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Adolescent health has a significant influence as individuals transition to adulthood and can have lifelong effects on well-being. In addition to well-established structural determinants of health such as racism and poverty, proximal determinants of adolescent health illuminate on the health effects of the daily circumstances of adolescents. Guided by the proximal determinants of adolescent health theory, we examined the association between adolescents' self-rated health and multiple domains of proximal determinants, including family relations, peer relationships, school environment, and neighborhood environment. Using data from the Fragile Families and Child Wellbeing Study, we analyzed 3,444 adolescents who were 14 to 15 years old. Results of ordered logistic regression analyses revealed significant associations between proximal determinants and adolescents' self-rated health even when taking into account all the domains simultaneously. This study highlights the importance of unraveling factors of multiple systems on adolescents' health and suggests implications for their subsequent transition to adulthood.

Objectives: The purpose of this study was to determine the effects of technology-based cancer survivorship care interventions according to the types of intervention and participant characteristics for adult cancer survivors; and the extent to which the types of intervention and participant characteristics moderate the observed effects. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing technology-based survivorship care interventions with control groups for posttreatment adult cancer survivors. Results: A total of 50 RCTs with 422 effect sizes suggested an overall significant treatment effect of technology-based survivorship care interventions. Survivorship care domains, comparison groups, and targeted outcomes were significant moderators influencing treatment effects. Conclusions: Our findings reinforce the value and applicability of technology-based survivorship care interventions that promote skill-building specifically. Interventions addressing multidimensional domains for survivorship care should be developed with advances in technology, which in turn influence enhancing cancer survivors' capacities to address psychosocial challenges. [ABSTRACT FROM AUTHOR]

Objective: It has long been documented that cognitive behavioral therapy (CBT) has positive impacts on improving mental health (MH) and quality of life (QoL) in the general population, but investigations on its effect on cancer survivors remain limited, especially for QoL outcomes. The purpose of this meta‐analysis is to investigate the effects of CBT as compared to control on cancer patients' MH and QoL outcomes. Control is defined in this study as standard therapy, waitlist control, and active/alternative therapy. Methods: In total, 154 clinical trials creating a sample size of 1627 individuals were collected. Analysis focusing on MH and QoL excluded 29 clinical trials resulting in a final analysis of 132 clinical trials (and 1030 effect sizes). R Statistical Software (version 4.2.2) and the robumeta package were utilized to complete analysis, which entailed robust variance estimation (RVE) in intercept‐only meta‐regression, and univariate meta‐regression (for moderator analysis). Results: Across 132 clinical trials and 1030 effect size estimates, we identified that CBT moderately improves MH and QoL in cancer patients d = 0.388, 95% CI 0.294–0.483, p < 0.001. Additionally, age and delivery format can influence the efficacy of CBT in this patient population. Conclusions: CBT statistically improves the MH and QoL psychosocial parameters in cancer patients with greater efficacy in younger patients. Important clinical and intervention‐related factors, that is, age and delivery, should be considered when oncologists consider CBT as a psychotherapeutic intervention for individuals with cancer. [ABSTRACT FROM AUTHOR]

Purpose: Few studies have specifically targeted symptom management interventions for adolescent and young adult (AYA) cancer survivors. A greater understanding of AYA cancer survivors' experiences with cancer treatment-related symptoms would help develop age-appropriate oncology symptom management interventions. The purpose of this qualitative analysis was to explore AYA cancer survivors' experience with cancer treatment-related symptoms. Methods: Nineteen post-treatment AYA cancer survivors (18–39 years old) who self-reported moderate–severe cancer treatment-related symptom severity participated in video conferencing or telephone interviews. The questions in the interview guide queried participants to share their experience with cancer treatment-related symptoms. Inductive content analysis was used to identify themes from the interviews. Results: The themes that emerged from the interviews included (1) cancer treatment-related symptoms negatively affected AYA cancer survivors' quality of life (e.g., symptoms served as a reminder of cancer recurrence possibility); (2) AYA cancer survivors' attitudes and feelings about communicating cancer treatment-related symptom concerns to clinicians (e.g., patient–clinician communication was bolstered when AYAs perceived that symptoms were being taken seriously); (3) AYA cancer survivors are interested in oncology symptom management clinical trials, but logistical challenges are barriers to participation; and (4) AYA cancer survivors are interested in nonpharmacological treatments for symptom management. Conclusion: Results highlight the burden of cancer treatment-related symptoms on day-to-day life among post-treatment AYA cancer survivors. Future work is needed to identify nonpharmacological symptom management interventions, strategies to improve patient–clinician communication about symptoms, and strategies to increase the visibility and accessibility of symptom management clinical trials for AYA cancer survivors. [ABSTRACT FROM AUTHOR]

Few studies have examined the distinct reproductive concerns (RC) of men and women in the adolescent and young adult (AYA) cancer patient population. The purpose of this mixed-methods study was to explore and differentiate the RC of AYAs. Participants completed the Reproductive Concerns After Cancer (RCAC) scale and participated in a semistructured interview. Interviews were deductively coded based on an analytic schema derived from the RCAC. After identifying participants through the electronic health record, 27 younger AYAs, ages 12–25, enrolled in the study. Four inductive themes emerged and differed by gender. These include differential temporality, acceptance, and openness to alternatives, partner influence, and parental/guardian influence. AYA men reported fewer RC (M = 49.4, SD = 9.6) compared to AYA women (M = 56.8, SD = 8.4). Oncofertility care providers are advised to account for short- and long-ranging concerns based on AYAs' gender. Future evaluations of patient-reported outcome measures specific to AYA RC are recommended. [ABSTRACT FROM AUTHOR]

Cognitive-behavioral therapy (CBT) is well supported for treating depressive and anxiety disorders. Trials of CBT for anxiety and depression in primary care have increased over the past decade, yet only one meta-analysis, published in 2015, examined this topic and the scope of that review is relatively narrow. This study conducted a systematic review and meta-analysis of primary care based CBT for depression and anxiety. A search of seven electronic databases, six professional websites, and reference lists from articles meeting inclusion criteria was conducted for studies published between 1900 and November 2018. Fifty-seven eligible studies (including 10,701 participants; 221 effect sizes) of randomized controlled trials were eligible and included for meta-analysis using robust variance estimation in meta-regression. Outcome indicators were depression and anxiety measures. An overall significant treatment effect, d = 0.400, 95% CI (0.235, 0.566), p < 0.001, of CBT for depression and anxiety disorders in primary care was identified. Subgroup analyses indicated significant treatment effect for: (1) depressive (d = 0.425, p < 0.001) and anxiety (d = 0.393, p < 0.01) outcomes, (2) studies conducted inside primary care (d = 0.412, p < 0.001), (3) studies using individual-based CBT (d = 0.412, p < 0.001), (4) studies without primary care physician involvement (d = 0.395, p < 0.001), and (5) studies using both tele-health (d = 0.563, p < 0.001) and in-person CBT (d = 0.363, p < 0.001). The percentage of White participants, treatment composition (CBT only versus CBT + other approaches), and treatment duration were significant moderators. Implications for clinical practice are discussed based on both moderator and subgroup analysis results., Author(s): Anao Zhang [sup.1] , Lindsay A. Borhneimer [sup.1] , Addie Weaver [sup.1] , Cynthia Franklin [sup.2] , Audrey Hang Hai [sup.2] , Samantha Guz [sup.3] , Li Shen [sup.4] [...]

Body image is a major psychosocial concern for all cancer patients but can affect the adolescent and young adult (AYA) population in distinct ways. Similarly, the prospect of infertility and the fertility preservation process can create additional stress during cancer treatment. Discussions regarding infertility inherently implicate the body and its reproductive function, but downstream effects on self-perception have not been previously described. The aim of this study was to explore the experiences of AYAs as they considered their risk of infertility and options for fertility preservation (FP), specifically the ways in which this impacted body image and FP decision-making. AYA cancer patients (n = 27) aged 12–25 years whose cancer and treatment conferred risk of infertility were recruited through electronic health record query at an NCI-Designated Comprehensive Cancer Center. Participants completed semi-structured interviews, which were recorded, transcribed, and deductively coded for themes related to information needs, knowledge of treatment effects on fertility, and reproductive concerns after cancer. Emergent, inductive themes related to body image were identified. Body image concerns, related to both physical appearance and body functioning emerged. Common concerns included anticipating change as it pertains to the body and its functions, physical discomfort, fear of judgment, and meeting expectations of the body. While these themes are broad in nature, they have been previously explored in relation to body image in general and their emergence in the oncofertility space provides guidance for further optimization of infertility and fertility preservation discussions. AYA cancer patients experience a multitude of body image related disturbances when faced with the possibility of infertility and fertility preservation. In identifying and exploring these themes, future opportunities for improving oncofertility practice and discussions among AYAs with a focus on body image positivity are called upon. [ABSTRACT FROM AUTHOR]

Purpose: Solution-focused brief therapy (SFBT) is practiced by social workers in clinical, community-based services, but no reviews of the outcome research have been completed. Methods: A meta-analysis of randomized studies. Outcome domains included depression, anxiety, behavioral health, health and wellbeing, family functioning, and psychosocial adjustment. Results: Twenty-eight studies with 340 effect sizes were analyzed in meta-regression with robust variation estimation (RVE). Overall, statistically significant and medium treatment effect sizes were found across outcome domains, g = 0.654, 95% CI : 0.386–0.922, p < 0.001. Interventions with 4 or more SFBT techniques across three categories (cooperative language, co-construction, and developing a therapeutic relationship; strengths and resources; and future-focused questions) showed a moderate treatment effect. Implications: SFBT is an effective intervention for depression, behavioral health, family functioning, and psychosocial outcomes when delivered in community-based services. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to evaluate the effectiveness of cognitive behavioral therapy (CBT) for Chinese diabetic patients suffering from depression. Method: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we researched seven electronic databases and two professional websites. Publication bias was assessed using funnel plot. Meta-analysis was conducted using meta-regression with robust variance estimation. Results: Final analysis included a total of 23 controlled trials containing 201 effect size estimates (including 5025 participants). Subgroup analyses indicated significant treatment effects for (1) depression outcomes, anxiety outcomes, psychological stress/distress outcomes, physiological outcomes, and general wellness outcomes, (2) studies with/without manuals, (3) studies using individual-based/group-based CBT, (4) studies in person/assisted with technology, and (5) studies providers with/without training. The treatment outcomes and intervention composition (CBT only versus CBT plus other approaches) were significant moderators. Conclusions: Findings of the study suggested CBT is a promising treatment option for depression among Chinese diabetes patients. [ABSTRACT FROM AUTHOR]

This meta-analysis synthesized randomized controlled trials of solution focused brief therapy (SFBT) in medical settings for patients' health-related psychosocial (e.g., depression, psychosocial adjustment to illness), behavioral (e.g., physical activity, nutrition score), and functional health (e.g., BMI, individual strength) outcomes. Medical setting is defined in this study as any healthcare setting that primarily focuses on patients' physical wellbeing. A comprehensive search strategy across five electronic databases, four academic journals, three professional websites, and reference lists of included articles resulted in a final sample of nine studies for meta-analytic synthesis. Combining outcomes indicated an overall significant effect of SFBT for health-related psychosocial outcomes (d = 0.34, p < .05.) and a nearly significant outcome for health-related behavioral outcomes (d = 0.28, p = .06), but not for functional health outcomes. Results indicated SFBT being an effective intervention for psychosocial outcomes and a promising approach for behavioral outcomes in medical settings., Author(s): Anao Zhang [sup.1] , Cynthia Franklin [sup.1] , Jennifer Currin-McCulloch [sup.1] , Sunyoung Park [sup.1] , Johnny Kim [sup.2] Author Affiliations: (Aff1) 0000 0004 1936 9924, grid.89336.37, The University [...]

Psychological distress is highly prevalent among adolescent and young adult (AYA) cancer patients, an age-defined population (15–39) disproportionately impacted by their cancer diagnosis. Solution-focused brief therapy (SFBT) is a strength-based and evidence-supported approach for youth with medical conditions. The use of SFBT in young cancer patients, however, has been rarely described. Building on the broaden-and-build theory of positive emotions, this study describes how SFBT clinicians intentionally foster positive emotions, especially hope, in an AYA cancer patient to foster therapeutic change. We found improvements in the patient's psychological distress as well as growth in levels of hope both in the immediate post-intervention assessment and in the 2-week follow-up. The findings of the study suggested that SFBT is a promising approach to the unique challenges confronting AYAs with cancer. It was not feasible for this case study to match the sex and racial identities for a therapist with the client's preference, which is considered a main limitation of this study. [ABSTRACT FROM AUTHOR]

Purpose of Review: Depression is prevalent and common among individuals living with diabetes. The aim of this review is to systematically assess and meta-analyze the treatment effect of cognitive-behavioral therapy for depression (and other affective outcomes) among patients with diabetes. Recent Findings: Earlier investigations found both psychosocial and pharmacological interventions, including cognitive-behavioral therapy, were promising in managing depression in patients with diabetes, though these findings remain inclusive due to poor study designs and a small number of trials included, which calls for a comprehensive systematic review and meta-analysis. Summary: A total of 33 studies (89 effect sizes) reported a moderate and statistically significant treatment effect of cognitive-behavioral therapy for depressive symptoms among individuals with diabetes (d = 0.301, 95% CI 0.115–0.487, p < 0.001). On average, cognitive-behavioral therapy was effective for psychological stress/distress outcomes but not for anxiety or physiological outcomes. The findings of the study confirmed CBT as an effective treatment option for depression among diabetes patients and identified important areas for future research. [ABSTRACT FROM AUTHOR]

Self-rated health (SRH) is a salient outcome for cancer survivors. Although depression is a well-studied correlate with SRH, few studies have focused on the role of cancer survivors' age on the association between depression and SRH. This study evaluates demographic and psychosocial factors associated with cancer survivors' SRH. We also assess the moderating role of age to the association between depression and SRH. This paper analyzed 2,470 U.S. cancer survivors from the 2019 National Health Interview Survey. Two ordered logistic regression models with complex survey weights were used for analyses. Missing data was addressed using multiple imputations by chained equations. Being female, higher education and higher income were positively associated with better SRH. While the relationship between higher education and higher income was consistent with previous findings, the positive association between being female and SRH was different from previous studies. Age significantly moderated the association between depression and SRH, evidenced by results of the joint tests of all interaction term coefficients being statistically significant, F(2, 544.6) = 5.13, p < 0.01. The findings of the study highlighted the significance of screening for social determinants of health and health disparity when supporting cancer survivors. Additionally, findings of this study emphasized the significance of adopting an age-specific approach when evaluating and addressing depression across different age groups of cancer survivors. [ABSTRACT FROM AUTHOR]