Search

OBJECTIVE: We conducted a meta-analysis of randomized controlled trials designed to promote smoking cessation among cancer survivors to (a) assess how effective interventions are at increasing quit rates, and (b) determine which intervention strategies are associated with effect sizes. METHODS: Out of 10,848 records that were located using computerized searches and informal sources, 21 interventions met the inclusion criteria for the review. We developed a bespoke taxonomy of 36 categories of techniques designed to change smoking behavior, and coded sample, intervention, and methodological characteristics. Random effects meta-analysis and metaregressions were conducted. RESULTS: The sample-weighted average effect size for smoking cessation was d+ = .030, and was not significantly different from zero (95%CI = -.042 to .101). Effect sizes exhibited both publication bias and small sample bias. Metaregressions indicated that, out of the many potential moderators that were tested, just a single intervention feature was associated with effect sizes. Interventions delivered solely by nurses exhibited larger effects compared to interventions from other sources. CONCLUSION: The present review indicates that current smoking cessation interventions for cancer survivors are ineffective. High-quality and effective interventions are needed. We offer suggestions regarding promising intervention strategies. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Cancer survivors who smoke cigarettes face health risks from continued smoking. Some smokers use e-cigarettes to reduce combustible cigarette use, but research on whether cancer survivors do the same is limited. Research is needed to understand whether smokers who are cancer survivors use e-cigarettes at higher rates than smokers never diagnosed with cancer, to inform provider-patient discussions about e-cigarettes. Using cross-sectional data from current cigarette smokers in Wave 1 (2013–2014) of the Population Assessment of Tobacco Health (PATH) study, we compared cancer survivors (n = 433) and those without a prior cancer diagnosis (n = 10,872) on e-cigarette use and reasons for use. Among smokers, 59.4% of cancer survivors and 63.2% of those without a cancer diagnosis had ever used e-cigarettes, and nearly one-quarter of both groups (23.1% and 22.3%, respectively) reported being current users. Multivariate results, however, suggest that cancer survivors might be more likely to be ever (OR = 1.28; p = .05) or current (OR = 1.25; p = .06) e-cigarette users compared to those never diagnosed, although results were marginally significant. The majority of both groups (> 71%) reported using e-cigarettes for perceived health-related reasons—including smoking reduction. Our study found that among smokers, cancer survivors were using e-cigarettes at similar rates as never-diagnosed smokers and both groups used e-cigarettes largely for perceived health-related reasons. Clinicians who treat cancer survivors may need to routinely ask their patients who smoke about e-cigarette use and address the limited research on the efficacy of e-cigarettes as a cessation aid as compared to other evidence-based options.

Objective: We conducted a meta-analysis of physical activity interventions among cancer survivors in order to (a) quantify the magnitude of intervention effects on physical activity, and (b) determine what combination of intervention strategies maximizes behavior change. \ud Methods: Out of 32,626 records that were located using computerized searches, 138 independent tests (N = 13,050) met the inclusion criteria for the review. We developed a bespoke taxonomy of 34 categories of techniques designed to promote psychological change, and categorized sample, intervention, and methodological characteristics. Random effects meta-analysis and meta-regressions were conducted; effect size data were also submitted to Meta-CART analysis.\ud Results: The sample-weighted average effect size for physical activity interventions was d+ = .35, equivalent to an increase of 1,149 steps per day. Effect sizes exhibited both publication bias and small sample bias but remained significantly different from zero, albeit of smaller magnitude (d+ ≥ .20), after correction for bias. Meta-CART analysis indicated that the major difference in effectiveness was attributable to supervised versus unsupervised programs (d+ = .49 vs. .26). Greater contact time was associated with larger effects in supervised programs. For unsupervised programs, establishing outcome expectations, greater contact time, and targeting overweight or sedentary participants each predicted greater program effectiveness, whereas prompting barrier identification and providing workbooks were associated with smaller effect sizes.\ud Conclusion: The present review indicates that interventions have a small but significant effect on physical activity among cancer survivors, and offers insights into how the effectiveness of future interventions might be improved.

OBJECTIVE Smoking poses significant health risks to cancer survivors. Cancer survivorship may heighten psychological distress and reduce social support and health-related quality of life (HRQOL) for years after diagnosis, which could inhibit long-term successful smoking cessation. Understanding longitudinal associations between these psychosocial characteristics and successful cessation could help clinicians tailor cessation interventions for their patients. METHODS Time-to-event analyses using data from the American Cancer Society Study of Cancer Survivors-I (SCS-I)-a longitudinal nationwide study-examined the relationship of psychosocial characteristics with cessation likelihood and amount of time from diagnosis to quitting in cancer survivors diagnosed 7 to 10 years prior. RESULTS Cancer survivors with high physical HRQOL were more likely to quit smoking within 10 years from cancer diagnosis than survivors with low physical HRQOL, controlling for cancer type and number of comorbid conditions at baseline (HR = 1.96; 95% CI: 1.10-2.70; P = .02). Survivors with high physical HRQOL also took less time to quit than survivors with low physical HRQOL. Survivors of tobacco-related cancers with low physical HRQOL were the least likely group to quit. No significant relationships between other psychosocial predictors and cessation outcomes were observed. CONCLUSIONS Smoking cessation programs are needed for all cancer survivors who smoke, but survivors with low physical HRQOL 1 year after diagnosis may need more intensive long-term smoking cessation interventions with multiple check-in points after smoking relapses. Cessation interventions that include strategies to mitigate physical symptoms in those with poor physical HRQOL deserve consideration in research and practice.

Prostate cancer is the most frequently diagnosed cancer among men in the United States (American Cancer Society, 2015; National Cancer Institute, 2014), with the vast majority (81%) of the diagnosed cases being localized and potentially curable (National Cancer Institute, 2014). Treatment decision making is a taxing process for patients with localized prostate cancer because of a large number of available treatment options (e.g., active surveillance, different types of prostatectomy, various forms of radiation with or without hormonal therapy) (National Comprehensive Cancer Network, 2015). For patients in a sexual relationship, healthcare providers treating prostate cancer commonly recommend that the patient’s partner be involved in treatment decision making (Boehmer & Clark, 2001). However, existing research often describes treatment decision making as a dyadic process between the patient and healthcare providers (Zeliadt et al., 2006), with little emphasis on partner involvement. Most descriptive (Berry et al., 2006; Diefenbach & Mohamed, 2007; Shaw, Scott, & Ferrante, 2013) and intervention studies (Berry et al., 2013; Lin, Aaronson, Knight, Carroll, & Dudley, 2009) about treatment decision making for prostate cancer have focused on the patients’ concerns and satisfaction with treatment decision making. However, partners play an important role in how well patients with prostate cancer manage their illness (Ervik, Nordoy, & Asplund, 2013; Wootten et al., 2014; Wu, Mohamed, Winkel, & Diefenbach, 2013). Partners provide informational support (e.g., gathering information, helping patients understand information) and emotional support (e.g., comfort, companionship) (Laidsaar-Powell et al., 2013; Sinfield, Baker, Agarwal, & Tarrant, 2008; Srirangam et al., 2003; Street et al., 2010). Previous research found that some partners were completely excluded from the treatment decision-making process for prostate cancer, and other couples had a joint decision-making style in which the partner discussed treatment issues with the patient (Boehmer & Clark, 2001). Limited research explores how partners are involved in treatment decision making, whether partner involvement is congruent with the patient’s expectation, and whether partner involvement is related to satisfaction with the patient’s cancer treatment. Finally, little is known about the reasons for partner noninvolvement in treatment decision making. To address these gaps, this exploratory study examined partners’ involvement in treatment decision making for patients with newly diagnosed localized prostate cancer. The researchers described partner preferences for and actual involvement in treatment decision making, congruence between partner involvement and patient preference, reasons for partner noninvolvement, and the relationship between partner involvement in treatment decision making and satisfaction with the patient’s treatment.

As reviewed in the article by Perry and colleagues (2014) in this volume, ample evidence has documented the contributions of peer support (PS) to health, health care, and prevention. Building on that foundation, this article discusses characteristics, contexts, and dissemination of PS, including (a) fundamental aspects of the social support that is often central to it; (b) cultural influences and ways PS can be tailored to specific groups; (c) key features of PS and the importance of ongoing support and backup of peer supporters and other factors related to its success; (d) directions in which PS can be expanded beyond prevention and chronic disease management, such as in mental health or interventions to prevent rehospitalization; (e) other opportunities through the US Affordable Care Act, such as through patient-centered medical homes and chronic health homes; and (f) organizational and policy issues that will govern its dissemination. All these demonstrate the extent to which PS needs to reflect its contexts—intended audience, health problems, organizational and cultural settings—and, thus, the importance of dissemination policies that lead to flexible response to contexts rather than constraint by overly prescriptive guidelines.

Hematopoietic stem cell transplant survivors often share advice with patients undergoing this difficult treatment. We content analyzed narratives written by 59 transplant survivors given the opportunity to share advice with patients. Analyses described categories of advice they shared and evaluated their perceptions of the helpfulness of advice they had received. We found nine advice categories and evidence for variation in their perceived helpfulness, especially for advice to “be your own advocate,” “have someone you can rely on,” and “think positive.” Findings suggest the need to investigate how seemingly innocuous advice can be unhelpful and potentially distressing to some patients.

Cancer survivors treated with hematopoietic stem cell transplant rely on their social network for successful recovery. However, some survivors have negative attitudes about using social resources (negative social network orientation) that are critical for their recovery.We examined the association between survivors' social network orientation and health-related quality of life (HRQoL) and whether it was mediated by social resources (network size, perceived support, and negative and positive support-related social exchanges).In a longitudinal study, 255 survivors completed validated measures of social network orientation, HRQoL, and social resources. Hypotheses were tested using path analysis.More negative social network orientation predicted worse HRQoL (p .001). This association was partially mediated by lower perceived support and more negative social exchanges.Survivors with negative social network orientation may have poorer HRQoL in part due to deficits in several key social resources. Findings highlight a subgroup at risk for poor transplant outcomes and can guide intervention development.