title: Cancer-related follow-up care among Hispanic and non-Hispanic childhood cancer survivors: The Project Forward study.
abstract: BACKGROUND
  Follow-up care is critical for childhood cancer survivors (CCS), who are at high risk for comorbidities and late effects of cancer treatments. Understanding the factors associated with maintaining follow-up care is needed, especially for Hispanic CCS, who have been under-represented in previous studies.
  
  
  METHODS
  Risk factors and protective factors for receiving cancer-related follow-up care were examined among 193 Los Angeles County CCS diagnosed between 2000 and 2007 (54% Hispanic; mean ± standard deviation age, 19.9 ± 2.8 years; age at diagnosis, 12.1 ± 3.0 years; time since diagnosis, 7.8 ± 2.0 years). Self-report surveys were used to assess follow-up care, insurance status, demographics, clinical factors, and psychosocial risk (eg, depression) and protective (eg, self-efficacy [SE]) factors. Multivariable logistic regression was used to identify factors associated with the previous receipt of cancer-related follow-up care (in prior 2 years) and the intent to seek future cancer-related follow-up care.
  
  
  RESULTS
  Seventy-three percent of CCS reported a cancer follow-up visit in the previous 2 years, which was positively associated (P < .05) with having health insurance, white ethnicity (vs Hispanic), younger age, and greater treatment intensity. Sixty-nine percent reported an intent to receive follow-up care in the next 2 years, which was positively associated (P < .05) with having health insurance and greater SE.
  
  
  CONCLUSIONS
  Hispanics and older CCS were more likely to lack previous follow-up care. Because health insurance was strongly associated with both previous follow-up care and the intent to seek care, the current results indicate that recent changes in health coverage may improve follow-up among CCS. Interventions targeting improved SE may help increase intent to receive follow-up care for this population.
authors.affiliation: Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California.
authors.forename: Joel E
authors.initials: JE
authors.lastname: Milam
authors.forename: Kathleen
authors.initials: K
authors.lastname: Meeske
authors.forename: Rhona I
authors.initials: RI
authors.lastname: Slaughter
authors.forename: Sandra
authors.initials: S
authors.lastname: Sherman-Bien
authors.forename: Anamara
authors.initials: A
authors.lastname: Ritt-Olson
authors.forename: Aura
authors.initials: A
authors.lastname: Kuperberg
authors.forename: David R
authors.initials: DR
authors.lastname: Freyer
authors.forename: Ann S
authors.initials: AS
authors.lastname: Hamilton
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003863:Depression / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D009369:Neoplasms / Q000191:economics / Q000208:ethnology / Q000523:psychology; D010553:Personality Development; D020377:Self Efficacy; D057566:Self Report; D017741:Survivors / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Hispanic; adolescent; cancer; childhood; follow-up care; insurance; survivorship; young adult