scholarly journals Self-Management and Health Care Use in an Adolescent and Young Adult Medicaid Population With Differing Chronic Illnesses

2015 ◽  
Vol 12 ◽  
Author(s):  
G. Alexandra Phillips ◽  
Nicole Fenton ◽  
Sarah Cohen ◽  
Karina Javalkar ◽  
Maria Ferris
Keyword(s):  
Health Care ◽  
Young Adult ◽  
Chronic Illnesses ◽  
Health Care Use ◽  
Adolescent And Young Adult ◽  
Self Management ◽  
Medicaid Population

Adolescent and Young Adult (AYA) Cancer Survivorship Curriculum In a University Setting

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4749-4749
Author(s):  
William Wood ◽  
Sarah Wright ◽  
Anne Stephens ◽  
Sheila Santacroce ◽  
Julie Blatt ◽  
...  
Keyword(s):  
Health Care ◽  
Young Adult ◽  
Focus Groups ◽  
Cancer Survivors ◽  
Cancer Survivorship ◽  
Late Effects ◽  
Adolescent And Young Adult ◽  
Self Management ◽  
Teaching Modules ◽  
University Setting

Abstract Abstract 4749 Background: That pediatric, adolescent and young adult cancers have become compatible with long term survivorship in the majority of cases has meant a growing emphasis on an understanding of the late effects of treatment. Among the barriers to successful health self-management in the context of transition of care from pediatricians to internists is the challenge of finding adult health care providers in the community who are comfortable caring for patients in this age group. We have developed a curriculum relating to different aspects of AYA survivorship for oncology and primary health care trainees who may come across AYA cancer survivors in the course of usual practice. Focus groups were used to refine the modules before the current application. Aim: To improve provider knowledge of AYA survivorship issues and management in a university setting. Methods: Using a combination of review articles, original research, and published guidelines for cancer survivorship, 8 teaching modules (power point presentations of 8–15 slides each) were developed: health care self-management; bone health; cardiac late effects; fertility late effects; neurocognitive late effects; psychosocial late effects; pulmonary late effects; and second malignancies. Modules were refined with the use of provider focus groups. These recently have been made available to trainees at UNC: (pediatrics [P], medicine-pediatrics [MP], medicine [M], medical hematology oncology [MHO], pediatric hematology oncology [PHO], and nurse practitioner students [NP]) in hard copy and on departmental websites. Computerized pre- and post-tests were developed for each module to assess content acquisition and will be required of the ~6 trainees/month rotating through the Survivors Clinics or on inpatient or outpatient services. At the end of each module, participants also are being asked, using a 3 point scale (agree [3], neutral [2], disagree [1]) if they feel the sessions gave them increased confidence in following AYA survivors. Participants also will be given the opportunity to critique the modules. Results: Preliminary results will not be available until December. However, enthusiasm among the target audience during the first 2 months of this program has been strong. Conclusion: Short teaching modules can be developed to engage trainees in AYA late effects issues. Ongoing work is being done to assess the effectiveness and usefulness of the modules for providers at UNC who care for adolescent and young adult cancer survivors. We anticipate that this approach will be expanded to our outreach practices. Parallel modules are in development for AYA survivors and their families. *With support from a 2009 ASH Alternative Training Pathway Grant, T. Shea, PI. Disclosures: No relevant conflicts of interest to declare.

Healthcare utilization and quality among survivors of adolescent and young adult cancer.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 21-21
Author(s):  
Anne C. Kirchhoff ◽  
Sapna Kaul ◽  
Mark Fluchel ◽  
Christopher F Parmeter ◽  
Holly Lynn Spraker
Keyword(s):  
Health Care ◽  
Young Adult ◽  
Health Care Quality ◽  
Comparison Group ◽  
Care Quality ◽  
Health Care Use ◽  
Medical Expenditure ◽  
Adolescent And Young Adult ◽  
Care Needs ◽  
Targeted Interventions

21 Background: To evaluate perceived health care quality among a national sample of survivors of adolescent and young adult (AYA) cancer relative to individuals from the general population. Methods: Using the Medical Expenditure Panel Surveys from 2008-2012, we identified 1,163 survivors diagnosed with cancer ages 15-39 who were at least five years from diagnosis and currently ages of 20-64. A comparison group with no history of cancer was created via propensity score matching on sex, age at study, race/ethnicity, census-region, and survey year. Participants with one or more health care visit in the past 12 months were asked to rate health care quality from all providers (0 = worst to 10 = best), which we categorized as low (0-4), moderate (5-7) and high (8-10). Among survivors, we identified factors such insurance and health status associated with health care quality using ordinal logistic regression. Results: Mean time since diagnosis was 18.3 years. A total of 18% of survivors of AYA cancer reported no health care visits in the previous 12 months compared to 25% of the comparison group (p < 0.001). Survivors rated their health care quality lower than the comparison group (low/moderate: 30.8% vs. 22.5%, respectively, p = 0.003). Among survivors, those who were publicly insured (odds ratio (OR) = 0.62, 95% confidence interval (CI): 0.39-0.97, p = 0.04) and uninsured (OR = 0.25, 95% CI: 0.13-0.48, p < 0.001) were more likely to provide lower health care quality ratings than privately insured survivors. Survivors in fair/poor health also reported poorer quality compared to those in excellent/very good/good health (OR = 0.43, 95% CI, p < 0.001). Conclusions: Survivors of AYA cancer reported greater health care use and poorer health care quality compared to individuals without cancer. Our results call for targeted interventions to meet AYA cancer survivors’ health care needs and expectations.

scholarly journals Nurse-led video-coaching interventions in childhood, adolescent and young adult cancer survivors (REVIVER): a protocol for mixed methods feasibility research

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Eline Bouwman ◽  
Rosella P. M. G. Hermens ◽  
Nicole M. A. Blijlevens ◽  
Judith B. Prins ◽  
Jacqueline J. Loonen
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Behavioural Therapy ◽  
Adolescent And Young Adult ◽  
Self Management ◽  
Adult Onset ◽  
Survivorship Care ◽  
Potential Effectiveness ◽  
Cognitive Behavioural ◽  
Interviewing Techniques

Abstract Background Successful cancer treatment can lead to cancer survivors being predisposed to an increased lifelong risk of adverse late health effects. Therefore, high-quality cancer survivorship care to earlier detect and treat late effects or to preserve survivor’s health is essential. Nevertheless, this care needs to be sustainable and cost-effective as well. We developed three different screen-to-screen nurse-led eHealth interventions for survivors of childhood, adolescent and young adult-onset cancer, collectively called the REVIVER interventions. Elaborating on person-centred care principles with content based on cognitive behavioural therapy modules and/or motivational interviewing techniques, these interventions aim to empower and coach survivors to improve (1) symptoms of cancer-related fatigue, (2) self-efficacy and self-management or (3) lifestyle. With the REVIVER study, we aim to evaluate the interventions’ feasibility and gain insights into the potential effectiveness. Methods The REVIVER study involves a mixed methods design, including (1) interviews till data saturation with cancer survivors who completed the interventions as well as with all involved medical professionals, (2) reviews of nurses reports and (3) a single-group, pre-post evaluation among cancer survivors. Eligible survivors are survivors of childhood, adolescent and young adult-onset cancer who are referred to one of the interventions, in complete remission of cancer, 16–44 years old at enrolment, completed treatment at least 5 years ago and have access to a device with Internet options. We will assess feasibility in terms of demand, adherence, acceptability, practicality and integration/implementation. Health-related quality of life, as primary outcome of the potential effectiveness evaluation, will be assessed at three different time points: prior to the intervention; immediately following the intervention and 6 months post-intervention. Secondary outcome measures include changes in level of fatigue, self-efficacy, self-management and lifestyle. Discussion This is the first study to evaluate the feasibility and potential effectiveness of eHealth nurse-led interventions elaborating on person-centred care, using cognitive behavioural therapy and/or motivational interviewing techniques as an innovative and promising approach for providing CAYA cancer survivorship care. If the interventions prove to be feasible and potential effective, a randomized controlled trial will be conducted to test the (cost)-effectiveness.

Asthma self-management with regular support reduces health care use and improves QoL at 8 mo

2020 ◽  
Vol 173 (12) ◽  
pp. JC67
Author(s):  
Christopher J. Worsnop ◽  
Christine F. McDonald
Keyword(s):  
Health Care ◽  
Health Care Use ◽  
Self Management

Effectiveness of a Brief Curriculum to Promote Condom and Health Care Use Among Out-of-School Young Adult Males

2013 ◽  
Vol 45 (1) ◽  
pp. 33-40 ◽  
Author(s):  
Arik V. Marcell ◽  
Elizabeth Allan ◽  
Eric A. Clay ◽  
Catherine Watson ◽  
Freya L. Sonenstein
Keyword(s):  
Health Care ◽  
Young Adult ◽  
Health Care Use ◽  
Adult Males ◽  
Young Adult Males ◽  
Out Of School

Limitations in health care access and utilization among long-term survivors of adolescent and young adult cancer

Cancer ◽  
2012 ◽  
Vol 118 (23) ◽  
pp. 5964-5972 ◽  
Author(s):  
Anne C. Kirchhoff ◽  
Courtney R. Lyles ◽  
Mark Fluchel ◽  
Jennifer Wright ◽  
Wendy Leisenring
Keyword(s):  
Health Care ◽  
Young Adult ◽  
Health Care Access ◽  
Adolescent And Young Adult ◽  
Care Access ◽  
Young Adult Cancer ◽  
Long Term Survivors

scholarly journals Psychosexual Care of Adolescent and Young Adult (AYA) Cancer Survivors

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1058
Author(s):  
Laura Reinman ◽  
Helen L. Coons ◽  
Jenna Sopfe ◽  
Robert Casey
Keyword(s):  
Health Care ◽  
Young Adult ◽  
Sexual Health ◽  
Health Care Providers ◽  
Adolescent And Young Adult ◽  
Medical Team ◽  
Care Providers ◽  
Medical Needs ◽  
Contextual Framework ◽  
Open Discussion

Adolescent and young adult (AYA) survivors of cancer have diverse psychosocial and medical needs, including those related to fertility and sexual health. Much of the focus of care around issues such as fertility and sexual health tends to be filtered through a biomedical lens. However, it is essential that health care providers assess and support AYA survivors using a biopsychosocial and contextual framework to ensure the most comprehensive and accurate understanding of AYA survivor needs, especially those related to psychosexual health. A trusting relationship between the multi-disciplinary medical team and the AYA survivor that allows for open discussion about the physical and psychosocial components of sexual health is key to providing best care and outcomes.

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