title: Self-advocacy training for cancer survivors. The Cancer Survival Toolbox.
abstract: OBJECTIVE
  With the advent of managed healthcare, self-advocacy has been identified as an essential skill for cancer survivors. This article describes a self-advocacy training program, the Cancer Survival Toolbox, developed through a unique collaborative effort by the National Coalition for Cancer Survivorship, the Association of Oncology Social Work, and the Oncology Nursing Society.
  
  
  METHODS
  Self-advocacy training is provided in audiotape format, as well as through the Internet and in interactive groups. The need for this training was established through surveys completed by 569 cancer survivors and 833 oncology professionals. Essential skills were identified through a literature review, and the content of the training was pilot tested with bicoastal groups of cancer survivors and with feedback from representatives of 15 national cancer organizations.
  
  
  RESULTS
  While the majority of the 569 respondents to the survivor survey were highly educated and between the ages of 31 and 60 years, fewer than half reported that when they first received a diagnosis of cancer they were able to communicate their needs effectively, had the skills necessary to make decisions, or were able to negotiate with healthcare providers, insurers, and employers. Results of the survey of professional oncology nurses and social workers also supported the need for self-advocacy training. Fewer than one third of the 833 respondents to the professional survey reported that their patients who had received new diagnoses of cancer had essential self-advocacy skills.
  
  
  CONCLUSIONS
  This self-advocacy training program is currently available on audiotape in English and Spanish. It is available in print in Chinese on the Internet. Data from the pilot groups indicate the program effectively addresses the self-advocacy skills of communication, information seeking, problem solving, decision making, and negotiating. Data are currently being collected to assess the efficacy of the audiotape format and the impact of the training on survivors and professionals. Future plans include training oncology professionals to teach these skills and to work collaboratively with survivors in advocacy efforts. Additional programs designed to address the needs of the uninsured as well as older adult and pediatric survivor populations are in development.
authors.affiliation: Springfield College School of Social Work, Massachusetts 01109, USA.
authors.forename: K
authors.initials: K
authors.lastname: Walsh-Burke
authors.forename: C
authors.initials: C
authors.lastname: Marcusen
mesh_terms: D000328:Adult; D000368:Aged; D003142:Communication; D003657:Decision Making; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology*; D010344:Patient Advocacy; D010353:Patient Education as Topic / Q000379:methods*; D010865:Pilot Projects; D011340:Problem Solving; D015397:Program Evaluation; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013637:Tape Recording