title: Preparing childhood cancer survivors for transition to adult care: The young adult perspective.
abstract: BACKGROUND
  Childhood cancer survivors (CCSs) remain at risk for developing treatment-associated health conditions as they age; however, many do not obtain recommended follow-up, putting them at unnecessary risk for morbidity. Educational interventions targeted at providing survivors with the knowledge and skills necessary for healthcare independence might improve adherence and outcomes as they transition care to the adult medical system.
  
  
  OBJECTIVE
  To identify informational needs, educational preferences, and support that young adult CCSs perceive as beneficial for transition from pediatric to adult medical care.
  
  
  METHODS
  Sixteen young adult CCSs (ages 22-39 years) who have transitioned to adult care participated in focus groups led by a trained moderator and analyzed using a thematic analysis approach.
  
  
  RESULTS
  Four major themes emerged: (1) education preferences-pediatric oncology provider as the primary source of information and guidance, enhanced by other formats, and early and ongoing engagement in education; (2) family role in transition-desire for independence and acknowledgement of need for ongoing parental support; (3) expectations for adult providers, such as close relationships, open communication, and care coordination; and (4) knowledge deficits regarding disease/treatment history, risk for long-term complications, and navigation of the adult medical system.
  
  
  CONCLUSIONS
  Transition education as described by young adult CCSs should be a developmentally appropriate process beginning in early adolescents, primarily administered by pediatric oncology providers, and delivered in multiple formats. While healthcare independence is a goal for young adult CCSs, all stakeholders must recognize that families and providers continue to have an important role supporting survivors with transition logistics and medical decision-making.
authors.affiliation: Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Boston, Massachusetts.|Harvard Medical School, Boston, Massachusetts.
authors.forename: Natasha N
authors.initials: NN
authors.lastname: Frederick
authors.affiliation: Harvard Medical School, Boston, Massachusetts.|Dana-Farber Cancer Institute Perini Family Survivors Center, Boston, Massachusetts.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Bober
authors.affiliation: Harvard Medical School, Boston, Massachusetts.
authors.forename: Lexie
authors.initials: L
authors.lastname: Berwick
authors.affiliation: Long Term Follow-up Clinic in Pediatric Oncology at Massachusetts General Hospital, Boston, Massachusetts.
authors.forename: Mary
authors.initials: M
authors.lastname: Tower
authors.affiliation: Harvard Medical School, Boston, Massachusetts.|Dana-Farber Cancer Institute Perini Family Survivors Center, Boston, Massachusetts.
authors.forename: Lisa B
authors.initials: LB
authors.lastname: Kenney
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms / Q000523:psychology / Q000628:therapy; D010353:Patient Education as Topic; D017741:Survivors; D060305:Transition to Adult Care
keywords: cancer survivorship; childhood cancer survivor; transition; transition to survivorship