title: A Formative Study of Colon Cancer Surveillance Care: Implications for Survivor-Centered Interventions.
abstract: Colon cancer is one of the most commonly diagnosed cancers in the United States, and an increasing number of survivors has underscored the need for improved colon cancer surveillance care quality. Post-treatment surveillance includes follow-up care visits and tests as well as psychosocial support and lifestyle counseling. This formative study explored the individual, interpersonal, and organizational-level factors related to adherence to surveillance care guidelines to identify modifiable factors for potential educational intervention strategies. A convenience sample of 22 survivors (12 women and 10 men) from two cancer centers were recruited to participate in focus groups or key informant telephone interviews to explore their experiences with care after completing treatment and complete a brief survey. Content analysis was used to identify themes. Results confirmed that survivors navigated a complex surveillance care schedule and described a strong trust in their health care providers that guided their follow-up care experiences. Participants defined the terms "survivorship" and "follow-up" in a variety of different ways. Individual-level themes critical to survivors' experiences included having a positive attitude, relying on one's faith, and coping with fears. Interpersonal-level themes centered around interactions and communication with family and health care providers in follow-up care. While organizational-level factors were highlighted infrequently, participants rated office reminder systems and communication among their multiple providers as valuable. Educational interventions capitalizing on survivors' connections with their physicians and focusing on preparing survivors for what to expect in the next phase of their cancer experience, could be beneficial at the end of treatment to activate survivors for the transition to the post-treatment period.
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29425, USA. sterba@musc.edu.|Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA. sterba@musc.edu.
authors.forename: Katherine Regan
authors.initials: KR
authors.lastname: Sterba
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29425, USA.|Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Zapka
authors.affiliation: Division of Behavioral Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worchester, MA, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: LaPelle
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29425, USA.|Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA.
authors.forename: Kent
authors.initials: K
authors.lastname: Armeson
authors.affiliation: Department of Public Health Sciences, Medical University of South Carolina, 135 Cannon Street, Charleston, SC, 29425, USA.|Hollings Cancer Center, Medical University of South Carolina, 68 President Street, MSC 955, Charleston, SC, 29425, USA.
authors.forename: Marvella E
authors.initials: ME
authors.lastname: Ford
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003110:Colonic Neoplasms / Q000517:prevention & control*; D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D003695:Delivery of Health Care; D018479:Early Intervention, Educational; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D010820:Physicians; D017741:Survivors
keywords: Colon cancer; Follow-up care; Survivorship