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Purpose Exercise interventions can increase physical activity and wellbeing of people living with/beyond cancer. However, little is known about maintenance of physical activity in this population ≥ 6 months post-exercise intervention, when theoretical evidence suggests behaviour maintenance occurs. Study aims are to (i) systematically review maintenance of physical activity ≥ 6-month post-exercise intervention, and (ii) investigate the influence of behaviour change techniques (BCTs) on physical activity maintenance in people living with/beyond cancer. Methods CINAHL, CENTRAL, EMBASE and PubMed databases were searched for randomised controlled trials up to August 2021. Trials including adults diagnosed with cancer that assessed physical activity ≥ 6 months post-exercise intervention were included. Results Of 142 articles assessed, 21 reporting on 18 trials involving 3538 participants were eligible. Five (21%) reported significantly higher physical activity ≥ 6 months post-exercise intervention versus a control/comparison group. Total number of BCTs (M = 8, range 2–13) did not influence intervention effectiveness. The BCTs Social support, Goal setting (behaviour), and Action planning, alongside supervised exercise, were important, but not sufficient, components for long-term physical activity maintenance. Conclusions Evidence for long-term physical activity maintenance post-exercise intervention for people living with/beyond cancer is limited and inconclusive. Further research is required to ensure the physical activity and health benefits of exercise interventions do not quickly become obsolete. Implications for Cancer Survivors Implementation of the BCTs Social support, Goal setting (behaviour), and Action planning, alongside supervised exercise, may enhance physical activity maintenance and subsequent health outcomes in people living with/beyond cancer.

Introduction: As many countries change to opt-out systems to address organ shortages, calls for similar reform in Australia persist. Community perspectives on consent systems for donation remain under-researched, therefore Australian perspectives on consent systems and their effectiveness in increasing donation rates were explored. Design: In this descriptive cross-sectional study, participants completed a survey presenting opt-in, soft opt-out, and hard opt-out systems, with corresponding descriptions. Participants chose the system they perceived as most effective and described their reasoning. Results: Participants (N = 509) designated soft opt-out as the most effective system (52.3%; hard opt-out 33.7%; opt-in 13.7%). Those who identified with an ethnic/cultural group or were not registered had greater odds of choosing opt-out. Six themes identified in thematic analysis reflected their reasoning: (1) who decides (individual, shared decision with family); (2) right to choose; (3) acceptability (ethics, fairness); and utility in overcoming barriers for (4) individuals (apathy, awareness, ease of donating, fear/avoidance of death); (5) family (easier family experience, family veto); (6) society (normalizing donation, donation as default, expanding donor pool). Choice and overcoming individual barriers were more frequently endorsed themes for opt-in and opt-out, respectively. Discussion: Results suggested the following insights regarding system effectiveness: uphold/prioritize individual's recorded donation decision above family wishes; involve family in decision making if no donation preference is recorded; retain a register enabling opt-in and opt-out for unequivocal decisions and promoting individual control; and maximize ease of registering. Future research should establish whether systems considered effective are also acceptable to the community to address organ shortages.

Objective To examine prostate cancer (PCa) survivors’ sexual help-seeking intentions, behaviours, and unmet needs. Methods In this prospective cohort study, men who underwent active, non-hormonal treatment completed baseline (N = 558) and 6-month follow-up (N = 387) questionnaires. Theory of planned behaviour (TPB) constructs (sexual help-seeking intention, perceived behavioural control (PBC), subjective norm, attitude), masculine values (e.g., sexual importance/priority, emotional self-reliance), sex life and functioning, sexual supportive care needs, distress (anxiety, depression), and sexual help-seeking behaviour were assessed. Results Most men (M age = 64.6 years; M years post-diagnosis = 4.0) received prostatectomy (93%), reported severe erectile dysfunction (52%), ≥ 1 unmet sexual care need (66%), and sought help from a doctor (baseline 52%, follow-up 42%). Sexual care needs were significantly associated with poorer erectile function, reduced satisfaction with sex-life, valuing sex as important/integral to identity (masculine values), and increased depression (p ≤ 0.001). Sexual help-seeking intentions were significantly associated with valuing sex as important/integral to identity, recent help-seeking, greater confidence/control, perceiving support from important others, and positive attitudes, for sexual help-seeking (p < 0.001). Significant predictors of sexual help-seeking (follow-up) were baseline intentions, recent help-seeking (p < 0.001), and increased anxiety (p < 0.05). Conclusions Men’s unmet sexual care needs, sexual help-seeking intentions, and behaviour appear driven by the importance/value attributed to sex, distress, positive feelings, support from others, and confidence for help-seeking. Psychosocial providers are well-placed to address men’s concerns, yet few sought their assistance. Interventions to improve men’s access to effective sexual care are needed, particularly focused on reframing masculine values about the importance of sex and leveraging TPB-based predictors of help-seeking.

Many young donors (i.e., young people who wish to donate organs upon death) are unaware of the need for family discussion to increase the likelihood of family consent for donation. They have low motivation to discuss and have not notified family of their wishes. We addressed a gap in existing research by developing and piloting six persuasive message appeals targeted specifically at young donors to encourage family discussion about donation. Young donors, who were Australian residents (7 females, 2 males) aged 21-25 years (M = 23.00; SD = 1.73), participated in qualitative interviews. Participants commented on their reactions to each message appeal, message effectiveness, and preferred appeals. Responses to message appeals were mixed. Mixed reactions were reflected in preferences for solely positive appeals or both positive and negative. Some participants felt negative emotional appeals were more impactful and memorable. Reactions to the provision of strategies to aid actual discussion (i.e., what to say, when to discuss, reminder prompts) in messages were guided by young donors’ views of family discussion as either ‘no big deal’ or requiring preparation. Participants believed that including scenarios in which a person makes a donation decision for themselves or a loved one was thought provoking, motivating, and clearly conveyed the impact of the choice not to discuss on others. The four preferred message appeals included equal numbers of messages with positive and negative framing, high and low/no strategy, and individual vs. other perspective. Future piloting of these message appeals with a larger audience of young donors will determine message effectiveness in encouraging family discussion.

Context: Discussing organ donation wishes with family prior to receiving a request for donation is essential to increase family consent. For young people who have already decided to be a donor (‘young donors’), notifying family is particularly critical. However, many young donors are unaware of the need for this discussion, have low motivation to discuss, and have not notified family of their wishes. Objectives: To explore young donors’ views on, experience with, and suggestions to encourage family discussion, and opinions about advertising/social marketing campaign materials.Participants: Young donors, who were Australian residents (N = 13; 10 females) aged 18-28 years (M = 23.00; SD = 2.74), participated in one of four focus groups. Results: Motivations for family discussion were having their wishes respected by family and reducing family distress. Barriers to discussing were not thinking about it and forgetting unless an immediate opportunity for discussion was provided. Young donors had different approaches to initiating family discussion depending on anticipated family reactions and confidence in discussing; straightforward (‘just say it’) and casual (‘no big deal’) or involving preparation and in-depth discussion. Campaign materials including information and personal stories about transplant recipients were perceived as effective in capturing attention and encouraging family discussion. Conclusions: Gaining the perspective of young donors to encourage family discussion is crucial. Key findings highlighted the need to consider young donors’ approaches to initiating family discussion and incorporating prompts and opportunities to facilitate family discussion in the development of future message appeals.

Family discussion of donation wishes is a critical driver of family authorisation of organ donation. However, few people discuss their wishes or feel certain of family member’s donation preferences. Empirically, individual determinants of discussing donation wishes with family have been examined using the theory of planned behaviour (TPB). The impact of cognitive-affective (e.g., disgust) and family (e.g., family communication) variables are less well studied, and not integrated together in decision-making frameworks. To address this gap, the role of family communication and ‘cognitive-affective’ variables, integrated within the TPB, were examined as predictors of intended and actual discussion of donation wishes with family. Participants (N=201) completed baseline measures of family communication, cognitive-affective (disgust, bodily integrity, medical mistrust, fear of not being dead, anxiety about discussing), and TPB (attitude, subjective norm, self-efficacy, intention) variables. Two-weeks later, participants (N=111) self-reported their discussion behaviour (n=42, 38% discussed). A revised structural equation model provided a good fit to these data. In this model, less anxiety about discussion and positive attitudes toward discussion predicted self-efficacy (R2=0.67). Positive attitudes, greater self-efficacy and perceived approval/support from important others (subjective norm) predicted discussion intentions (R2=0.70). Intention predicted discussion behaviour (R2=0.22). Cognitive-affective variables (except discussion anxiety) and family communication did not have a prominent role. Interventions which emphasise that family expect and approve of donation discussions, portray donation discussions as positively valued, and bolster self-efficacy are needed to increase discussion of organ donation wishes. Bolstering self-efficacy could be achieved by providing tangible strategies to assist individuals to reduce their anxiety about discussing their wishes, and encouraging positive attitudes towards discussion and its importance in family authorisation for donation.

© 2020, International Society for Third-Sector Research. Volunteers are a critical operational resource for not-for-profit organisations in the health and welfare sector. However, trends towards episodic volunteering may be a source of disruption. This study examined contemporary management beliefs and practices about episodic volunteers in the sector. A cross-sectional online survey with 186 managers and coordinators of episodic volunteers across North America and the Asia Pacific examined organisational values and beliefs about volunteers; perceived benefits and challenges of working with episodic volunteers; volunteering management. Episodic volunteers were highly beneficial to organisational profile, mission, service profile, and cost savings. Challenges include matching recruitment to workplace and skill needs; lack of paid staff to supervise and train volunteers and inadequate administrative support. There is a disjunct between the perceived value provided to the not-for-profit sector by episodic volunteers and the extent to which episodic volunteering is supported through organisational training and management practices.

Special charity events are an important source of revenue for non‐profit organisations in cancer control yet volunteering is declining and turnover is high. Experiences at cause‐related events may influence retention, particularly emotions connected to the cause and ceremonies which honour cancer survivors and remember loved ones. We explore the degree to which emotions associated with cause‐related volunteering and collective action in the literature are felt in response to Relay For Life and what emotions predict three indicators of retention: intention to return for future events, satisfaction with volunteering, and organisational commitment. Volunteers (n = 410) completed a cross‐sectional survey at Relay For Life events in Queensland, Australia. Multiple regression analyses examined whether emotions associated with events predicted each indicator of retention, adjusting for number of years spent volunteering for events. Sixty‐two percent reported an intention to return the following year. The most commonly reported event‐related emotions were hope, pride, and empathy (62–69%). Intention to return, satisfaction, and commitment were each significantly predicted by hope and pride. The findings suggest special charity events in cancer control could retain volunteers by fostering pride and hope (e.g., for a cancer free future); however, future prospective research which examines the mechanisms of these relationships is warranted.

Blood collection agencies (BCAs) are expanding core business by inviting blood donors to donate stool for fecal microbiota transplantation (FMT). However, whether blood donors also want to donate stool is unclear since, despite its benefits, stool donation is viewed by many as unpleasant. This study examined the prevalence, contributors to, and role of these mixed feelings (ambivalence) in stool donation intentions. Study design and methods This cross-sectional study surveyed Australian residents aged 18 years or more who believed themselves eligible to donate blood and met broad criteria for prescreening as a stool donor (eg, healthy, not taking medication). Survey questions assessed attitude, norms, self-efficacy, motives, disgust, ambivalence, and intentions to donate stool. Results A total of 382 eligible blood donors aged not more than 50 years (mean, 28.71 years; 48% female, 62% "healthy" body mass index) participated. Six percent indicated no ambivalence about donating stool. In regression, significant determinants of ambivalence were less awareness of FMT, lower self-efficacy, motivated by ensuring that stool is available for loved ones, and more disgust about stool donation. Higher ambivalence contributed to decreased donation intention. Self-efficacy and disgust differentiated participants with moderate ambivalence, a group likely responsive to intervention, from those with low or high ambivalence. Conclusion Ambivalence about donating stool was common among eligible blood donors. BCAs should raise awareness about stool donation and FMT before requesting donation. BCAs may increase cost savings and donor retention by giving clear guidance about donation requirements and implementing processes that build confidence. Early screening of potential donors for ambivalence and disgust will enable BCAs to provide decision support.

Background With the coronavirus disease 2019 (COVID-19) pandemic continuing to accelerate and blood collection agencies (BCAs) warning of shortages, it is critical to identify the current determinants of donor behavior for donors and nondonors. Study design and methods In May and June 2020, Australian residents who believed themselves eligible to donate blood responded to measures assessing constructs from an integrated protection motivation theory, organizational trust, and theory of planned behavior framework, with donor status also assessed. Results A total of 507 residents (47% male, mean age 28.69 years; 272 had donated/attempted to donate) participated. A revised structural equation model was a good fit to these data. In this model, perceived risk, severity, anxiety, and response cost associated with donating during the COVID-19 pandemic underpinned threat appraisals, while response efficacy, self-efficacy, and attitude toward donating during COVID-19 informed coping appraisals. Trust in the BCA predicted lower threat and higher coping appraisals, and higher coping appraisals predicted stronger subjective norms. Intention to donate during the COVID-19 pandemic was positively predicted by subjective norm and self-efficacy. Donation-related behavior was positively predicted by intention, with this relationship stronger for nondonors than donors. Conclusion Self-efficacy and approval from others, underpinned by coping appraisals and organizational trust, play a critical role in intentions to donate. BCAs that focus on maintaining trust with (potential) donors, providing clear messaging stating the minimal threat of contracting COVID-19 from donating and the protective measures in place, and showing how donating is achievable, may help to ensure a safe and secure blood supply throughout the COVID-19 pandemic.

To examine prostate cancer (PCa) survivors' sexual help-seeking intentions, behaviours, and unmet needs.In this prospective cohort study, men who underwent active, non-hormonal treatment completed baseline (N = 558) and 6-month follow-up (N = 387) questionnaires. Theory of planned behaviour (TPB) constructs (sexual help-seeking intention, perceived behavioural control (PBC), subjective norm, attitude), masculine values (e.g., sexual importance/priority, emotional self-reliance), sex life and functioning, sexual supportive care needs, distress (anxiety, depression), and sexual help-seeking behaviour were assessed.Most men (M age = 64.6 years; M years post-diagnosis = 4.0) received prostatectomy (93%), reported severe erectile dysfunction (52%), ≥ 1 unmet sexual care need (66%), and sought help from a doctor (baseline 52%, follow-up 42%). Sexual care needs were significantly associated with poorer erectile function, reduced satisfaction with sex-life, valuing sex as important/integral to identity (masculine values), and increased depression (p ≤ 0.001). Sexual help-seeking intentions were significantly associated with valuing sex as important/integral to identity, recent help-seeking, greater confidence/control, perceiving support from important others, and positive attitudes, for sexual help-seeking (p0.001). Significant predictors of sexual help-seeking (follow-up) were baseline intentions, recent help-seeking (p0.001), and increased anxiety (p0.05).Men's unmet sexual care needs, sexual help-seeking intentions, and behaviour appear driven by the importance/value attributed to sex, distress, positive feelings, support from others, and confidence for help-seeking. Psychosocial providers are well-placed to address men's concerns, yet few sought their assistance. Interventions to improve men's access to effective sexual care are needed, particularly focused on reframing masculine values about the importance of sex and leveraging TPB-based predictors of help-seeking.

Objective: To examine the relationship between health behaviours, masculinity, quality of life, and psychological distress in men with prostate cancer. Methods: We conducted a prospective study of 225 men with prostate cancer. Men completed baseline and 12‐month follow up assessments. Measures included the Health Behaviours Inventory 20; the Masculinity in Chronic Disease Inventory 22; Brief Symptom Inventory 18; the Expanded Prostate Cancer Index Composite; the Short Form Health Survey 36. Results: Higher engagement in the proper use of health care resources predicted lower bowel (p = 0.002) and urinary bother (p < 0.001), lower psychological distress (p < 0.001), and better mental health (p = 0.023). Risky substance use behaviours predicted increased urinary bother (p = 0.024). Greater endorsement of family responsibilities predicted lower psychological distress (p = 0.015) and better mental health (p = 0.036). Greater endorsement of optimistic capacity (p = 0.040) and strength (p = 0.036) predicted lower sexual bother. Greater endorsement of action approach (p = 0.012) predicted increased sexual bother. Older age predicted greater psychological distress (p = 0.007), poorer physical quality of life (p = 0.049), and poorer mental health (p = 0.008). Conclusions: Engagement in health behaviours and endorsement of masculine ideals emerged as having potential to play a role in improving the quality of life and psychological distress of men with prostate cancer. Particularly, men who utilised health care resources and identified strongly with masculine ideals concerning family responsibilities, optimistic capacity and strength had better quality of life and psychological distress.

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. The degree to which peer support is used and accepted as a supportive care approach by women with breast cancer is unclear. We examine peer support use across three major modalities (i.e. support groups, online platforms, one-on-one) and identify enablers and barriers to peer support using the beliefs framework of the theory of planned behaviour. A population-based sample of women newly diagnosed with breast cancer (n = 3105) who were on average 54.08 weeks since diagnosis completed mailed surveys at baseline measuring beliefs about peer support and intention. Peer support use was measured via telephone interview at baseline and prospectively at 12-month follow-up (n = 2780). In all, 37% of women had used at least one peer support service since diagnosis (support group = 20%, online = 18%, one-on-one = 10%). A path analysis examined what beliefs enabled or acted as barriers to peer support use at follow-up adjusting for past behaviour (i.e. baseline use), sociodemographic characteristics, and treatment. In order of relative strength, enablers included beliefs that peer support is an outlet for honest expression of feelings (β =.35), a source of empathy (β =.30), approved by doctors (β =.07), and approved by family/partner (β =.04). Barriers were beliefs that it encourages dwelling about breast cancer (β = −.06) and involves exposure to negative stories about this disease (β = −.04). Strategies which communicate the potential emotional support benefits of a shared illness experience and social approval by others, particularly the medical profession, may help to promote acceptance of peer support and encourage service uptake in breast cancer.

In Queensland, Australia drowning deaths of children under the age of 5 have increased over the last 3 years, with home swimming pools being the most common site of this tragedy. Restriction of access to pools and supervision of children using the pool are two behaviours that can prevent drowning. Pool owners who were parents or guardians of children aged under 5 years (N = 242) completed a survey regarding these behaviours. We examined the impact of owners’ risk perceptions and feelings of anticipated regret on the pool safety intention and behaviours of (1) restriction of child access and (2) supervision of children, after taking into account established psychosocial determinants of decision making conceptualised by the theory of planned behaviour (attitude, subjective norm, perceived behavioural control). In addition, underlying beliefs (attitudinal, normative, control) were examined. While anticipated regret significantly predicted intentions for both behaviours, risk perception was not a significant predictor of intention to perform either behaviour. The established decision-making constructs of attitudes, norms, and control factors influenced intention, with intention and control factors predicting behaviour. Furthermore, the critical beliefs identified in this study, in particular the approval from close others and experts in the swimming domain, provides for a better understanding of pool safety behaviour. The findings based on psychological variables and critical beliefs can be applied to future intervention strategies aimed at decreasing the incidence of childhood drowning.

© 2017 The Authors Objective: To examine if geographic variations in the participation rates in the National Bowel Cancer Screening Program (NBCSP) are related to population-level socio-demographic characteristics. Methods: Data reflecting participation in the NBCSP for 504 Local Government Areas (LGAs) between July 2011 and June 2013 were extracted from the Social Health Atlas of Australia. Logistic regression models were used to examine independent associations (odds ratios [ORs]) between participation, Remoteness Area (RA) and selected socio-demographic variables. Results: Compared to the participation rate for major cities (33.4%), participation was significantly higher in inner regional areas (36.5%, OR=1.15), but was much lower in remote (27.9%, OR=0.77) or very remote areas (25.0%, OR=0.65). When controlling for study period, gender, proportion of persons aged 65 years and older, Indigenous status, cultural background and socioeconomic status, significantly higher rates were observed in all non-metropolitan areas than in major cities. Indigenous status was strongly related to the poorer participation in remote areas. Conclusions: Socio-demographic characteristics, particularly Indigenous status, cultural background and population ageing, seem to be more important drivers of regional disparities in NBCSP participation than geographic remoteness. Implications for public health: This study provides important evidence to understand the regional disparities in participating in the national screening program.

Prostate cancer (PC) treatment side-effects such as erectile dysfunction (ED) can impact men's quality of life (QoL), psychosocial and psycho-sexual adjustment. Masculinity (i.e., men's identity or sense of themselves as being a man) may also be linked to how men respond to PC treatment and ED however the exact nature of this link is unclear. This review aims to provide a snapshot of the current state of evidence regarding ED, masculinity and psychosocial impacts after PC treatment. Three databases (Medline/PsycINFO, CINHAL, and EMBASE) were searched January 1st 1980 to January 31st 2016. Study inclusion criteria were: patients treated for PC; ED or sexual function measured; masculinity measured in quantitative studies or emerged as a theme in qualitative studies; included psychosocial or QoL outcome(s); published in English language, peer-reviewed journal articles. Fifty two articles (14 quantitative, 38 qualitative) met review criteria. Studies were predominantly cross-sectional, North American, samples of heterosexual men, with localised PC, and treated with radical prostatectomy. Results show that masculinity framed men's responses to, and was harmed by their experience with, ED after PC treatment. In qualitative studies, men with ED consistently reported lost (no longer a man) or diminished (less of a man) masculinity, and this was linked to depression, embarrassment, decreased self-worth, and fear of being stigmatised. The correlation between ED and masculinity was similarly supported in quantitative studies. In two studies, masculinity was also a moderator of poorer QoL and mental health outcomes for PC patients with ED. In qualitative studies, masculinity underpinned how men interpreted and adjusted to their experience. Men used traditional (hegemonic) coping responses including emotional restraint, stoicism, acceptance, optimism, and humour or rationalised their experience relative to their age (ED inevitable), prolonged life (ED small price to pay), definition of sex (more than erection and penetration), other evidence of virility (already had children) or sexual prowess (sown a lot of wild oats). Limitations of studies reviewed included: poorly developed theoretical and context-specific measurement approaches; few quantitative empirical or prospective studies; moderating or mediating factors rarely assessed; heterogeneity (demographics, sexual orientation, treatment type) rarely considered. Clinicians and health practitioners can help PC patients with ED to broaden their perceptions of sexual relationships and assist them to make meaning out of their experience in ways that decrease the threat to their masculinity. The challenge going forward is to better unpack the relationship between ED and masculinity for PC patients by addressing the methodological limitations outlined so that interventions for ED that incorporate masculinity in a holistic way can be developed.

Background To describe trajectories of health-related quality of life (QoL), life satisfaction, and psychological adjustment for men with prostate cancer over the medium to long term and identify predictors of poorer outcomes using growth mixture models. Methods One-thousand sixty-four (82.4% response) men diagnosed with prostate cancer were recruited close to diagnosis and assessed over a 72-month (6-year) period with self-report assessment of health-related QoL, life satisfaction, cancer-related distress, and prostate specific antigen anxiety. Urinary, bowel, and sexual function were also assessed using validated questionnaires. Results Poorer physical QOL was predicted by older age, lower education, lower income, comorbidities, and receiving hormone therapy. Lower life satisfaction was related to younger age, lower income, not being partnered, and comorbidities. Poorer psychological trajectories were predicted by younger age, lower income, comorbidities, and receiving radical prostatectomy or brachytherapy. Better urinary, bowel, and sexual function were related to better global outcomes over time. Anxiety about prostate specific antigen testing was rare. Conclusions Distinct trajectories exist for medium- to long-term QoL, life satisfaction, and psychological adjustment after prostate cancer; with age and socioeconomic deprivation playing a differential role in men's survivorship profile and the impact of functional status on outcomes increasing over time. These results reinforce the need for an appraisal of men's life course in addition to treatment side effects when planning survivorship care after cancer.

© 2019 John Wiley & Sons, Ltd. Objective: To assess the impact of demographic characteristics and masculinities on seeking support for psychosocial care needs in men with prostate cancer. Methods: Prostate cancer survivors (n = 225) completed mail-out surveys measuring psychological care needs, masculinities, and psychological and emotional help-seeking intention and behaviour at 6- and 12-month follow-ups. Results: Older age was associated with seeking help from a general practitioner (GP), χ2 (1,225) = 4.72, P =.03, and being born overseas was associated with seeking peer support (1,225) = 7.13, P =.01. Men with higher levels of optimistic action who reported moderate to high unmet psychological need were less likely to seek help for psychological and emotional concerns at 6- (odds ratio [OR] = 0.06, confidence interval [CI], 0.01-0.46) and 12-month (OR = 0.13, CI, 0.26-0.65) follow-ups. Conclusions: Optimistic action may explain why some men with prostate cancer fail to seek help for their psychological care needs. Clinicians should be aware that men with chronic illness who appear to approach challenges with optimistic action may in fact be less likely to seek psychological help when needed.

© 2019 John Wiley & Sons Ltd Objective: To prospectively explore predictors of hope in people with colorectal cancer at 24 months post-diagnosis. Methods: The present study is a secondary analysis of two waves within a longitudinal survey of patients newly diagnosed with colorectal cancer in Queensland, Australia. Baseline predictors (sociodemographic, disease, lifestyle characteristics, cancer threat appraisal and quality of life domains) were measured via mailed surveys and telephone interviews at 6 months post-diagnosis. Hope was measured via mailed surveys at 24 months post-diagnosis. Results: At 24 months post-diagnosis, 1,265 participants completed the hope measure. Hope was predicted by higher education, physical activity, cancer threat appraisal and each quality of life domain (i.e., physical, social, emotional and functional well-being; and colorectal cancer-specific concerns), which explained 23.63% of the total variance in hope, F(14, 1,081) = 23.89, p

© 2018 John Wiley & Sons Ltd Female partners of prostate cancer (PCa) survivors experience heightened psychological distress that may be greater than that expressed by PCa patients. However, optimal approaches to detect distressed, or at risk of distress, partners are unclear. This study applied receiver operating characteristics analysis to evaluate diagnostic accuracy, sensitivity and specificity of the Distress Thermometer (DT) compared to widely used measures of general (Hospital Anxiety and Depression Scale) and cancer-specific (Impact of Events Scale-Revised) distress. Participants were partners of men with localised PCa (recruited around diagnosis) about to undergo or had received surgical treatment (N = 189), and partners of men diagnosed with PCa who were 2–4 years post-treatment (N = 460). In both studies, diagnostic utility of the DT overall was not optimal. Although area under the curve scores were acceptable (ranges: 0.71–0.92 and 0.83–0.94 for general and cancer-specific distress, respectively), sensitivity, specificity and optimal DT cut-offs for partner distress varied for general (range: ≥2 to ≥5) and cancer-specific (range: ≥3 to ≥5) distress both across time and between cohorts. Thus, it is difficult to draw firm conclusions about the diagnostic capabilities of the DT for partners or recommend its use in this population. More comprehensive screening measures may be needed to detect partners needing psychological intervention.

Background: New advanced melanoma therapies are associated with improved survival; however, quality of survivorship, particularly psychosocial outcomes, for patients overall and those treated with newer therapies is unclear. Objective: Synthesize qualitative and quantitative evidence about psychosocial outcomes for advanced (stage III/IV) melanoma patients. Methods: Five databases were searched (01/01/1980 to 31/01/2016). Inclusion criteria were as follows: advanced melanoma patients or sub-group analysis; assessed psychosocial outcomes; and English language. Results: Fifty-two studies met review criteria (4 qualitative, 48 quantitative). Trials comprise mostly medical not psychosocial interventions, with psychosocial outcomes assessed within broader quality of life measures. Patients receiving chemotherapy or IFN-alpha showed decreased emotional and social function and increased distress. Five trials of newer therapies appeared to show improvements in emotional and social function. Descriptive studies suggest that patients with advanced, versus localized disease, had decreased emotional and social function and increased distress. Contributors to distress were largely unexplored, and no clear framework described coping/adjustment trajectories. Patients with advanced versus localized disease had more supportive care needs, particularly amount, quality, and timing of melanoma-related information, communication with and emotional support from clinicians. Limitations included: lack of theoretical underpinnings guiding study design; inconsistent measurement approaches; small sample sizes; non-representative sampling; and cross-sectional design. Conclusions: Quality trial evidence is needed to clarify the impact of treatment innovations for advanced melanoma on patients' psychosocial well-being. Survivorship research and subsequent translation of that knowledge into programs and services currently lags behind gains in the medical treatment of advanced melanoma, a troubling circumstance that requires immediate and focused attention.

BACKGROUND Anxiety is a frequently cited barrier to blood donor recruitment. Although the mere presence of donation paraphernalia can heighten anxiety for some individuals, such stimuli are a necessary and unavoidable part of donation. Drawing on France and colleagues' research on tailored donor education and coping materials, the current study assessed whether modifying recruitment materials could improve donor recruitment in a context where anxiety is heightened. STUDY DESIGN AND METHODS A field study comprising a 2 (presence or absence of a mobile blood collection unit [MCU]) × 2 (recruitment brochure: standard, coping) between-subjects design was conducted with 922 nondonors who believed themselves eligible to donate blood. In either the presence or absence of the MCU, participants received a standard or modified recruitment brochure modeled on France and colleagues' education and coping materials. Donation anxiety, attitude, subjective norm, self-efficacy, and intention were assessed, and donation behavior was tracked for 30 days. RESULTS Participants who were assessed in the presence of the MCU reported heightened anxiety, and female participants reported decreased self-efficacy. The coping brochure improved self-efficacy, heightened the intention to donate in the presence of the MCU, and promoted blood donation behavior relative to the standard brochure. Path analyses supported a model in which, in the presence of the MCU, the coping brochure boosted self-efficacy and led to increased donation intention and behavior. CONCLUSIONS In a context in which donation-related anxiety is heightened, provision of materials that address prospective donor concerns and suggest coping strategies can bolster self-efficacy and promote recruitment.

Building on previous research that examined role identity in relation to volunteering, this study explored the impact of identity and personality for three giving behaviors: donating money, volunteering time, and donating blood. This study examined the contribution of general identity as a helpful person, role identity specific to each behavior, and personality traits of conscientiousness and agreeableness within the decision-making framework of the theory of planned behavior (TPB). Participants ( N = 203) completed a questionnaire measuring role identity (general and behavior specific), conscientiousness and agreeableness, and the TPB constructs of attitude, subjective norm, perceived behavioral control, and intention to donate. Three months later, participants reported whether they had engaged in each behavior. The results demonstrated that identity as a donor (i.e., specifically of money, time, or as a blood donor) emerged as more important in determining people’s giving actions than general role identity as a helpful person or global personality characteristics.

Masculine beliefs are influential in men’s responses to illness; however, current measures of masculinity may not be salient for highly prevalent chronic diseases such as prostate cancer. To address this gap, a contextualized measure of masculinity for men with prostate cancer was developed. A novel measure of masculinity, the Masculinity in Chronic Disease Inventory (MCD-I), was developed based on existing qualitative data and tested for acceptability and face validity with 19 men previously treated for prostate cancer. A cross-sectional survey of 403 Australian men with prostate cancer (Mage = 70.34 years; SD = 7.25) then assessed convergent, divergent, and discriminant validity for the MCD-I using existing reliable and valid measures of masculinity, masculine self-esteem, quality of life, erectile dysfunction, and sexual help seeking. A 6-factor structure for the MCD-I (22 items) was confirmed with good to excellent internal reliabilities (alpha = 0.69–0.92) for the subscale domains of Strength, Sexual Importance/Priority; Family Responsibilities; Emotional Self-Reliance; Optimistic Capacity; and Action Approach. Acceptable convergent and divergent validity was supported, and the MCD-I was also able to discriminate between men with severe versus moderate to mild erectile dysfunction (p = .002) and the Sexual Importance/Priority domain discriminated between men who had sought sexual advice and those who had not (p = .005). A contextual approach to measuring masculinity in men with prostate cancer may help avoid reductionist approaches for focusing on erectile dysfunction in these populations. This also presents a way forward for gender-sensitive psychosocial services and programs for men experiencing prostate cancer. (PsycINFO Database Record (c) 2018 APA, all rights reserved)

Charity sport events (CSEs) are a key revenue source for nonprofit organizations (NPOs) with large numbers of volunteers needed for success and cost-effectiveness. This study explored determinants of CSE volunteers' satisfaction, organizational commitment and intended future actions (CSE, other NPO activity/event volunteering, donating money). Relay for Life volunteers (N = 290) from one Australian state completed a cross-sectional survey. Significant pathways were found from socializing/enjoyment (β = 0.17), fighting cancer (β = 0.29), financial support (β = 0.21) motives and social norm (β = 0.23) to satisfaction; 52% variance was explained. Age (β = −0.09), survivorship (β = 0.09), region (β = 0.07), fundraising goal (β = 0.08), advocacy (β = 0.15), financial support (β = 0.25), social/enjoyment (β = 0.23) motives, social norm (β = 0.23) and satisfaction (β = 0.21) were linked with commitment; 63% variance was explained. Paths between satisfaction, commitment and intended future actions (CSE, NPO activity/event volunteering) were significant (βs = 0.17–0.43). Future targets to increase CSE volunteer satisfaction and commitment involve similar (social/enjoyment) and diverse (action-oriented) motives, with satisfaction and commitment key contributors to future actions supporting NPOs. Copyright © 2016 John Wiley & Sons, Ltd.

ObjectiveTo explore men’s lived experience of advanced prostate cancer (PCa) and preferences for support.DesignCross-sectional qualitative study applying open-ended surveys and interviews conducted between June and November 2016. Interviews audio-recorded and transcribed verbatim and analysed from an interpretive phenomenological perspective.SettingAustralia, nation-wide.Participants39 men diagnosed with advanced PCa (metastatic or castration-resistant biochemical progression) were surveyed with 28 men subsequently completing a semistructured in depth telephone interview.ResultsThematic analysis of interviews identified two organising themes: lived experience and supportive care. Lived experience included six superordinate themes: regret about late diagnosis and treatment decisions, being discounted in the health system, fear/uncertainty about the future, acceptance of their situation, masculinity and treatment effects. Supportive care included five superordinate themes: communication, care coordination, accessible care, shared experience/peer support and involvement of their partner/family.ConclusionsLife course and the health and social context of PCa influence men’s experiences of advanced disease. Multimodal interventions integrating peer support and specialist nurses are needed that more closely articulate with men’s expressed needs.

Background: One third of cancer deaths are attributable to modifiable lifestyle, behaviour and psychosocial risk factors. Psycho-oncology can contribute significantly to prevention initiatives such as those described in national cancer control plans (NCCPs), to reduce or eliminate these risk factors. However, the extent to which psycho-oncology expertise has informed prevention objectives in plans is unclear. Methods: Accordingly, 35 English language NCCPs were located via existing databases and were searched using Adobe text searches ('psycho', 'social', 'behav' and 'intervention') to identify (a) representations of psycho-oncology, its dimensions (psychological, social and behavioural) and roles (e.g. psychologist); and (b) behaviour/lifestyle change interventions. Results: A third of NCCPs included the term psycho- or psychosocial-oncology; approximately half referred to a psycho-oncology dimension regarding prevention and early detection and half included actions/objectives relating to health professionals and provision of psychosocial care. The majority of cancer plans included prevention outcomes and focussed primarily on smoking cessation and alcohol reduction. Interventions commonly proposed were education, regulation and service provision; however, many were aspirational statements of intent rather than specific interventions. Psycho-oncology was represented in NCCPs but was limited in reference to prevention with few behavioural interventions utilised. Conclusions: Psycho-oncology input is needed to prescribe evidence-based interventions in cancer plans that not only educate, regulate and provide resources but also motivate, empower and create a supportive normative environment for behaviour change. In this manuscript, and throughout this Special Issue on Cancer Prevention, important principles, ideas and evidence within psycho-oncology are outlined which, if properly implemented, can help reduce the global cancer burden.

Young novice drivers are at considerable risk of injury on the road. Their behaviour appears vulnerable to the social influence of their parents and friends. The nature and mechanisms of parent and peer influence on young novice driver (16–25 years) behaviour was explored via small group interviews (n = 21) and two surveys (n1 = 1170, n2 = 390) to inform more effective young driver countermeasures. Parental and peer influence occurred in pre-Licence, Learner, and Provisional (intermediate) periods. Pre-Licence and unsupervised Learner drivers reported their parents were less likely to punish risky driving (e.g., speeding). These drivers were more likely to imitate their parents and reported their parents were also risky drivers. Young novice drivers who experienced or expected social punishments from peers, including ‘being told off’ for risky driving, reported less riskiness. Conversely drivers who experienced or expected social rewards such as being ‘cheered on’ by friends – who were also more risky drivers – reported more risky driving including crashes and offences. Interventions enhancing positive influence and curtailing negative influence may improve road safety outcomes not only for young novice drivers, but for all persons who share the road with them. Parent-specific interventions warrant further development and evaluation including: modelling safe driving behaviour by parents; active monitoring of driving during novice licensure; and sharing the family vehicle during the intermediate phase. Peer-targeted interventions including modelling of safe driving behaviour and attitudes; minimisation of social reinforcement and promotion of social sanctions for risky driving also need further development and evaluation.

Copyright © 2017 John Wiley & Sons, Ltd. Objective: Female partners of men with prostate cancer (PCa) experience heightened psychological distress; however, long-term distress for this group is not well described. We examined partner's psychological and cancer-specific distress over 2 years and predictors of change. Methods: A cohort of 427 female partners (63% response; mean age 62.6 y) of PCa survivors completed baseline (2-4 y post-PCa treatment) assessments of anxiety, depression, and cancer-specific distress and were followed up at 6, 12, 18, and 24 months. Caregiver burden, threat and challenge appraisal, self-efficacy, and dyadic adjustment were assessed as potential predictors of distress. Results: Over time, 23% to 25% of women reported anxiety; 8% to 11% depression; 5% to 6% high cancer-specific distress. Higher caregiver burden and more threat appraisals were associated with increased distress, anxiety, depression, and cancer-specific distress over time. Higher dyadic adjustment over time and more challenge appraisals at 24 months were associated with less distress, anxiety, and depression. Increased partner self-efficacy was associated with lower distress and depression at baseline. Conclusions: A substantial subgroup of partners experience ongoing anxiety, with depression less prevalent but also persistent. Caregiver burden, partner self-efficacy, threat, and challenge appraisals present as potential supportive care targets.

© 2018, Springer-Verlag GmbH Germany, part of Springer Nature. Purpose: This study aimed to identify the factors which health professionals believe influence clinical care and outcomes for people with cancer in regional areas of Australia. Methods: Twelve semi-structured interviews were conducted with a variety of health professionals. Interview questions explored health professional’s perspectives on barriers to cancer care for patients, factors which influence clinical care, and access to support in regional areas. Data were interpreted using an inductive thematic analysis approach. Results: Two global themes were identified: rural culture and the health system. Within these global themes, health professionals discussed barriers to cancer care in regional areas, predominantly associated with travel, limited workforce, and poor communication within the health system. Participants also noted many positive aspects of cancer care in regional areas, including more personalised care for the patients and faster career progression for professionals. Conclusions: Despite several strategies to improve rural cancer care in recent times, including innovative models of care and increased infrastructure, health professionals still perceive many barriers to cancer care in regional Australia. These are predominantly associated with patient demographics, travel difficulties, and inadequate governance. However, there are also many notable benefits to receiving care in regional areas which have been absent from previous literature. These positive factors should be incorporated in efforts to enhance regional cancer care through the recruitment of health professionals to regional areas and development of regional community support networks.

Background: Approximately 20% of men with a diagnosis of prostate cancer present with locally advanced or advanced disease. Few studies consider longer-term impact of disease progression and treatment adverse effects on health-related quality of life (QoL) of these men. Objective: Describe changes in health-related QoL over 5 years for men with newly diagnosed locally advanced or advanced prostate cancer. Interventions/Methods: Eighty-one men with locally advanced or advanced prostate cancer referred to the study by their treating urologist completed a self-administered questionnaire assessing distress, cancer-specific distress, decision regret, satisfaction with life, and global and disease-specific health-related QoL. Questionnaires were administered close to diagnosis (baseline), 2, 6, 12, 24, 36, 48, and 60 months' follow-up. Results: Men were of mean age 68.3 (SD, 7.9) years and at mean of 31.9 (SD, 50.5) days postdiagnosis. The most common treatment received was androgen deprivation therapy (95.1%) or radiation therapy (79%). The proportion of men classified as distressed (Distress Thermometer) ranged from 46.3% (baseline) to 32.6% (60 months). Decrements in physical QoL were found at 2, 6, 12, 24, 36, and 48 months compared with baseline. Life satisfaction ratings were lower at 6 months compared with baseline. Sexual concerns were consistently high across the 5 years ( Expanded Prostate Cancer Index Composite G30). Conclusions: In the context of advanced disease, results indicate that health-related QoL fluctuates from diagnosis to 5 years later. A substantial proportion remained distressed at 5-year follow-up. Implications for Practice: Care frameworks supporting ongoing assessment of health-related QoL concerns of men with advanced prostate cancer are needed with a particular focus on sexual adjustment.

© 2017 The Authors. European Journal of Cancer Care Published by John Wiley & Sons Ltd Across Australia, prostate cancer support groups (PCSG) have emerged to fill a gap in psychosocial care for men and their families. However, an understanding of the triggers and influencers of the PCSG movement is absent. We interviewed 21 SG leaders (19 PC survivors, two partners), of whom six also attended a focus group, about motivations, experiences, past and future challenges in founding and leading PCSGs. Thematic analysis identified four global themes: illness experience; enacting a supportive response; forming a national collective and challenges. Leaders described men's feelings of isolation and neglect by the health system as the impetus for PCSGs to form and give/receive mutual help. Negotiating health care systems was an early challenge. National affiliation enabled leaders to build a united voice in the health system and establish a group identity and collective voice. Affiliation was supported by a symbiotic relationship with tensions between independence, affiliation and governance. Future challenges were group sustainability and inclusiveness. Study findings describe how a grassroots PCSG movement arose consistent with an embodied health movement perspective. Health care organisations who seek to leverage these community resources need to be cognisant of SG values and purpose if they are to negotiate effective partnerships that maximise mutual benefit.

[Extract] The medical and social context of prostate cancer (PCa) has changed dramatically since the introduction of PSA testing for early detection in the late 1980s,¹ leading to a peak in incidence in the developed world in the 1990s and again a decade later.² Since that time, novel PCa treatments have rapidly emerged in the radiation and medical oncology field, as well as surgical advances.³ The recent emergence of active surveillance for low-risk disease has further expanded possible treatment approaches.⁴ Market forces from consumers, clinicians, and the therapeutic industry have driven changes in clinical and surgical management and treatment; however, psycho-oncological research and survivorship care arguably has lagged behind. Specifically, although men are surviving longer, they may not be surviving well. In 2012, there were over 1.1 million incident cases of PCa diagnosed and more than 300 000 deaths worldwide.⁵ Five-year prevalence estimates suggest that there are over 3.8 million PCa survivors globally⁶ with this expected to increase rapidly in future.⁷ The challenges we face in meeting the needs of these men and their families into the future are vast.

Binge eating (BE) among female university students is rising in prevalence and few studies have considered the role of social cognitive processes in decisions to engage in BE. This study adopted a theory of planned behavior (TPB) belief-based approach to examine the beliefs that underpin female university students' intentions to BE. Participants (N = 250) completed self-report questionnaires assessing BE intentions and the TPB behavioral (advantages and disadvantages of BE), normative (important others approving/disapproving of BE), and control (barriers toward and motivators for BE) belief measures. For analyses, participants were grouped based on a median split of the overall intention score into those with higher and lower intentions to binge eat. Differences in the TPB beliefs about BE between these two groups were then assessed. Female students with higher intentions to binge eat differed significantly in their endorsement of the likely beliefs related to BE, compared to female students with lower in...

PURPOSE: While there is research indicating that many factors influence the young novice driver's increased risk of road crash injury during the earliest stages of their independent driving, there is a need to further understand the relationship between the perceived risky driving behaviour of parents and friends and the risky behaviour of drivers with a Provisional (intermediate) licence. METHOD: As part of a larger research project, 378 drivers aged 17-25 years (M=18.22, SD=1.59, 113 males) with a Provisional licence completed an online survey exploring the perceived riskiness of their parents' and friends' driving, and the extent to which they pattern (i.e. base) their driving behaviour on the driving of their parents and friends. RESULTS: Young drivers who reported patterning their driving on their friends, and who reported they perceived their friends to be risky drivers, reported more risky driving. The risky driving behaviour of young male drivers was associated with the perceived riskiness of their fathers' driving, whilst for female drivers the perceived riskiness of their mothers' driving approached significance. CONCLUSIONS: The development and application of countermeasures targeting the risky behaviour of same-sex parents appears warranted by the robust research findings. In addition, countermeasures need to encourage young people in general to be non-risky drivers; targeting the negative influence of risky peer groups specifically. Social norms interventions may minimise the influence of potentially-overestimated riskiness. Language: en

The experience of prostate cancer is for most men a major life stress with the psychological burden of this disease falling more heavily on those who are younger. Despite this, being young as it applies to prostate cancer is not yet clearly defined with varied chronological approaches applied. However, men’s responses to health crises are closely bound to life course and masculinities from which social roles emerge. This paper applied qualitative methodology (structured focus groups and semistructured interviews with expert informants) using interpretative phenomenological analysis to define what it means to be young and have prostate cancer. Structured focus groups were held with 26 consumer advisors (men diagnosed with prostate cancer who provide support to other men with prostate cancer or raise community awareness) and health professionals. As well, 15 men diagnosed with prostate cancer and in their 40s, 50s, or 60s participated in semi-structured interviews. Participants discussed the attributes that describe a young man with prostate cancer and the experience of being young and diagnosed with prostate cancer. Chronological definitions of a young man were absent or inconsistent. Masculine constructions of what it means to be a young man and life course characteristics appear more relevant to defining young as it applies to prostate cancer compared with chronological age. These findings have implications for better understanding the morbidities associated with this illness, and in designing interventions that are oriented to life course and helping young men reconstruct their identities after prostate cancer.

Drink walking, that is walking in a public place while intoxicated, is associated with increased risk of injury and fatality. Young people and males are especially prone to engaging in this behaviour, yet little is known about the factors associated with individual's decisions to drink walk. The present research explores the role of different normative influences (friendship group norm, parent group norm, university peer group norm) and perceived risk, within an extended theory of planned behaviour (TPB) framework, in predicting young people's self-reported drink walking intentions. One hundred and eighteen young people (aged 17-25 years) completed a survey including sociodemographic measures and extended TPB measures related to drink walking. Overall the extended TPB explained 72.8% of the variance in young people's intentions to drink walk in the next six months with attitude, perceived behavioural control, friendship group norm, and gender (male) emerging as significant predictors. Males, as compared with females, had higher intentions to drink walk and lower perceptions of risk regarding drink walking. Together, these findings provide a clearer indication of the salient normative influences and gender differences in young pedestrian's decisions to walk while intoxicated. Such findings can be used to inform future interventions designed to reduce injuries and fatalities associated with drink walking.

Objective: The lack of consistency between peoples' attitudes toward organ donation and organ donation registration behavior has long perplexed scholars. Ajzen and Fishbein's principle of compatibility offers a potential explanation for the attitude-behavior discrepancy. This principle states that attitudes will better predict behavior if the specificity of a measured attitude matches the specificity of the behavior under consideration. Method: Two studies, using different samples and different modes of data collection, measured general attitudes toward organ donation and specific attitudes toward registering as a donor, while simultaneously offering a registration opportunity. Results: Compared with general attitudes about organ donation, attitudes specific to organ donor registration were superior predictors of registration intentions and behaviors. Specific attitudes explained at least 70% more variance in registration behaviors than general attitudes. Conclusion: The lack of attitude-behavior consistency in the organ donor domain can be partially explained by limited compliance with the principle of compatibility.

Mindfulness interventions are increasingly popular in cancer care, emerging in both literature and practice.1, 2 Evidence suggests that mindfulness is helpful for women diagnosed with breast cancer,1 but this may not be the case in other settings.3 To understand when, how, and which mindfulness skills promote effective coping with cancer, well‐validated measures are needed. The Five Facets of Mindfulness Questionnaire (FFMQ)4 is a self‐report measure of engagement in mindfulness practices. The five facets include observing or noticing ones' reaction, ability to describe this reaction, acting with awareness, nonjudging of inner experience, and nonreactivity to inner experience. The FFMQ was originally validated with university students4 and is widely used to measure mindfulness for patients with noncommunicable disease (depression5), including cancer.1, 2 However, these studies overrepresent women with breast cancer, present a factor structure that differs in clinical populations from that originally proposed,5 and none examine construct validity of the FFMQ in cancer populations. Accordingly, we validated the FFMQ using confirmatory factor analysis in men diagnosed with advanced prostate cancer (PCa).

An extended theory of planned behavior (TPB) was used to understand the factors, particularly control perceptions and affective reactions, given conflicting findings in previous research, informing younger people's intentions to join a bone marrow registry. Participants (N = 174) completed attitude, subjective norm, perceived behavioral control (PBC), moral norm, anticipated regret, self-identity, and intention items for registering. The extended TPB (except PBC) explained 67.2% of variance in intention. Further testing is needed as to the volitional nature of registering. Moral norm, anticipated regret, and self-identity are likely intervention targets for increasing younger people's bone marrow registry participation.