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For adolescents and young adults (AYAs, 12–24 years), a parental cancer diagnosis can disrupt critical developmental processes and family relationships, negatively impacting wellbeing. However, few supportive interventions are available to affected offspring. This paper reports the feasibility and acceptability of Truce, an Acceptance and Commitment Therapy (ACT)-based weekly program for AYAs impacted by parental cancer. A multi-method, multi-informant approach was used, with data drawn from facilitator, AYA and parent/caregiver feedback collected after each session and at the end of the program. Truce was delivered with high fidelity to the program manual and high participant interest. AYAs and parents/caregivers reported perceived benefits of participation around therapeutic teachings, peer connection, and parental participation. While subsequent work will determine whether Truce has significant psychosocial benefits for participants, findings are a promising indicator of the potential for ACT-based group interventions to support AYAs affected by parental cancer.

Truceis an Acceptance and Commitment Therapy group program for young people who have a parent with cancer. In a pragmatic controlled trial, we compared Trucewith a wait-list condition to assess its effect on unmet needs and distress. We also investigated how process variables—mindfulness, cognitive inflexibility, family functioning, and life events—might influence outcomes. Participants' unmet needs improved over time (β^ = −5.01, SE = 16.48, p = 0.036, effect size = 0.42), and those improvements were greater for the intervention group compared to controls (β^ = −5.03, SE = 2.41, p = 0.040, effect size = 0.29). There was no evidence of a significant program benefit for distress. For the intervention group, greater improvements in unmet needs were associated with higher baseline distress (t = 2.36, df = 47, p = 0.022), and being less mindful at baseline (t = 2.07, df = 47, p = 0.044). No significant mediators were identified. For the control group only, experiencing negative/mixed life events related to cancer was a significant moderator of improvement (t = −2.36, df = 33, p = 0.024). Truceappears to offer therapeutic benefits to young people who have a parent with cancer, over and above the expected adjustment to the situation over time. The program seems to buffer the impact of negative cancer-related life events on participants’ well-being, but the mechanisms of change remain unclear.

ObjectivesTo assess the availability and efficacy of interventions open to adolescents and young adults (AYAs; 15-25 years) bereaved by a parent’s or sibling’s cancer.MethodsA systematic review of peer-reviewed literature on interventions available to AYAs bereaved by a parent’s or sibling’s cancer was conducted through searches of six online databases (PsycINFO, Medline, Scopus, Embase, SWAB and Web of Science Core Collection).ResultsDatabase and reference searches yielded 2985 articles, 40 of which were included in the review. Twenty-two interventions were identified that were available for bereaved young people. However, only three were specific to young people bereaved by familial cancer, and none were specific to AYAs. Interventions primarily provided opportunities for participants to have fun, share their experiences and/or memorialise the deceased; psychoeducation about bereavement, grief and coping was less common. Only six interventions had been satisfactorily evaluated, and no intervention targeted or analysed data for AYAs separately. Overall, some evidence suggested that interventions (especially those that were theoretically grounded) had positive effects for bereaved young people. However, benefits were inconsistently evidenced in participants’ self-reports and often only applied to subgroups of participants (eg, older youths and those with better psychological well-being at baseline).ConclusionsConsidering the very limited number of interventions specific to bereavement by familial cancer and the lack of interventions targeting AYAs specifically, it is unclear whether currently available interventions would benefit this population. The population of AYAs bereaved by familial cancer is clearly under-serviced; further development and evaluation of interventions is needed.

Given the increasing prevalence of cancer, there is a growing need for health interventions educating individuals about the disease and its impacts, risk‐reduction strategies and how to support others who are affected. School‐based programs are a promising medium addressing these issues in adolescents, yet no comprehensive cancer education program exists in Australia. This paper reports on the piloting of a cancer awareness program for Australian students. When Cancer Comes Alongis a 90‐minute interactive presentation covering cancer's impacts, risk‐reduction strategies and how to support those affected. The program was piloted in four Australian secondary schools, with students (N = 113, 13‐16 years) and teachers (N = 2) providing feedback via postprogram survey. Participants reported high satisfaction overall (92%‐97%) and with each program component (71%‐95%), and agreed that the program achieved learning outcomes (72%‐95%). Results indicate that When Cancer Comes Alongis relevant, engaging and age‐appropriate. Participants reported improved understanding of cancer, its impacts, risk‐reduction strategies and how to support those affected. A larger‐scale evaluation is underway to more comprehensively evaluate program outcomes. The program has potential in educating students about various aspects of the cancer experience. It further demonstrates the feasibility and value of addressing psychosocial impacts and support strategies as well as information about cancer risks, elements which have not previously been combined in educational interventions. Equipping adolescents with the knowledge and skills to reduce their cancer risk and support others who are affected has significant health promotion implications for cancer prevention and support provision. This paper describes the piloting of a cancer awareness program for high school students that addresses what cancer is, its impacts, risk‐reduction strategies and how to support someone affected by cancer. Participating students and teachers indicated high satisfaction, suggesting the program is relevant, age‐appropriate and effective in educating adolescents about cancer.

Patient experience is positively associated with clinical effectiveness, quality care, and patient safety. This study examines the experience of care of adolescents and young adult (AYA) cancer patients from Australia and the United States, allowing a comparison of patient experiences in the context of different national models of cancer care delivery. Participants (n= 190) were aged 15–29 years and received cancer treatment from 2014 to 2019. Australians (n= 118) were recruited nationally by health care professionals. U.S. participants (n= 72) were recruited nationally via social media. The survey included demographic and disease variables, and questions regarding medical treatment, information and support provision, care coordination, and satisfaction across the treatment pathway. Sensitivity analyses examined the possible contribution of age and gender. Most patients from both countries were satisfied or very satisfied with their medical treatment (chemotherapy, radiotherapy, and surgery). There were significant differences between countries in the provision of fertility preservation services, age-appropriate communication, and psychosocial support. Our findings suggest when a national system of oversight with both state and federal funding is implemented, as is the case in Australia but not in the United States, significantly more AYAs with cancer receive age-appropriate information and support services, and improved access to specialist services such as fertility care. A national approach with government funding and centralized accountability appears to be associated with substantial benefits for the well-being of AYAs undergoing cancer treatment.

Parental cancer is a significant problem for adolescent and young adult offspring. To understand the extent of the problem of parental cancer for Australian offspring, data regarding those impacted are required. The aim of this study was to enumerate and describe the characteristics of Western Australian adolescent and young adult offspring (12–24 years) and their parents with cancer using linked population data.

Objective: Parental cancer is a significant problem for adolescent and young adult offspring. To understand the extent of the problem of parental cancer for Australian offspring, data regarding those impacted are required. The aim of this study was to enumerate and describe the characteristics of Western Australian adolescent and young adult offspring (12–24 years) and their parents with cancer using linked population data. Methods: A retrospective cohort study was conducted using data from the Western Australia Data Linkage System, which provided results generalisable at a national level. Results: Between 1982 and 2015, 57,708 offspring were impacted by 34,600 parents’ incident malignant cancer diagnoses. The most common diagnosis was breast cancer. Of the 36.4% of parents who died, this was mostly a result of cancer. Most families resided in regional areas and were of high or middle socioeconomic status. Significant predictors of earlier parent death included low socioeconomic status, remoteness, age, having more children and having older children. Conclusion: A considerable number of adolescent and young adult offspring are impacted by parental cancer at a potentially vulnerable age. This research provides knowledge to better understand who is affected by parental cancer in Australia. Implications for public health: These results may be useful for planning and implementation of Australian supportive services.

More than 1000 Australian adolescents and young adults (AYAs) are diagnosed with cancer annually. Many report unmet social well-being needs, which impact their mental health. Australian AYA cancer care providers lack guidance to address these needs well. We aimed to develop guidelines for caring for the social well-being of AYAs with cancer in Australia. Following the Australian National Health and Medical Research Council guidance, we formed a multidisciplinary working group (n= 4 psychosocial researchers, n= 4 psychologists, n= 4 AYA cancer survivors, n= 2 oncologists, n= 2 nurses, and n= 2 social workers), defined the scope of the guidelines, gathered evidence via a systematic review, graded the evidence, and surveyed AYA cancer care providers about the feasibility and acceptability of the guidelines. The guidelines recommend which AYAs should have their social well-being assessed, who should lead that assessment, when assessment should occur with which tools/measures, and how clinicians can address AYAs' social well-being concerns. A key clinician, who is knowledgeable about AYAs' developmental needs, should lead the assessment of social well-being during and after cancer treatment. The AYA Psycho-Oncology Screening Tool is recommended to screen for social well-being needs. The HEADSSS Assessment (Home, Education/Employment, Eating/Exercise, Activities/Peer Relationships, Drug use, Sexuality, Suicidality/Depression, Safety/Spirituality Assessment) can be used for in-depth assessment of social well-being, while the Social Phobia Inventory can be used to assess social anxiety. AYA cancer care providers rated the guidelines as highly acceptable, but discussed many feasibility barriers. These guidelines provide an optimal care pathway for the social well-being of AYAs with cancer. Future research addressing implementation is critical to meet AYAs' social well-being needs.

Despite improved prognosis, living with cancer can still negatively impact young people’s psychosocial wellbeing. Mindfulness-based interventions (MBI) have been shown to help manage cancer-related stress but tailored interventions for young people are warranted. In addition, attendance at intensive face-to-face mindfulness-based interventions is often a barrier to access and adherence.

The psychosocial needs of adolescent and young adult (AYA) siblings of cancer patients are easily overlooked. Accordingly, the evidence base informing short and long-term outcomes for these young people is sparse. This review provides an overview of recent research highlighting the experiences, unmet needs and psychosocial issues of AYA siblings, together with recent interventions.

Emerging adulthood is the life stage between adolescence and young adulthood, and it has been associated with several important developmental milestones. A cancer diagnosis has the potential to disrupt the normal achievement of these milestones. Many psychosocial themes relevant to emerging adults living with cancer have been identified, but there has been only limited research into the needs of this group.

Studies of parenting programs often have enrolment rates of 20% or more of the targeted parents. These rates are usually from funded research projects, and may not equate to enrolment rates in programs using clinically viable recruitment strategies without large specialist funding. Two studies were conducted to explore the enrolment rates of parents in group parenting programs. The first investigated the enrolment rate of parents of 5—12-yearold children in a community parenting program, using a clinically viable recruitment strategy. Flyers were twice sent home with the children advertising the program, which was offered both during the day and evening. Parents from nine Australian schools, with a total of 5,275 students from 3,740 families, were offered the program. Only 0.48% enrolled (N = 18 parents). In the second study, the variables of program cost (free vs $20), pre-enrolment requirements (completion of three questionnaires vs no questionnaires), and program duration/type (four-session general parenting program vs single-session specific problem program) were explored. Results showed that the different levels on each variable had no significant impact on parent enrolment. Discussion concludes that, without specialist funding, the snowball effect of parents enrolling because of word-of-mouth endorsement may be a key factor in ensuring that enough parents attend such programs. This has important planning implications for services wishing to introduce new programs to their community. The clinical implications are that more consideration needs to be given to methods that improve enrolment rates in such programs, and in particular programs training clinicians to conduct such community parenting programs should include a module on recruitment strategies.