Changing Childhood Cancer Survivors Health Behaviors to Modify Risks of Late Effects

2.50
Hdl Handle:
http://hdl.handle.net/10755/165328
Category:
Abstract
Type:
Presentation
Title:
Changing Childhood Cancer Survivors Health Behaviors to Modify Risks of Late Effects
Author(s):
Cox, C.; McLaughlin, R.; Rai, S.; Steen, B.; Hudson, M.
Author Details:
C. Cox, St. Jude Children's Research Hospital, Memphis, Tennessee, USA; R. McLaughlin; S. Rai; B. Steen; M. Hudson
Abstract:
The late effects of therapy increase childhood cancer survivors' risk of chronic health problems. Young survivors fail to engage in important health-promoting behaviors, and they practice risk behaviors at alarming rates. Interventions to target behavior change must be developed if there is to be a significant impact on reducing late effects. Purpose: A recent (2002) clinical trial failed to demonstrate a clear impact of an intervention on changing health behaviors in adolescent survivors. The study outcome was a single summative measure: risk behaviors comprised the lower end and health-protective behaviors comprised the higher end of a unidimensional scale. We re-examined these same data by separately evaluating the impact of the intervention on 5 health risk and 9 health protective behaviors. Theoretical/Scientific Framework: The Health Belief Model guided the selection of study variables and the development of the intervention in the parent study. The Interaction Model of Client Health Behavior guided the secondary analysis through the re-configuration of study variables and their relationships. Methods: The randomized trial compared 132 adolescent survivors in the intervention arm with 135 in the standard care arm at baseline and at 1-year follow-up relying on self-report and medical record data. Disease and treatment knowledge were compared against the medical record; late effects risk perceptions and health/risk behaviors were assessed on Likert scales (Cronbach's alpha = 0.75 to 0.92). Data Analysis: Each of the 14 behaviors were evaluated separately in contrast to the parent study's single summative measure; age, gender, and the wide variation in baseline behaviors were addressed within an ANCOVA model. Breast (p=0.0001) /testicular ( p= 0.004) self-examination increased as did perceptions about needing to change behavior (p=0.004), effort needed to stay healthy (p=0.0001), and knowledge (p=0.014). Significant interactions between gender and treatment group were demonstrated. Findings and Implications: The intervention's impact was demonstrated by treating health-risk and health-protective behaviors separately rather than as a single summative measure. Gender and age influenced the intervention's effects, suggesting that a "one-size fits all" approach to changing behavior is ineffective in adolescent survivors. The development of interventions to modify health behaviors in adolescent survivors must extend beyond cognitive processing theories and include important concepts of motivation and tailoring of intervention approaches.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2005
Conference Name:
30th Annual Oncology Nursing Society Congress
Conference Host:
Oncology Nursing Society
Conference Location:
Orlando, Florida, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleChanging Childhood Cancer Survivors Health Behaviors to Modify Risks of Late Effectsen_GB
dc.contributor.authorCox, C.en_US
dc.contributor.authorMcLaughlin, R.en_US
dc.contributor.authorRai, S.en_US
dc.contributor.authorSteen, B.en_US
dc.contributor.authorHudson, M.en_US
dc.author.detailsC. Cox, St. Jude Children's Research Hospital, Memphis, Tennessee, USA; R. McLaughlin; S. Rai; B. Steen; M. Hudsonen_US
dc.identifier.urihttp://hdl.handle.net/10755/165328-
dc.description.abstractThe late effects of therapy increase childhood cancer survivors' risk of chronic health problems. Young survivors fail to engage in important health-promoting behaviors, and they practice risk behaviors at alarming rates. Interventions to target behavior change must be developed if there is to be a significant impact on reducing late effects. Purpose: A recent (2002) clinical trial failed to demonstrate a clear impact of an intervention on changing health behaviors in adolescent survivors. The study outcome was a single summative measure: risk behaviors comprised the lower end and health-protective behaviors comprised the higher end of a unidimensional scale. We re-examined these same data by separately evaluating the impact of the intervention on 5 health risk and 9 health protective behaviors. Theoretical/Scientific Framework: The Health Belief Model guided the selection of study variables and the development of the intervention in the parent study. The Interaction Model of Client Health Behavior guided the secondary analysis through the re-configuration of study variables and their relationships. Methods: The randomized trial compared 132 adolescent survivors in the intervention arm with 135 in the standard care arm at baseline and at 1-year follow-up relying on self-report and medical record data. Disease and treatment knowledge were compared against the medical record; late effects risk perceptions and health/risk behaviors were assessed on Likert scales (Cronbach's alpha = 0.75 to 0.92). Data Analysis: Each of the 14 behaviors were evaluated separately in contrast to the parent study's single summative measure; age, gender, and the wide variation in baseline behaviors were addressed within an ANCOVA model. Breast (p=0.0001) /testicular ( p= 0.004) self-examination increased as did perceptions about needing to change behavior (p=0.004), effort needed to stay healthy (p=0.0001), and knowledge (p=0.014). Significant interactions between gender and treatment group were demonstrated. Findings and Implications: The intervention's impact was demonstrated by treating health-risk and health-protective behaviors separately rather than as a single summative measure. Gender and age influenced the intervention's effects, suggesting that a "one-size fits all" approach to changing behavior is ineffective in adolescent survivors. The development of interventions to modify health behaviors in adolescent survivors must extend beyond cognitive processing theories and include important concepts of motivation and tailoring of intervention approaches.en_GB
dc.date.available2011-10-27T12:16:34Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T12:16:34Z-
dc.conference.date2005en_US
dc.conference.name30th Annual Oncology Nursing Society Congressen_US
dc.conference.hostOncology Nursing Societyen_US
dc.conference.locationOrlando, Florida, USAen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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