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Advisory Committee Chair

Larrell Wilkinson

Advisory Committee Members

Elizabeth Baker

Retta Evans

Maria Pisu

Scott Snyder

Document Type

Dissertation

Date of Award

2018

Degree Name by School

Doctor of Philosophy (PhD) School of Education

Abstract

Young adult survivors are an understudied group and have been considered invisible in cancer care and research. This population has unique medical and psychosocial needs that can influence health outcomes and behaviors. There are also health disparities that exist within this population in treatment and survivorship. Receiving a survivorship care plan (SCP) can equip young adults with the knowledge to advocate for risk-based cancer follow-up and impact health outcomes and behaviors. The purpose of this study is to examine the relationship between receipt of an SCP and age at diagnosis, health outcomes, and health behaviors. Study data were obtained from the Behavioral Risk Factor Surveillance System. The theoretical bases for this study was derived from the Andersen Model of Healthcare Utilization. The association of age at diagnosis with receipt of an SCP was investigated. Next, the association of the receipt of an SCP with health outcomes was examined. Finally, the relationship between the receipt of an SCP and health behaviors was explored. Key findings from the first study indicated the need for consistency of the components of the SCP that are provided to young adult survivors and that race/ethnicity and health insurance status were significantly associated with receipt of an SCP. In the second study, gender, race/ethnicity, employment status, and the interaction of receiving a written summary and post-treatment instructions with race was significantly associated with the number of poor mental health days. Age at time of survey and enabling and need factors were significantly associated with poor physical health days. Lastly, in the third study, receipt of instructions, education level, gender, and general health status were associated with tobacco consumption; receipt of a written summary, gender, health insurance status, and general health status were associated with alcohol consumption; and education level, marital status, and income was associated with physical activity. More research on how health disparities influence both the receipt of an SCP and also how an SCP influences specific aspects of the young adult cancer survivorship experience is also needed.

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