Advertisement

A Hope-Based Intervention to Address Disrupted Goal Pursuits and Quality of Life Among Young Adult Cancer Survivors

  • Carla J. BergEmail author
  • Robin C. Vanderpool
  • Betelihem Getachew
  • Jackelyn B. Payne
  • Meghan F. Johnson
  • Yasmeni Sandridge
  • Jennifer Bierhoff
  • Lana Le
  • Rakiyah Johnson
  • Amber Weber
  • Akilah Patterson
  • Sarah Dorvil
  • Ann Mertens
Article

Abstract

Over 70,000 US young adults are diagnosed with cancer annually, disrupting important life transitions and goal pursuits. Hope is a positive psychology construct associated with better quality of life (QOL) that focuses on goal-oriented thinking. We developed and tested Achieving Wellness After Kancer in Early life (AWAKE), a scalable 8-week app-based program consisting of educational videos, mood/activity tracking, and telephone-based coaching to promote hope and QOL in young adult cancer survivors (YACS, 18–40 years old). A two-arm RCT was used to examine the feasibility, acceptability, and potential efficacy of AWAKE (n = 38) versus attention control (AC; n = 18) among YACS within 2 years of completing treatment and recruited from two NCI-designated cancer centers. Outcomes including hope (Trait Hope Scale), QOL (36-Item Short Form Health Survey; Functional Assessment of Cancer Therapy-General), depressive symptoms (Patient Health Questionnaire-9), and substance use were assessed at baseline, 8 weeks, and 6 months. Participants were an average of 32.55 (SD = 5.45) years old; 75.0% were female, and 80.4% White. The most common cancers were breast cancer (28.6%), melanoma (16.1%), and leukemia/lymphoma (12.5%). High retention, engagement, and satisfaction rates were documented in both conditions; AWAKE versus AC participants rated video content as more relevant (p = 0.007) and reported greater likelihood of talking positively about the program (p = 0.005). Many efficacy change scores showed positive trends in AWAKE versus AC. Reorienting to one’s goal pursuits after cancer diagnosis and treatment is critical and may be supported through hope-based interventions. Findings suggest that the AWAKE warrants subsequent research testing its efficacy, effectiveness, and scalability.

Keywords

Adolescent and young adult cancer survivors Survivorship Psychological factors 

Notes

Funding Information

This research was supported by Emory University’s Winship Cancer Institute (P30 CA138292; Winship Invests Pilot Program; PI: Berg). This project was supported by services from the University of Kentucky Markey Cancer Center Behavioral and Community-Based Research and Cancer Research Informatics Shared Resource Facilities (P30 CA177558).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional Review Boards at Emory University (IRB00086979) and the University of Kentucky (16-0751-P2H) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    American Cancer Society (2018) Cancer facts & figures 2018. Atlanta, American Cancer Society https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2018/cancer-facts-and-figures-2018.pdf. Accessed April 16, 2019Google Scholar
  2. 2.
    Hullmann SE, Robb SL, Rand KL (2015) Life goals in patients with cancer: a systematic review of the literature. Psycho-Oncology 25(4):387–399CrossRefGoogle Scholar
  3. 3.
    NCI Surveillance, E., and End Results Program (SEER) (2018) NCI Surveillance, Epidemiology, and End Results Program (SEER) 2018. https://seer.cancer.gov/. Accessed April 16, 2019
  4. 4.
    Ketterl TG, Syrjala KL, Casillas J, Jacobs LA, Palmer SC, McCabe MS, Ganz PA, Overholser L, Partridge A, Rajotte EJ, Rosenberg AR, Risendal B, Rosenstein DL, Baker KS (2019) Lasting effects of cancer and its treatment on employment and finances in adolescent and young adult cancer survivors. Cancer 125(11):1908–1917CrossRefGoogle Scholar
  5. 5.
    Tai E, Buchanan N, Townsend J, Fairley T, Moore A, Richardson LC (2012) Health status of adolescent and young adult cancer survivors. Cancer 118(19):4884–4891CrossRefGoogle Scholar
  6. 6.
    Tai E, Buchanan N, Westervelt L, Elimam D, Lawvere S (2014) Treatment setting, clinical trial enrollment, and subsequent outcomes among adolescents with cancer: a literature review. Pediatrics 133:S91–S97CrossRefGoogle Scholar
  7. 7.
    Zebrack B, Mathews-Bradshaw B, Siegel S (2010) Quality cancer care for adolescents and young adults: a position statement. J Clin Oncol 28(32):4862–4867CrossRefGoogle Scholar
  8. 8.
    Lowe KA, Escoffery C, Mertens AC, Berg CJ (2016) Distinct health behavior and psychosocial profiles of young adult cancer survivors: a mixed methods study. J Cancer Surviv 10(4):619–632CrossRefGoogle Scholar
  9. 9.
    Berg CJ, Stratton E, Esiashvili N, Mertens A (2016) Young adult cancer survivors’ experience with cancer treatment and follow-up care and perceptions of barriers to engaging in recommended care. J Cancer Educ 31(3):430–442CrossRefGoogle Scholar
  10. 10.
    Barthel EM, Spencer K, Banco D, Kiernan E, Parsons S (2016) Is the adolescent and young adult cancer survivor at risk for late effects? It depends on where you look. J Adolesc Young Adult Oncol 5(2):159–173CrossRefGoogle Scholar
  11. 11.
    Barr RD, Ferrari A, Ries L (2016) Cancer in adolescents and young adults: a narrative review of the current status and a view of the future. JAMA Pediatr 170(5):495–501CrossRefGoogle Scholar
  12. 12.
    Keegan TH, Ries LAG, Barr RD, Geiger AM, Dahlke DV, Pollock BH, Archie Bleyer W (2016) Comparison of cancer survival trends in the United States of adolescents and young adults with those in children and older adults. Cancer 122(7):1009–1016CrossRefGoogle Scholar
  13. 13.
    Bleyer WA (2002) Cancer in older adolescents and young adults: epidemiology, diagnosis, treatment, survival, and importance of clinical trials. Med Pediatr Oncol 38(1):1–10CrossRefGoogle Scholar
  14. 14.
    Bleyer A (2011) Latest estimates of survival rates of the 24 most common cancers in adolescent and young adult Americans. J Adolesc Young Adult Oncol 1(1):37–41CrossRefGoogle Scholar
  15. 15.
    Bleyer A (2012) How NCCN guidelines can help young adults and older adolescents with cancer and the professionals who care for them. J Natl Compr Cancer Netw 10(9):1065–1071CrossRefGoogle Scholar
  16. 16.
    LIVESTRONG Young Adult Alliance (2014) Closing the gap: a strategic plan: addressing the recommendations of the Adolescent and young adult Oncology progress Review Group. Austin, Lance Armstrong Foundation, p 2007Google Scholar
  17. 17.
    Yang Y, Li W, Wen Y, Wang H, Sun H, Liang W, Zhang B, Humphris G (2019) Fear of cancer recurrence in adolescent and young adult cancer survivors: a systematic review of the literature. Psychooncology 28(4):675–686CrossRefGoogle Scholar
  18. 18.
    Wexler ID, Corn BW (2012) An existential approach to oncology: meeting the needs of our patients. Curr Opin Support Palliat Care 6(2):275–279CrossRefGoogle Scholar
  19. 19.
    Dahlke V, Deborah KF, Hong YA, Kellstedt D, Ory MG (2017) Adolescent and young adult cancer survivorship educational programming: a qualitative evaluation. JMIR Cancer 3(1):e3CrossRefGoogle Scholar
  20. 20.
    Snyder CR, Lopez SJ (2009) Oxford handbook of positive psychology. Oxford University Press, OxfordGoogle Scholar
  21. 21.
    Schroevers MJ, Kraaij V, Garnefski N (2011) Cancer patients’ experience of positive and negative changes due to the illness: relationships with psychological well-being, coping, and goal reengagement. Psycho-Oncology 20(2):165–172CrossRefGoogle Scholar
  22. 22.
    Casellas-Grau A, Font A, Vives J (2014) Positive psychology interventions in breast cancer. A systematic review. Psycho-Oncology 23(1):9–19CrossRefGoogle Scholar
  23. 23.
    Ferrell BR, Hassey Dow K, Grant M (1995) Measurement of the quality of life in cancer survivors. Qual Life Res 4(6):523–531CrossRefGoogle Scholar
  24. 24.
    Snyder CR (2002) Hope theory: rainbows in the mind. Psychol Inq 13:249–275CrossRefGoogle Scholar
  25. 25.
    Snyder CR (1996) To hope, to lose, and hope again. J Pers Interpers Loss 1:3–16Google Scholar
  26. 26.
    Stanton AL, Danoff-Burg S, Cameron CL, Bishop M, Collins CA, Kirk SB, Sworowski LA (2000) Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. J Consult Clin Psychol 68(5):875–882CrossRefGoogle Scholar
  27. 27.
    Berg CJ, Snyder CR, Hamilton N (2008) The effectiveness of a hope intervention in coping with cold pressor pain. J Health Psychol 13(6):804–809CrossRefGoogle Scholar
  28. 28.
    Berg CJ, Ritschel LA, Swan DW, An LC, Ahluwalia JS (2011) The role of hope in engaging in healthy behaviors among college students. Am J Health Behav 35(4):402–415CrossRefGoogle Scholar
  29. 29.
    Coleman S, Berg CJ, Thompson NJ (2014) Social support, nutrition intake, and physical activity in cancer survivors. Am J Health Behav 38(3):414–419CrossRefGoogle Scholar
  30. 30.
    Berg CJ, Thomas AN, Mertens AC, Schauer GL, Pinsker EA, Ahluwalia JS, Khuri FR (2012) Correlates of continued smoking versus cessation among survivors of smoking-related cancers. Psycho-Oncology 22(4):799–806CrossRefGoogle Scholar
  31. 31.
    Larcombe I, Mott M, Hunt L (2002) Lifestyle behaviours of young adult survivors of childhood cancer. Br J Cancer 87(11):1204–1209CrossRefGoogle Scholar
  32. 32.
    Rustoen T, Cooper BA, Miaskowski C (2011) A longitudinal study of the effects of a hope intervention on levels of hope and psychological distress in a community-based sample of oncology patients. Eur J Oncol Nurs 15(4):351–357CrossRefGoogle Scholar
  33. 33.
    Cheavens J, Feldman DB, Gum A, Michael ST, Snyder CR (2006) Hope therapy in a community sample. Soc Indic Res 77:61–78CrossRefGoogle Scholar
  34. 34.
    Snyder CR, Harris C, Anderson JR, Holleran SA, Irving LM, Sigmon SX, Yoshinobu L, Gibb J, Langelle C, Harney P (1991) The will and the ways: development and validation of an individual-differences measure of hope. J Pers Soc Psychol 60(4):570–585CrossRefGoogle Scholar
  35. 35.
    Babyak MA, Snyder CR, Yoshinobu L (1993) Psychometric properties of the hope scale: a confirmatory factor analysis. J Res Pers 27:154–169CrossRefGoogle Scholar
  36. 36.
    Cheavens J, Gum A, Snyder CR (2000) The Trait Hope Scale. In: Maltby CAL, Hill A (eds) Handbook of psychological tests. Mellen Press, Lampeter, pp 248–258Google Scholar
  37. 37.
    Hays RD, Sherbourne CD, Mazel R (1995) User’s manual for the Medical Outcomes Study (MOS) core measures of health-related quality of life. RAND Corporation, Santa MonicaGoogle Scholar
  38. 38.
    Cella, David F., David S. Tulsky, George Gray, Bernie Sarafian, Elizabeth Linn, Amy Bonomi, Margaret Silberman, Suzanne B. Yellen, Patsy Winicour, Judy Brannon, Karen Eckberg, Stephen Lloyd, Sandy Purl, Carol Blendowski, Michelle Goodman, Madeline Barnicle, Irene Stewart, Marnie McHale, Philip Bonomi, Edward Kaplan, Samuel Taylor IV, Charles R. Thomas, Jr, and Jules Harriset. 1993. The Functional Assessment of Cancer Therapy scale: development and validation of the general measure. J Clin Oncol 11(3): 570–579Google Scholar
  39. 39.
    Kroenke K, Spitzer RL (2002) The PHQ-9: a new depression diagnostic and severity measure. Psychiatr Ann 32(9):1–7CrossRefGoogle Scholar
  40. 40.
    Centers for Disease Control and Prevention, Behavioral risk factor surveillance system, 2011 (2012) Centers for Disease Control and Prevention. https://www.cdc.gov/brfss/data_documentation/index.htm. Accessed April 15, 2019
  41. 41.
    Jafari E, Najafi M, Sohrabi F, Dehshiri GR, Soleymani E, Heshmati R (2010) Life satisfaction, spirituality well-being and hope in cancer patients. Procedia Soc Behav Sci 5:1362–1366CrossRefGoogle Scholar
  42. 42.
    Rawdin B, Evans C, Rabow MW (2013) The relationships among hope, pain, psychological distress, and spiritual well-being in oncology outpatients. J Palliat Med 16(2):167–172CrossRefGoogle Scholar
  43. 43.
    Holt CL, Clark EM, Klem PR (2007) Expansion and validation of the spiritual health locus of control scale: factorial analysis and predictive validity. J Health Psychol 12(4):597–612CrossRefGoogle Scholar
  44. 44.
    Irving LM, Snyder CR, Jeffrey Crowson J, Jr. (1998) Hope and coping with cancer by college women. J Pers 66(2):195–214CrossRefGoogle Scholar

Copyright information

© American Association for Cancer Education 2019

Authors and Affiliations

  • Carla J. Berg
    • 1
    Email author
  • Robin C. Vanderpool
    • 2
  • Betelihem Getachew
    • 1
  • Jackelyn B. Payne
    • 3
  • Meghan F. Johnson
    • 2
  • Yasmeni Sandridge
    • 1
  • Jennifer Bierhoff
    • 1
  • Lana Le
    • 1
  • Rakiyah Johnson
    • 4
  • Amber Weber
    • 1
  • Akilah Patterson
    • 1
  • Sarah Dorvil
    • 1
  • Ann Mertens
    • 5
  1. 1.Department of Behavioral Sciences and Health Education, Rollins School of Public HealthEmory UniversityAtlantaUSA
  2. 2.Markey Cancer CenterUniversity of KentuckyLexingtonUSA
  3. 3.Department of PsychologyStony Brook UniversityStony BrookUSA
  4. 4.Division of Infectious Diseases, Department of MedicineEmory University School of MedicineAtlantaUSA
  5. 5.Department of PediatricsEmory University and Aflac Cancer and Blood Disorders Center of Children’s Healthcare of AtlantaAtlantaUSA

Personalised recommendations