Journal of Cancer Education最新文献

Cancer survivors living in rural areas have poorer health outcomes due in part to poorer access to survivorship programs. This study evaluated the feasibility, acceptability, and preliminary efficacy of a scalable, remotely-delivered health coaching lifestyle intervention for cancer survivors. In this phase II pilot study, we recruited young and middle-aged adult cancer survivors (18-64 years) to participate in a remotely-delivered eight-week lifestyle behavior change intervention that included remote health coaching sessions (administered by trained student health coaches), remote health education videos, and a wearable activity/sleep monitor. Feasibility was measured by enrollment, retention, and attrition rates, while acceptability was assessed via a post-intervention survey. Preliminary efficacy was evaluated by changes in psychosocial mechanisms, health behaviors, and cancer-related health outcomes. Our enrollment rate (49%) fell just short of our target (50%). Our retention rate (83%) exceeded our target rate of 75%. Adherence rates also exceeded targets (75%) with 99% of remote health coaching sessions attended, 84% of educational videos viewed, and activity monitors worn on 87% of all intervention days. Acceptability rates were also high with most participants reporting the program was beneficial (90%) and that they would recommend it to others (87%). We observed medium-large effects for several secondary/exploratory outcomes including behavioral regulation skills (Cohen's d = 2.04), fatigue (d = 0.86), and global health scores (d = 0.99). No pre-post changes were observed for physical activity, diet, or sleep behaviors. Findings suggest it is feasible to deliver an acceptable remote lifestyle intervention to young and middle-aged cancer survivors. Improvements in targeted psychosocial and cancer-related health markers are promising and support the need for a larger, controlled follow-up study. These findings support the feasibility of delivering a remote, lifestyle behavior change program to young and middle-aged cancer survivors.

Health literacy (HL) has been found to affect perceived information provision (PIP), satisfaction with information provision, and health-related quality of life (HRQoL) in patients with cancer. Patients with a rare cancer are confronted with challenges, such as a lack of information. The aim of this study was to explore the impact of HL on PIP, satisfaction with information provision, and on HRQoL in rare compared to common cancer patients.A population-based study was conducted using the PROFILES registry. Patients with rare (n = 385) and common (n = 1,692) cancer were included. Within group associations (low/medium HL, high HL, rare cancer, common cancer) were assessed. Regression analyses were used to assess associations between HL, PIP, satisfaction, and HRQoL, taking cancer group into account.Within the low/medium HL group, no statistically significant differences were found between rare and common cancer patients. Yet, within the high HL group, rare cancer patients scored significantly lower on all PIP-categories (except PIP-medical tests), satisfaction and HRQoL. Within the rare cancer group, patients with low/medium HL scored lower, compared to those with high HL, on PIP-medical tests and PIP-treatment, while within the common cancer group, patients with low/medium HL scored lower on all PIP-categories, satisfaction and HRQoL (all: p<0.05).Information needs might vary between patients with a different HL level and/or cancer group. Healthcare professionals should take individual needs into account, with a special focus on patients with a rare cancer and low/medium HL, in order to convey information in an understandable, patient-tailored way.

Cancer is the leading cause of death in Canada, and care for cancer patients is becoming increasingly complex. Oncology education, particularly for internal medicine trainees, has been shown to be lacking in both a Canadian and global context. In Canada, residency training is now delivered through a competence-based medical education system. Trainees achieve competency by completing "tasks" called Entrustable Professional Activities (EPAs). Using document analysis, 27 EPAs encompassing 401 observations were identified in the general internal medicine residency curriculum. These were mapped to 17 subspecialties. Cardiology and general medicine EPAs comprised the highest proportions at 12% and 10% respectively. However, oncology-related objectives comprised only 6% of all EPAs, ranking 9^th in representation among the subspecialties. We believe updated efforts are needed to improve oncology education within internal medicine training given increasing public health needs. Creating a national curriculum with standardized learning objectives that may complement the Competence by Design (CBD) curriculum could satisfy this educational need.

The National Cancer Institute (NCI) reports declines in the size and retention of early career researchers. To address a growing need in training that fosters retention and success, we developed, implemented, and evaluated a virtual, Acceptance and Commitment Therapy (ACT)-based, intensive, three-day workshop. This workshop focused on resiliency and leadership skills for early-career NCI-funded investigators conducting basic, translational, or clinical research. A multidisciplinary team of supportive oncology researchers from Dana-Farber Cancer Institute and Massachusetts General Hospital developed a workshop focused on: (1) advanced research methods in oncology research; (2) leadership skills; and (3) resilience skills using an ACT framework. This workshop trained 91 early career investigators over five cohorts. Participants completed self-report measures at three time points: pre-course, 6 months, and 12 months for evaluation. Most participants were female (59.3%), White, and had a PhD. Of those who responded to the survey at 6 months follow-up (n = 80), the majority reported using acceptance skills (63.8%), values (67.5%), and cognitive defusion (60%). At 12 months follow-up (n = 77), 67.5% reported use of acceptance, 70.1% reported using values, and 51.9% used cognitive defusion. We developed a three-day workshop focused on resiliency training for NCI-funded, early career investigators using an ACT framework. The majority of participating investigators reported retention and utilization of ACT-based skills at 6- and 12-months post-workshop. While findings suggest that early career investigators can learn and retain ACT-based skills to enhance resilience, further research is needed to determine whether these skills contribute to long-term career sustainability.

A lack of diversity in the biomedical research workforce significantly affects our ability to address the public health burden and financial costs associated with cancer health disparities. To address this issue, we created the Meharry Cancer Summer Undergraduate Research Program (SURP). The Meharry Cancer SURP is a 10-week intensive research experience designed to expose undergraduate students to the area of cancer health disparities; provide students with a greater understanding of basic, clinical and translational cancer research; and to inspire participants to pursue cancer-focused careers. During the first six years of the program a nationwide search was performed to identify and select 10-17 participants per year. Students performed research projects with experienced investigators at either Meharry Medical College or Vanderbilt-Ingram Cancer Center. Each student participated in a week-long cancer biology mini course to ensure students understood fundamental concepts common to all cancers and relevance to the study of health disparities. They also attended research seminars given by oncologists and cancer researchers and career development sessions designed to provide information on cancer-focused career options and the tools required to submit competitive applications to medical and/or PhD graduate schools. Together these activities increased student awareness of cancer research and cancer health disparities. They also provided opportunities for participants to become part of the larger cancer research community.

UK medical schools currently have no formal educational curricula for surgery and oncology. Many students and resident doctors also report low confidence levels and struggle to grasp key concepts within these fields. This study assessed the impact of an online teaching series on learner confidence in surgical oncology. Nine sessions focused on the surgical management of multiple forms of cancer were delivered. Learner confidence before and after the sessions was compared using paired t-tests, and qualitative feedback was collected and analysed using grounded theory. 275 people attended the sessions live from countries in Europe, Asia, and Africa, and 193 provided feedback. Attendees' cumulative confidence rating was significantly higher after the sessions (p = 0.0001, t = 14.0, Cohen's d = 4.06). 168 learners provided positive qualitative feedback, and 88 gave constructive criticism. Common strong points included the presentation, content, and visual materials used during the teaching. Recordings of the sessions were accessed by 391 learners across five continents. 48 provided feedback, and their mean confidence level was significantly greater after accessing the content compared to before (p = 0.0001, t = 8.104, Cohen's d = 3.90). There are currently few formal teaching programmes focusing on surgical oncology. Our series successfully improved learner confidence about the surgical management of a variety of malignancies. The promotion of similar online teaching methods with improved interactivity and accessibility should allow more learners across the world to build confidence in this field.