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PURPOSE Adolescents and young adults (AYAs; age 18-39 years) with cancer report needing support with health insurance. We conducted a pilot randomized controlled trial to assess the feasibility and acceptability of a virtual health insurance navigation intervention (HIAYA CHAT) to improve health insurance literacy (HIL), awareness of Affordable Care Act (ACA) protections, financial toxicity, and stress. MATERIALS AND METHODS HIAYA CHAT is a four-session navigator delivered program; it includes psychoeducation on insurance, navigating one’s plan, insurance-related laws, and managing costs. Participants were eligible if they could access an internetcapable device, were <1 year from diagnosis, and received treatment from University of Utah Healthcare or Intermountain Health systems. We assessed the feasibility, acceptability, and preliminary efficacy of HIAYA CHAT compared with usual navigation care, including HIL (nine items), insurance knowledge (13 items), ACA protections (eight items), COmprehensive Score for financial Toxicity (COST; 11 items), and Perceived Stress Scale (PSS; four items), using t tests and Cohen’s d. RESULTS From November 2020 to December 2021, N 5 86 AYAs enrolled (44.6% participation) and 89.3% completed the 5-month follow-up survey; 68.6% were female, 72.1% were White, 23.3% were Hispanic, 65.1% were age 26-39 years, and 87.2% were privately insured. Of intervention participants (n 5 45), 67.4% completed all four sessions; among an exit interview subset (n 5 10), all endorsed the program (100%). At follow-up, compared with usual navigation care, intervention participants had greater improvements in HIL, insurance and ACA protections knowledge, and PSS; effect sizes ranged from moderate to large (0.42-0.77). COST did not differ. CONCLUSION The results support the feasibility and acceptability of HIAYA CHAT with related improvements in HIL. [ABSTRACT FROM AUTHOR]

Background: Emerging research suggests that survivors of childhood and adolescent cancers are at risk for morbidity and mortality associated with air pollutants. However, caregiver perceptions of the effects of air pollution are unknown. Thus, to address this gap we described caregivers' perceptions of air pollution's impact on general population health and specifically on childhood cancer survivors, and caregivers' air pollution information-seeking and exposure reduction behaviors.Methods: Participants were Utah residents, ≥18 years, and caregiver of a childhood cancer survivor who had completed treatment. Semi-structured interviews were conducted with caregivers to describe their perspectives on air quality, how air pollution impacts health (general population and survivor health), and their information seeking and exposure reduction behaviors. Interviews were recorded, transcribed, and analyzed through two rounds of structured coding.Results: Caregivers (N = 13) were non-Hispanic white and primarily females (92.3%) between 30 and 49 years old (46.2%). Most families lived within the Wasatch Front (69.2%), the main metropolitan of Utah. Two categories emerged pertaining to caregiver's perceptions of air pollution: 1) Limited awareness about the health effects of air pollution, and 2) Unsuccessful information seeking and minimal exposure reduction behaviors. All caregivers held negative perceptions of air pollution in Utah, but most were unaware of how pollution affects health. While some families limited air pollution exposure by avoiding outdoor activity or physically leaving the region, few practiced survivor-specific exposure reduction. Nearly half of caregivers worried about potential effects of air pollution on survivor health and wanted more information.Conclusions: Despite negative perceptions of air pollution, caregivers were divided on whether air pollution could impact survivor health. Few caregivers engaged in exposure reduction for their cancer survivor. As air pollution levels increase in the U.S., continued research on this topic is essential to managing cancer survivor respiratory and cardiovascular health. [ABSTRACT FROM AUTHOR]

Objective: To describe how young adult cancer caregivers (YACC) use social media for social support during a cancer experience.Methods: Eligible YACC were 18 to 39 years, used Facebook and/or Instagram at least once per week, and cared for an adult cancer patient diagnosed 6 months to 5 years prior (N = 34). Recruitment of a cross-sectional sample occurred through oncology clinics in Utah and online advertising by caregiving and cancer organizations from September 2017 to June 2018. Semi-structured telephone interviews were recorded, transcribed, iteratively coded, and qualitatively analyzed, yielding four categories concerning how YACC use social media.Results: Caregivers were most commonly spouses aged 29 years on average (range 21-38); cancer patients were 37 years (range 19-76). Analysis yielded four distinct yet related categories: Category 1: Posting about cancer on social media often begins as a strategy for YACC to efficiently provide updates about the cancer patient. Category 2: Caregivers who actively post on social media experience a variety of different functional social supports to which they otherwise would not have access. Category 3: Posting about cancer online presents an opportunity for negative consequences. Category 4: Potential for negative consequences influences how some caregivers use social media.Conclusions: Supportive services, including social media-based supports, are needed for YACC in formats that are convenient for them as they balance their caretaking duties with their daily lives. [ABSTRACT FROM AUTHOR]

Grooming behaviour, which maintains and cleans the integument, is a widespread behaviour of birds, mammals and arthropods. The extent to which grooming is influenced by large-scale environmental differences, such as geographical and seasonal variation, remains largely unexplored. We investigated spatial and temporal variation in the grooming behaviour of a common species of bird, the American kestrel, Falco sparverius. Specifically, we compared the self-grooming behaviour (preening and scratching) of kestrels in the subtropical Bahamas to kestrels in temperate northern Utah, U.S.A., in both summer and winter. We also compared differences in parasite 'pressure' by quantifying the prevalence and abundance of ectoparasitic lice (Insecta: Phthiraptera) on kestrels in both locations. Bahama kestrels had significantly more lice than Utah kestrels, which is typical of birds in humid regions, compared to arid regions. Bahama kestrels groomed significantly more than Utah kestrels, which may constrain the time–activity budgets of Bahama kestrels. Within each region, however, birds with more lice did not groom more. This pattern is consistent with geographical differences in programmed grooming, rather than stimulus-driven grooming. Kestrels in both locations groomed significantly more in summer than in winter, presumably because feather moult occurs in summer. To our knowledge, this study provides the first demonstration of geographical variation in the grooming behaviour of any animal. Experimental studies are needed to confirm the causes and consequences of this variation. Spatial and temporal comparisons of grooming in other birds, as well as mammals and arthropods, would be informative. • American kestrels varied in grooming time, both seasonally and geographically. • Birds in the subtropics groomed more than birds in the temperate region. • Parasitic feather lice were more abundant on subtropical than temperate birds. • Birds in both regions groomed more in summer (during moult) than in winter. [ABSTRACT FROM AUTHOR]