title: Follow-up Care Education and Information: Identifying Cancer Survivors in Need of More Guidance.
abstract: Cancer survivors engage in cancer screenings and protective health behaviors at suboptimal rates despite their increased risk for future illness. Survivorship care plans and other educational strategies to prepare cancer survivors to adopt engaged roles in managing long-term follow-up care and health risks are needed. In a sample of cancer survivors, we identified patient characteristics and psychosocial predictors associated with increased follow-up care informational needs. Cross-sectional surveys were administered to early-stage breast and prostate survivors (N = 278; 68 % breast) at least 2 years post treatment from four community hospital programs in New Jersey between May 2012 and July 2013. Patient demographics, medical history, psychosocial characteristics (i.e., worries about the future, fear of disease recurrence, and patient activation), and perceptions of oncology and primary care were assessed. African-American survivors (AOR = 2.69, 95 % confidence interval [CI] 1.27-5.68) and survivors with higher comorbidity (AOR =1.16, CI 1.01-1.33) were more likely to want additional information to guide follow-up care. Adjusting for race and comorbidities, survivors who wanted more information to guide their follow-up care reported greater worries about the future (p < 0.05) and fears about disease recurrence (p < 0.05) compared to those who did not want additional information. Results emphasize the need to develop cancer survivorship educational strategies that are both responsive to the needs of specific populations (e.g., African-American survivors and patients with multiple comorbidities) and the psychosocial profiles that motivate requests for more extensive follow-up guidance.
authors.affiliation: Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA. omalledm@rwjms.rutgers.edu.|Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 1 World's Fair Drive, Suite 1502, Somerset, NJ, 08873, USA. omalledm@rwjms.rutgers.edu.|Rutgers, School of Social Work, New Brunswick, NJ, USA. omalledm@rwjms.rutgers.edu.
authors.forename: Denalee M
authors.initials: DM
authors.lastname: O'Malley
authors.affiliation: Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.|Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 1 World's Fair Drive, Suite 1502, Somerset, NJ, 08873, USA.|Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
authors.forename: Shawna V
authors.initials: SV
authors.lastname: Hudson
authors.affiliation: Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.|Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 1 World's Fair Drive, Suite 1502, Somerset, NJ, 08873, USA.|Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.|Biometrics Division, Rutgers School of Public Health, Piscataway, NJ, USA.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Ohman-Strickland
authors.affiliation: Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.|Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 1 World's Fair Drive, Suite 1502, Somerset, NJ, 08873, USA.
authors.forename: Alicja
authors.initials: A
authors.lastname: Bator
authors.affiliation: Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.|Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 1 World's Fair Drive, Suite 1502, Somerset, NJ, 08873, USA.
authors.forename: Heather S
authors.initials: HS
authors.lastname: Lee
authors.affiliation: Rutgers Biomedical and Health Sciences, Rutgers, The State University of New Jersey, Rutgers Biomedical and Health Sciences, New Brunswick, NJ, USA.|Department of Family Medicine and Community Health, Rutgers Robert Wood Johnson Medical School, 1 World's Fair Drive, Suite 1502, Somerset, NJ, 08873, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Gundersen
authors.affiliation: Fox Chase Cancer Center/Temple Health, Philadelphia, PA, USA.
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Miller
mesh_terms: D001943:Breast Neoplasms / Q000517:prevention & control / Q000523:psychology*; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control / Q000523:psychology*; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000517:prevention & control / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: Breast cancer; Follow-up; Informational needs; Prostate cancer; Survivorship