Supporting long-term follow-up of young adult survivors of childhood cancer: Correlates of healthcare self-efficacy

Authors

  • Kimberly A. Miller,

    Corresponding author
    1. Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California
    • Correspondence

      Kimberly A. Miller, Department of Preventive Medicine, Keck School of Medicine, 2001 N. Soto St, Suite 318-A, Los Angeles, CA 90032.

      Email: kim.miller@med.usc.edu

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  • Katherine Y. Wojcik,

    1. Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California
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  • Cynthia N. Ramirez,

    1. Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California
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  • Anamara Ritt-Olson,

    1. Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California
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  • David R. Freyer,

    1. Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California
    2. Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, California
    3. Children's Center for Cancer and Blood Diseases, Children's Hospital Los Angeles, Los Angeles, California
    4. USC Norris Comprehensive Cancer Center, Los Angeles, California
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  • Ann S. Hamilton,

    1. Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California
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  • Joel E. Milam

    1. Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California
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Abstract

Background

Healthcare self-efficacy (HCSE), the perceived confidence to manage one's health care, has been identified as a critical component in the transition process from pediatric to adult-oriented care for childhood cancer survivors (CCSs). HCSE is amenable to intervention and associated with long-term follow-up care among CCSs. However, factors associated with HCSE have not been fully explored among CCSs.

Procedure

We identified correlates of HCSE among a sample of CCSs (n = 193). Descriptive statistics and linear regression methods were used in this cross-sectional analysis.

Results

In univariate analyses, higher physical and psychosocial quality of life, posttraumatic growth, and religious/spiritual importance were associated with higher HCSE. Attendance at a survivorship clinic, having a regular source of care (both noncancer and oncologist), and any type of health insurance were also associated with HCSE. Hispanic ethnicity was negatively associated with HCSE relative to non-Hispanics. In a multivariable model, psychosocial quality of life, religious/spiritual importance, survivorship clinic attendance, having a regular oncologist, and Hispanic ethnicity remained significantly associated with HCSE.

Conclusions

CCSs who reported greater well-being, who rated religion and spirituality of high importance, and who accessed specialized cancer services expressed greater HCSE. Hispanic CCSs, however, reported less HCSE than non-Hispanics. Interventions that attend to the quality of life and spiritual needs of CCSs have potential to build HCSE to support the healthcare transition process. Because Hispanic CCSs may be at risk of lower perceived confidence to navigate their health care, culturally competent, efficacy-enhancing interventions are needed for this population.

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