aimed to fill this research-practice gap. OBJECTIVE In this systematic review, we present a synthesis of studies examining the feasibility and efficacy of telemental health interventions for youth aged ≤25 years with chronic illnesses. METHODS PubMed, Embase, Web of Science, PsycInfo, and Cochrane Database of Systematic Reviews were searched from 2008 to 2020. We included experimental, quasiexperimental, and observational studies of telemental health interventions designed for children, adolescents, and young adults aged ≤25 years with chronic illnesses, in which feasibility or efficacy outcomes were measured. Only English-language publications in peer-reviewed journals were included. We excluded studies of interventions for caregivers or health care providers, mental health problems not in the context of a chronic illness, disease and medication management, and prevention programs for healthy individuals. RESULTS We screened 2154 unique study records and 109 relevant full-text articles. Twelve studies met the inclusion criteria, and they represented seven unique telemental health interventions. Five of the studies included feasibility outcomes and seven included efficacy outcomes. All but two studies were pilot studies with relatively small sample sizes. Most interventions were based on cognitive behavioral therapy and problem-solving therapy. The subset of studies examining intervention feasibility concluded that telemental health interventions were appropriate, acceptable, and satisfactory to patients and their parents. Technology did not create barriers in access to care. For the subset of efficacy studies, evidence in support of the efficacy of telemental health was mixed. Significant heterogeneity in treatment type, medical diagnoses, and outcomes precluded a meta-analysis. CONCLUSIONS The state of the science for telemental health interventions designed for youth with chronic illnesses is in a nascent stage. Early evidence supports the feasibility of telehealth-based delivery of traditional in-person interventions. Few studies have assessed efficacy, and current findings are mixed. Future research should continue to evaluate whether telemental health may serve as a sustainable alternative to in-person care after the COVID pandemic.

scholarly journals The benefits and burdens of cancer: A prospective, longitudinal cohort study of adolescents and young adults.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 243-243
Author(s):  
Joelle P. Straehla ◽  
Krysta Shutske ◽  
Joyce P. Yi-Frazier ◽  
Claire M Wharton ◽  
Kevin Scott Baker ◽  
...  
Keyword(s):  
Young Adults ◽  
Cancer Diagnosis ◽  
Sense Of Self ◽  
Well Being ◽  
Adolescents And Young Adults ◽  
Personal Strengths ◽  
Patient Reported ◽  
After Cancer ◽  
Prospective Longitudinal ◽  
Time Point

243 Background: Much of the literature describing psychosocial consequences of cancer among adolescents and young adults (AYAs) has reported negative outcomes; however, AYAs also have potential for protective, positive outcomes. We aimed to prospectively characterize AYA patient-reported benefit and burden-finding after cancer diagnosis and hypothesized that benefit finding would be a salient coping mechanism. Methods: Semi-structured, 1:1 interviews were conducted with AYA patients after cancer diagnosis at 3 time points over 2 years, to elicit their expectations, hopes, worries, personal strengths, and challenges. A priori coding themes were defined from validated scales: changed sense of self, relationships, philosophy of life, and physical well-being. Verbatim transcripts were coded using content analyses by 3 independent coders for instances of benefit or burden by construct. Raw counts, ratios, and confidence intervals were calculated and compared by patient and time point. Results: Seventeen patients (mean age 17.1 ± 2.7; 8 [47%] male) completed 44 interviews with > 100 hours of transcript-data. Most common diagnoses were sarcoma (n = 8), acute leukemia (n = 6), and lymphoma (n = 3). Twelve patients completed all 3 interviews; reasons for withdrawal included death in all but 2 cases. Mean (±SD) counts of patient-reported benefit were higher than burden at each time point (T1, T2, T3); the benefit: burden ratio was > 1 in 68% of interviews (Table). Of the themes, changed sense of self was the most common benefit identified (44% of all reported benefits [95% CI 37%, 52%]) whereas physical complaints was the most common burden (32% [95% CI 25%, 39%]). Longitudinal analysis of subthemes among patients completing 3 interviews (N = 12) indicated an increase in self-identified positive and negative impact of cancer on personal, social and existential perspectives. Conclusions: AYA patients with cancer identified more benefits than burdens related to their diagnoses at all times studied. There was a shift over time in the distribution of benefit and burden finding constructs which may highlight areas for potential intervention. [Table: see text]

Fertility preservation for transgender adolescents and young adults: a systematic review

2019 ◽  
Vol 25 (6) ◽  
pp. 694-716 ◽  
Author(s):  
Shira Baram ◽  
Samantha A Myers ◽  
Samantha Yee ◽  
Clifford L Librach
Keyword(s):  
Systematic Review ◽  
Young Adults ◽  
Fertility Preservation ◽  
Medical Data ◽  
Adolescents And Young Adults ◽  
Future Research ◽  
Sex Reassignment Surgery ◽  
Research Papers ◽  
Knowledge And Beliefs ◽  
Desire To Have Children

Abstract BACKGROUND Many transgender individuals choose to undergo gender-affirming hormone treatment (GAHT) and/or sex reassignment surgery (SRS) to alleviate the distress that is associated with gender dysphoria. Although these treatment options often succeed in alleviating such symptoms, they can also negatively impact future reproductive potential. OBJECTIVE AND RATIONALE The purpose of this systematic review was to synthesize the available psychosocial and medical literature on fertility preservation (FP) for transgender adolescents and young adults (TAYAs), to identify gaps in the current research and provide suggestions for future research directions. SEARCH METHODS A systematic review of English peer-reviewed papers published from 2001 onwards, using the preferred reporting items for systematic reviews and meta-analyses protocols (PRISMA-P) guidelines, was conducted. Four journal databases (Ovid MEDLINE, PubMed Medline, Ovid Embase and Ovid PsychINFO) were used to identify all relevant studies exploring psychosocial or medical aspects of FP in TAYAs. The search strategy used a combination of subject headings and generic terms related to the study topic and population. Bibliographies of the selected articles were also hand searched and cross-checked to ensure comprehensive coverage. All selected papers were independently reviewed by the co-authors. Characteristics of the studies, objectives and key findings were extracted, and a systematic review was conducted. OUTCOMES Included in the study were 19 psychosocial-based research papers and 21 medical-based research papers that explore fertility-related aspects specific for this population. Key psychosocial themes included the desire to have children for TAYAs; FP discussions, counselling and referrals provided by healthcare providers (HCPs); FP utilization; the attitudes, knowledge and beliefs of TAYAs, HCPs and the parents/guardians of TAYAs; and barriers to accessing FP. Key medical themes included fertility-related effects of GAHT, FP options and outcomes. From a synthesis of the literature, we conclude that there are many barriers preventing TAYAs from pursuing FP, including a lack of awareness of FP options, high costs, invasiveness of the available procedures and the potential psychological impact of the FP process. The available medical data on the reproductive effects of GAHT are diverse, and while detrimental effects are anticipated, the extent to which these effects are reversible is unknown. WIDER IMPLICATIONS FP counselling should begin as early as possible as a standard of care before GAHT to allow time for informed decisions. The current lack of high-quality medical data specific to FP counselling practice for this population means there is a reliance on expert opinion and extrapolation from studies in the cisgender population. Future research should include large-scale cohort studies (preferably multi-centered), longitudinal studies of TAYAs across the FP process, qualitative studies of the parents/guardians of TAYAs and studies evaluating the effectiveness of different strategies to improve the attitudes, knowledge and beliefs of HCPs.

Modifiable risk behaviors in adolescents and young adults (AYA) with cancer.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18095-e18095 ◽  
Author(s):  
Lia J. Smith ◽  
Andrea C. King ◽  
Xiaolei Lin ◽  
Donald Hedeker ◽  
Tara O. Henderson
Keyword(s):  
Substance Use ◽  
Young Adults ◽  
Sleep Quality ◽  
Risk Behaviors ◽  
Cancer Diagnosis ◽  
Linear Trend ◽  
Marijuana Use ◽  
Risky Behaviors ◽  
Adolescents And Young Adults ◽  
Trend Analyses

e18095 Background: A cancer diagnosis in adolescents and young adults (AYA) comes at a complex developmental interval that often coincides with risky behaviors, such as substance use. Modifiable risk behaviors are an important area of research to minimize morbidity for AYA. Our goal was to examine substance use, affect, and other health indicators in a diverse AYA cancer patient sample. Methods: We identified patients between the ages of 18-39 years and 6 or more months from date of cancer diagnosis. Measures included demographic, general health and substance use variables, the Center for Epidemiologic Studies Depression Scale (CES-D), and the State-Trait Anxiety Inventory (STAI-T). Linear trend analyses were performed to examine group differences. Backward-selection ordinal regression analyses identified specific factors associated with risky health behaviors. Results: Participants (60% male; Mage = 27; 70% White; 14% Black) included 100 patients with primary diagnoses of lymphoma (N = 45); leukemia (N = 37); sarcoma (N = 10); other (N = 8). Median time from cancer diagnosis was 2 years (range 6 months - 20 years). Past year alcohol, cigarette, and marijuana use was reported in 80% ,15%, and 33% of participants, respectively. We classified three subgroups based on past year alcohol and smoking, including non-smoker/non-drinker (n = 20), non-smoker/drinker (n = 65), and smoker/drinker (n = 15). Linear trend analyses indicated that the groups did not differ on time since diagnosis, but the smoker/drinker group initiated drinking younger ( p< 0.01), were more likely to use marijuana in the past year ( p< 0.01), and had increased depressive symptoms (CES-D; p< 0.01), anxiety (STAI-T; p< 0.05), body pain ( p< 0.05), and poorer sleep quality ( p< 0.05). Backward model selection treating outcome categories as ordinal indicated that frequent marijuana use and poor sleep quality were associated with being a past year smoker/drinker. Conclusions: A sizeable portion of AYA cancer patients engage in drinking and smoking, which is associated with negative affect and poorer self-reported health. Targeted interventions should be considered to reduce risky behaviors in this population.

scholarly journals Non-oncology physician visits after diagnosis of cancer in adolescents and young adults

2016 ◽  
Vol 10 (4) ◽  
pp. 783-788 ◽  
Author(s):  
Marianne J. Heins ◽  
Maria F. Lorenzi ◽  
Joke C. Korevaar ◽  
Mary L. McBride
Keyword(s):  
Young Adults ◽  
Adolescents And Young Adults ◽  
Physician Visits ◽  
Diagnosis Of Cancer
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