title: Adolescent and Young Adult Cancer Survivors' Valuation of Post-Treatment Recommended Care.
abstract: OBJECTIVE
  Examine whether survivors of adolescent and young adult (AYA) cancer value recommended post-treatment care using focus groups and a willingness to pay (WTP) survey. WTP, a measure of value, indicates the dollar amount individuals are willing to pay to use a service.
  
  
  METHODS
  Participants were recruited through the Utah Cancer Registry. N = 28 survivors diagnosed with cancer at ages 15-39 and currently aged ≥18 participated in focus groups, and N = 4 in phone interviews (participation rate = 50%). All participants responded to a demographic survey and WTP questions based on one-time and monthly payments for annual visits. Focus group participants responded to an open-ended question on the value of follow-up care. Interval regressions identified factors associated with WTP. Qualitative analysis summarized themes for the open-ended question.
  
  
  RESULTS
  Focus group participants reported valuing follow-up care as it brings peace of mind and helps them manage their health. Yet, 38% reported not having a cancer-related visit in the previous year. Only 27% and 43% of survivors agreed to pay any one-time and monthly payments, respectively. The monthly payment mean WTP was $41 (95% confidence interval [CI]: 31-84), equating to $494 annually, which is greater than the mean WTP for one-time payment ($362, 95% CI: 293-432, p < 0.001), suggesting that survivors may prefer monthly payments. Several factors, including being female and in better health, predicted higher WTP.
  
  
  CONCLUSIONS
  Many AYA cancer survivors report not visiting their doctors annually for post-treatment care despite verbally valuing care. Models that demonstrate high quality and distribute costs over time should be evaluated to encourage survivors to receive recommended care.
authors: 1 Department of Preventive Medicine and Community Health, University of Texas Medical Branch , Galveston, Texas.
authors: Sapna
authors: S
authors: Kaul
authors: 2 Huntsman Cancer Institute, University of Utah , Salt Lake City, Utah.
authors: Rochelle R
authors: RR
authors: Smits-Seemann
authors: 3 Utah Department of Health , Salt Lake City, Utah.
authors: Eduardo R
authors: ER
authors: Zamora
authors: 4 Primary Children's Hospital, University of Utah , Salt Lake City, Utah.|5 Department of Pediatrics, University of Utah , Salt Lake City, Utah.
authors: Holly
authors: H
authors: Spraker-Perlman
authors: 6 Program in Real Estate, Virginia Tech , Blacksburg, Virginia.
authors: Kevin J
authors: KJ
authors: Boyle
authors: 2 Huntsman Cancer Institute, University of Utah , Salt Lake City, Utah.|5 Department of Pediatrics, University of Utah , Salt Lake City, Utah.
authors: Anne C
authors: AC
authors: Kirchhoff
mesh_terms: D000293:Adolescent; D000328:Adult; D000359:Aftercare; D000073116:Cancer Survivors / Q000523:psychology*; D005260:Female; D017144:Focus Groups / Q000379:methods*; D005102:Health Expenditures / Q000639:trends*; D006801:Humans; D008297:Male; D055815:Young Adult
keywords: adolescent and young adult; cancer; follow-up care; survivors; values; willingness to pay