A comparison of the sociodemographic, medical, and psychosocial characteristics of adolescents and young adults diagnosed with cancer recruited in-person and online: A Canadian cross-sectional survey.

Introduction: Adolescents and young adults diagnosed with cancer (AYAs) are under-represented in research. The Internet and social media could increase the reach of recruitment efforts but may impact sample characteristics. This study evaluated the characteristics of AYAs recruited in-person at an urban hospital versus the Internet in terms of their sociodemographic and medical characteristics, and psychosocial wellbeing, and offers recommendation for increasing the inclusivity and representativeness of research samples. Methods: Participant data from a cross-sectional survey of AYAs in Canada were evaluated. In-person hospital recruitment used a registry to identify patients attending ambulatory clinics. Internet recruitment included notices on hospital, team members', and community partners' social media channels, and email newsletters. Independent sample t-tests and Chi-squared tests were used to identify differences in participant sociodemographic, medical, and psychosocial characteristics based on recruitment source. Results: Of 436 participants, 217 (49.8%) were recruited in-person and 219 (50.2%) online. Online participants were more likely: to be white (p < .001), women (p < .001), and Canadian-born (p < .001); to speak English at home (p < .001), live alone (p = .001) and live in rural settings (p = .014); and to be farther from diagnosis (p = .023), diagnosed with breast cancer (p < .001), and cancer free (p < .001) compared to the hospital sample. Online participants also reported higher anxiety, depression, and loneliness (p < .001), and lower social support (p < .001), self-efficacy for coping with cancer (p < .001), and life satisfaction (p = .006). Conclusions: Online recruitment yielded a more geographically diverse but less sociodemographically diverse sample of AYAs who were farther from diagnosis and had poorer psychosocial wellbeing than in-person recruitment at an urban hospital. Future research efforts should consider partnering with under-represented communities and using targeted and stratified online and in-person recruitment strategies to achieve an inclusive and representative sample of AYAs.

The Delivery of Palliative and End-of-Life Care to Adolescents and Young Adults Living with Cancer: A Scoping Review.

The primary purpose of this scoping review was to provide an overview of the existing evidence on the delivery of palliative and end-of-life care to adolescents and young adults (AYAs) living with cancer, by identifying knowledge gaps and discussing the key characteristics and types of evidence in this field. This study employed a JBI scoping review design. CINAHL (EBSCO), Embase (Elsevier), MEDLINE (Ovid), APA PsycINFO (EBSCO), and Web of Science (Science Citation Index Expanded and Social Sciences Citation Index; Clarivate Analytics) databases were searched along with grey literature sources to February 2022 for related studies on the delivery of palliative and end-of-life care to AYAs. No search restrictions were applied. Two independent reviewers screened titles, abstracts, and full-text articles for eligibility, and they extracted data from studies that met the inclusion criteria. A total of 29,394 records were identified through our search strategy and 51 studies met the inclusion criteria of the study. The studies were published between 2004 and 2022, with the majority from North America (65%). The included studies involved patient, healthcare provider, caregiver, and public stakeholders. Their primary foci were often on end-of-life outcomes (41%) and/or advance care planning/end-of-life priorities and decision-making (35%). This review identified several evidence gaps within the field, including a focus primarily on patients who have died. Findings highlight the need for more collaborative research with AYAs on their experiences with palliative and end-of-life care, as well as their involvement as patient partners in research.

Online Medical Misinformation in Cancer: Distinguishing Fact From Fiction.

It is without question that the Internet has democratized access to medical information, with estimates that 70% of the American population use it as a resource, particularly for cancer-related information. Such unfettered access to information has led to an increase in health misinformation. Fortunately, the data indicate that health care professionals remain among the most trusted information resources. Therefore, understanding how the Internet has changed engagement with health information and facilitated the spread of misinformation is an important task and challenge for cancer clinicians. In this review, we perform a meta-synthesis of qualitative data and point toward empirical evidence that characterizes misinformation in medicine, specifically in oncology. We present this as a call to action for all clinicians to become more active in ongoing efforts to combat misinformation in oncology.

Social Media and Professional Development for Oncology Professionals.

The use of social media continues to increase in health care and academia. Health care practice, particularly the oncologic field, is constantly changing because of new knowledge, evidence-based research, clinical trials, and government policies. Therefore, oncology trainees and professionals continue to strive to stay up-to-date with practice guidelines, research, and skills. Although social media as an educational and professional development tool is no longer completely new to medicine and has been embraced, it is still under-researched in terms of various outcomes. Social media plays several key roles in professional development and academic advancement. We reviewed the literature to evaluate how social media can be used for professional development and academic promotion of oncology professionals.

Peer Support Needs and Preferences for Digital Peer Navigation among Adolescent and Young Adults with Cancer: A Canadian Cross-Sectional Survey.

Adolescents and young adults (AYA) with cancer desire peer support and require support programs that address their unique needs. This study investigated the need for, and barriers to, peer support and preferences for digital peer navigation among AYA. A cross-sectional survey was administered to AYA, diagnosed with cancer between the ages of 15-39, at a cancer center and through social media. Descriptive summary statistics were calculated. Participants (n = 436) were on average 31.2 years (SD = 6.3), 3.3 years since-diagnosis (SD = 3.8), and 65% (n = 218) were women. Over three-quaters (n = 291, 76.6%) desired peer support from cancer peers, but 41.4% (n = 157) had not accessed peer support. Main access barriers were: Inconvenience of in-person support groups (n = 284, 76.1%), finding AYA with whom they could relate (n = 268, 72.4%), and finding AYA-specific support programs (n = 261, 70.4%). Eighty-two percent (n = 310) desired support from a peer navigator through a digital app, and 63% (n = 231) were interested in being a peer navigator. Participants indicated a greater need for emotional (n = 329, 90.1%) and informational support (n = 326, 89.1%) than companionship (n = 284, 78.0%) or practical support (n = 269, 73.6%) from a peer navigator. Foremost peer matching characteristics were cancer-type (n = 329, 88.4%), specific concerns (n = 317, 86.1%), and age-at-diagnosis (n = 316, 86.1%). A digital peer navigation program was desired by over 80% of a large Canadian sample of AYA and could potentially overcome the barriers AYA experience in accessing peer support. The design of a peer navigation program for AYA should consider the matching characteristics and multidimensional support needs of AYA.

Interventions to change clinicians' behavior related to suicide prevention care in the emergency department: a scoping review.

OBJECTIVE: The objective of this scoping review was to explore, characterize, and map the literature on interventions and intervention components implemented to change emergency department clinicians' behavior related to suicide prevention using the Behaviour Change Wheel as a guiding theoretical framework. INTRODUCTION: An emergency department is a critical place for suicide prevention, yet patients are often discharged without proper suicide risk assessments or referrals. In response, we must support emergency department clinicians' behavior change to follow evidence-based suicide prevention strategies. However, reviews to date have yet to systematically and theoretically examine the functional mechanisms of interventions and how these characteristics can influence emergency department clinicians' behaviors related to suicide prevention care. INCLUSION CRITERIA: This review considered interventions that targeted emergency department clinicians' behavior change related to suicide prevention. Behavior change referred to observable practice changes as well as proxy measures of behavior change, including changes in knowledge and attitude. METHODS: This review followed JBI methodology for scoping reviews. Searches included PubMed, PsycINFO, CINAHL, Embase, and gray literature, including targeted Google searches for relevant organizations/websites, ProQuest Dissertations and Theses Global, and Scopus conference papers (using a specific filter). This review did not apply any date limits, but our search was limited to the English language. Data extraction was undertaken using a charting table developed specifically for the review objective. Narrative descriptions of interventions were coded using the Behaviour Change Wheel's intervention functions. Reported outcome measures were categorized. Findings were tabulated and synthesized narratively. RESULTS: This review included a total of 70 sources, describing 66 different interventions. Forty-one studies were included from the database searches, representing a mixture of experimental (n = 2), quasi-experimental (n = 24), non-experimental (n = 12), qualitative (n = 1), and mixed methods (n = 2) approaches. An additional 29 citations were included from gray literature searches. One was a pilot mixed methods study, and the rest were interventions. Identified interventions comprised a wide range of Behaviour Change Wheel intervention functions to change clinicians' behavior: education (n = 48), training (n = 40), enablement (n = 36), persuasion (n = 21), environmental restructuring (n = 18), modeling (n = 7), and incentivization (n = 2). Based on the Behaviour Change Wheel analysis, many interventions targeted more than one determinant of behavior change, often employing education and training to improve clinicians' knowledge and skills simultaneously. Among the 42 studies that reported outcome measures, effectiveness was measured at clinician (n = 38), patient (n = 4), or organization levels (n = 6). Few studies reported implementation outcomes, such as measures of reach (n = 4), adoption (n = 5), or fidelity (n = 1). There were no evaluation data reported on the interventions identified through Google searches. CONCLUSIONS: Interventions included in this review were diverse and leveraged a range of mechanisms to change emergency department clinicians' behavior. However, most interventions relied solely on education and/or training to improve clinicians' knowledge and/or skills. Future research should consider diverse intervention functions to target both individual- and organization-level barriers for a given context. The ultimate goal for changing emergency department clinicians' behavior is to improve patient health outcomes related to suicide-related thoughts and behaviors; however, current research has most commonly evaluated clinicians' behavior in isolation of patient outcomes. Future studies should consider reporting patient-level outcomes alongside clinician-level outcomes.

The delivery of palliative and end-of-life care to adolescents and young adults living with cancer: a scoping review protocol.

OBJECTIVE: This review will provide an overview of the evidence on the delivery of palliative and end-of-life care to adolescents and young adults living with cancer, by identifying knowledge gaps and discussing the key characteristics and types of evidence in this field. INTRODUCTION: Adolescents and young adults receive their diagnoses at an important stage of development, and often access health systems that are ill-equipped to deal with them, leading to many unmet needs. Some of these needs can be addressed by holistic palliative care services. A better understanding of the literature in this area is needed to identify what is known about the delivery of care to adolescents and young adults. INCLUSION CRITERIA: This review will consider studies that pertain to the delivery of palliative and end-of-life care for adolescents and young adults living with cancer. Relevant research may be in the context of ambulatory services, advance care planning, palliative care units, home care, hospices, and end-of-lifecare facilities. Studies that concern other oncology populations will be excluded. METHODS: CINAHL (EBSCO), MEDLINE (Ovid), Embase (Elsevier), APA PsycINFO (EBSCO), and Web of Science (Science Citation Index Expanded and Social Sciences Citation Index; Clarivate Analytics) databases will be searched, along with other sources of gray literature. No date limit will be set. Two independent reviewers will screen titles and abstracts for studies that meet the review's inclusion criteria and the fulltext of eligible studies will be reviewed. Data from studies that are eligible for inclusion will be extracted using two independent reviewers and presented in a tabular form with an accompanying narrative summary.

The Experiences of Young Adults Living with Metastatic/Advanced Cancer: A Scoping Review.

There is limited research on young adults (YAs) living with cancer and even less concerning those with metastatic/advanced disease. The purpose of this scoping review was to map and summarize the current state of empirical research on the psychosocial experiences of YAs living with metastatic/advanced cancer, highlighting gaps in the published literature. This study was guided by Arksey and O'Malley's scoping review methodology. MEDLINE, CINAHL, and PsycINFO were searched in consultation with a medical research librarian, for English-language articles published until June 2018. Three key journals were hand-searched along with the first 100 hits on Google Scholar. In addition, ProQuest Dissertations and Theses was searched for dissertations published until February 2018. Two authors independently screened titles/abstracts to identify articles for full text review. Data were extracted on study characteristics and outcomes related to the guiding review question. Thematic analysis was used to analyze the data and identify overarching themes. Summary statistics were reported. The search strategy retrieved 2846 published articles. After reviewing 47 in full text, 10 studies were eligible for inclusion. The results from the included studies fell into four themes: (1) search to make meaning of their illness; (2) patient-provider relationships; (3) mental health and psychosocial well-being; and (4) interventions. Research concerning the psychosocial experiences of YAs living with metastatic/advanced cancer is limited. The authors provide four recommendations as a starting point for further research. Understanding the patient experience is imperative for designing effective health policies, programs, and interventions for this population.

Health Researchers' Use of Social Media: Scoping Review.

BACKGROUND: Health researchers are increasingly using social media in a professional capacity, and the applications of social media for health researchers are vast. However, there is currently no published evidence synthesis of the ways in which health researchers use social media professionally, and uncertainty remains as to how best to harness its potential. OBJECTIVE: This scoping review aimed to explore how social media is used by health researchers professionally, as reported in the literature. METHODS: The scoping review methodology guided by Arksey and O'Malley and Levac et al was used. Comprehensive searches based on the concepts of health research and social media were conducted in MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, and Web of Science databases, with no limitations applied. Articles were screened at the title and abstract level and at full text by two reviewers. One reviewer extracted data that were analyzed descriptively to map the available evidence. RESULTS: A total of 8359 articles were screened at the title and abstract level, of which 719 were also assessed at full text for eligibility. The 414 articles identified for inclusion were published in 278 different journals. Studies originated from 31 different countries, with the most prevalent being the United States (52.7% [218/414]). The health discipline of the first authors varied, with medicine (33.3% [138/414]) being the most common. A third of the articles covered health generally, with 61 health-specific topics. Papers used a range of social media platforms (mean 1.33 [SD 0.7]). A quarter of the articles screened reported on social media use for participant recruitment (25.1% [104/414]), followed by practical ways to use social media (15.5% [64/414]), and use of social media for content analysis research (13.3% [55/414]). Articles were categorized as celebratory (ie, opportunities for engagement, 72.2% [299/414]), contingent (ie, opportunities and possible limitations, 22.7% [94/414]) and concerned (ie, potentially harmful, 5.1% [21/414]). CONCLUSIONS: Health researchers are increasingly publishing on their use of social media for a range of professional purposes. Although most of the sentiment around the use of social media in health research was celebratory, the uses of social media varied widely. Future research is needed to support health researchers to optimize their social media use.

"It Could Have Been Me": An Interpretive Phenomenological Analysis of Health Care Providers' Experiences Caring for Adolescents and Young Adults with Terminal Cancer.

Purpose: Adolescents and young adults (AYAs) with terminal cancer are a marginalized population with unique medical and psychosocial needs. AYAs commonly report challenges with their health care experiences, however, little is known about the experiences of the health care providers (HCPs) who deliver this specialized care. The purpose of the current study was to understand HCPs' experiences caring for AYAs with terminal cancer. Methods: Nine HCPs (four nurses and five physicians) took part in in-depth semistructured interviews. Participants were eligible if they were a nurse or physician in Atlantic Canada; cared for at least one AYA patient with terminal cancer in the past 3 years; and were able to speak and understand English. Data were analyzed using interpretive phenomenological analysis. Results: Analyses revealed four superordinate themes present in the data: (1) many unknowns and uncertainties associated with providing care for AYAs compounded by minimal or no training specifically concerning this population; (2) an intense emotional experience compared with caring for patients with terminal cancer of other ages; (3) personal identification with patients and their families; and (4) attempts to make sense of the circumstance thwarted by feelings of injustice and unfairness. Conclusions: HCPs experienced unique emotional and logistical challenges when caring for AYAs with terminal cancer, which can influence the care they provide. HCPs' experiences highlight the need for training to support clinicians in caring for AYAs with terminal cancer to optimize their own well-being and delivery of health care services to this population.

Maternal health outcomes for incarcerated women: A scoping review.

AIMS AND OBJECTIVES: To inform a systematic synthesis of what is known about the maternal health outcomes of incarcerated women, this scoping review uses a theoretical framework of intersectional feminism. BACKGROUND: Despite rising imprisonment of women, there is a lack of research, from a feminist perspective, on perinatal health outcomes among incarcerated women. DESIGN: Systematic scoping review using the Joanna Briggs Institute scoping review methodology. METHODS: In consultation with a medical research librarian, key databases and journals were searched for English and French-language articles published up to February 2018. Two authors independently screened titles and abstracts to identify articles for full-text review. Study quality was appraised using the McGill Mixed Methods Appraisal Tool. The study adheres to PRISMA-EQUATOR guidelines. RESULTS: Forty-five studies met the preset criteria and were reviewed in full text. In addition, 13 studies met consensus for inclusion. Method, setting, participants, sample, relevant outcomes and relevant findings were extracted from each study for synthesis. Included studies had varied methods and were published from 1989-2014. Participants included women imprisoned during the perinatal period up to six months postpartum. All studies were conducted in carceral contexts, with 12 based in the USA and one in Australia. Outcomes of interest included breastfeeding, operative deliveries, gestational complications, depression, stress, experiences, bonding and sterilisation. CONCLUSION: The research on maternal health outcomes pertaining to incarcerated women is limited. There is a need for in-depth examination of breastfeeding with this population. Researchers need to examine the prevalence and impact of carceral force, such as shackling, solitary confinement, strip-searching and restraints in pregnancy. There is a need for research that asks what health outcomes matter to the women themselves. RELEVANCE TO CLINICAL PRACTICE: Providers must be conscious of intersecting layers of discrimination and trauma incarcerated women experience and its impact on maternal health in the perinatal period and advocate for women.

"Figure Out What It Is You Love to Do and Live the Life You Love": The Experiences of Young Adults Returning to Work After Primary Cancer Treatment.

This study explored young adult (YA; 18-39 years of age) cancer survivors' perspectives on and experiences with return to work (RTW) following primary cancer treatment. A prospective qualitative longitudinal method was employed, using in-depth telephone interviews at three time points. Data were analyzed using thematic analysis. Five people (ages 25-40) participated and four themes were identified: YAs face uncertainty about RTW; cancer may be a catalyst for career change; employment benefits are important; and YA-specific resources are needed to support RTW.

Social Media and the Adolescent and Young Adult (AYA) Patient with Cancer.

Over 70,000 adolescent and young adults (AYA) aged 15 to 39 years are diagnosed with cancer each year in the US. The National Cancer Institute (NCI) has identified AYA cancer patients as a unique population. The most common cancers in this age group include tumors typically seen in pediatric patients such as acute lymphoblastic leukemia (ALL) and brain tumors, as well as cancers more typically seen in adult patients such as breast cancer and melanoma. In addition, some cancers have their highest incidence in AYA patients, such as Hodgkin Lymphoma, testicular cancer, and bone tumors. AYA patients face additional unique issues due to their age, not just questions about treatment choices due to lack of data but also questions about fertility, relationships, loss of autonomy, and interruptions in school/work with potentially significant financial complications. This age group also has very high rates of social media usage with up to 90 % of adults aged 18 to 29 using social networking sites. In this review, we will describe the use of social media in AYAs with cancer and highlight some of the online resources for AYAs.