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Background: The LGBTQI+ population makes up at least 7.6% of the US population. LGBTQI+ populations are at increased risk of experiencing LGBTQI+‐related discrimination and cis‐heteronormativity in healthcare leading to poorer health outcomes throughout the cancer care continuum. We aimed to explore LGBTQI+ cancer survivors' perspectives of how cancer has changed their perceptions of self and relationships using data from OUT: The National Cancer Survey. Methods: We conducted an inductive qualitative content analysis of responses to four open‐ended questions from OUT: The National Cancer Survey. Data were collected from September 2020 to April 2021. Eligible participants were 18 years of age or older at time of survey, had been previously diagnosed with cancer, identified as LGBTQI+, and currently lived in the US. Open‐ended survey questions asked about the impact of cancer on LGBTQI+ cancer survivors' perceptions of self and relationships. To maximize inter‐rater reliability, 20% of the survey responses were double coded. Chi‐squared tests assessed differences in changes across the life‐course. Results: Of the participants in the OUT survey (N = 2382), 86.9% (N = 2069) provided responses to at least one of the four open‐ended questions. The content analysis sample participants were primarily aged 40–59 (39.3%) and 60–79 (49.4%), gay (54.7%), cisgender men (59.4), White (89.7%), and not on active treatment (77.4%). A total of 5179 codes were applied to the 2069 responses. A total of 5 overarching categories and 18 sub‐categories were identified. Themes included: (1) changes in perceptions of self; (2) changes to relationships; (3) changes to health and (4) LGBTQI+ specific unmet needs. The most commonly reported categories were changes in perceptions of self (77%, n = 1593) and changes to health (47%, n = 972). Most cancer‐related changes were more frequently reported by young adult survivors. Conclusions: This content analysis illuminates the unique challenges that the LGBTQI+ population faces while navigating through the cancer care continuum. [ABSTRACT FROM AUTHOR]

Purpose: Quality of life (QOL) among young breast cancer survivors (YBCS) is often worse than QOL of older breast cancer survivors or age‐matched peers without a history of cancer. Families commonly support YBCS, particularly during treatment, but little is known about long‐term YBCS and family member QOL. The purpose of this study was to identify demographic, clinical, and psychosocial predictors of physical and mental QOL in YBCS and biological relatives and investigate associations between their QOL (i.e., QOL interdependence). Methods: This secondary data analysis includes a random sample of long‐term YBCS (≤ 45 years old at diagnosis) and up to two female relatives at baseline (post‐treatment) and 18‐month follow‐up. The sample consists of 189 dyads (YBCS and one relative) and 121 triads (YBCS and two relatives). Actor‐partner interdependence models (APIMs) were used to estimate the influence of YBCS's and relatives' demographic, clinical, and psychosocial factors on their own QOL (actor effects) and the other persons' QOL (partner effects). Results: For YBCS and relatives, QOL at the baseline was associated with their QOL at 18‐months. YBCS's perceived cancer risk was associated with their own and relatives' QOL. Older relatives' physical QOL at baseline was associated with younger relatives' physical QOL at follow‐up. Age, race, marital status, years since diagnosis, education, out‐of‐pocket costs of care, routine sources of care, income, family support, fear of recurrence, anxiety, and depression were also significant predictors of QOL. Conclusions: Findings revealed independent and interdependent effects on QOL. These predictors point to potential targets of support for families. Trial Registration: ClinicalTrials.gov ID: NCT01612338 [ABSTRACT FROM AUTHOR]

Background In addition to greater delays in cancer screening and greater financial hardship, rural-dwelling cancer patients experience greater costs associated with accessing cancer care, including higher cumulative travel costs. This study aimed to identify and synthesize peer-reviewed research on the cumulative and overlapping costs associated with care access and utilization. Methods A scoping review was conducted to identify relevant studies published after 1995 by searching 5 electronic databases: PubMed, Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), PsycInfo, and Healthcare Administration. Eligibility was determined using the PEO (Population, Exposure, and Outcomes) method, with clearly defined populations (cancer patients), exposures (financial hardship, toxicity, or distress; travel-related burdens), and outcomes (treatment access, treatment outcomes, health-related quality of life, and survival/mortality). Study characteristics, methods, and findings were extracted and summarized. Results Database searches yielded 6439 results, of which 3366 were unique citations. Of those, 141 were eligible for full-text review, and 98 studies at the intersection of cancer-related travel burdens and financial hardship were included. Five themes emerged as we extracted from the full texts of the included articles: 1) Cancer treatment choices, 2) Receipt of guideline-concordant care, 3) Cancer treatment outcomes, 4) Health-related quality of life, and 5) Propensity to participate in clinical trials. Conclusions This scoping review identifies and summarizes available research at the intersection of cancer care-related travel burdens and financial hardship. This review will inform the development of future interventions aimed at reducing the negative effects of cancer-care related costs on patient outcomes and quality of life. [ABSTRACT FROM AUTHOR]

This study sought to understand COVID‐19‐related organizational decisions were made across sectors. To gain this understanding, we conducted semi‐structured interviews with organizational decision‐makers in North Carolina about their experiences responding to COVID‐19. Conventional content analysis was used to analyse the context, inputs, and processes involved in decision‐making. Between October 2020 and February 2021, we interviewed 44 decision‐makers from the following sectors: business (n = 4), community non‐profit (n = 3), county government (n = 4), healthcare (n = 5), local public health (n = 5), public safety (n = 7), religious (n = 6), education (n = 7) and transportation (n = 3). We found that during the pandemic, organizations looked to scientific authorities, the decisions of peer organizations, data about COVID‐19, and their own experience with prior crises. Interpretation of inputs was informed by current political events, societal trends, and organization mission. Decision‐makers had to account for divergent internal opinions and community behaviour. To navigate inputs and contextual factors, organizations decentralized decision‐making authority, formed auxiliary decision‐making bodies, learned to resolve internal conflicts, learned in real time from their crisis response, and routinely communicated decisions with their communities. In conclusion, aligned with systems and contingency theories of decision‐making, decision‐making during COVID‐19 depended on an organization's 'fit' within the specifics of their existing system and their ability to orient the dynamics of that system to their own goals. [ABSTRACT FROM AUTHOR]

Objectives: Older adults with diabetes have double the normal average risk for depression. While women also report higher rates of depression, men are less likely than women to recognize symptoms and seek assistance for mental health treatment. Racial disparities in mental health care use among men have also been identified. While age and gender differences in mental health care use have been accounted for in adults with comorbid diabetes and depression little is known about within group differences among men. The purpose of this study was to examine the influence of age and race on mental health service use in a sample of men with comorbid diabetes and depression., Methods: This study utilized secondary data from a large health care delivery system serving in a Midwestern urban city and included 335 Black, and non-Latino White men with comorbid type 2 diabetes and depression., Results and Discussion: Findings indicate that men under the age of 55 were less likely to experience a 6-month or more delay in receiving a psychiatric medication prescription after their initial depression diagnosis. Black men over 55 years of age were significantly more likely to experience a delay of over six months to receiving psychiatric medication. More research is needed to explore preferred depression treatment methods for older Black men with type 2 diabetes, in addition to any issues with access to pharmacological medications to treat depression.