Engage: A Survivorship Program to Improve Childhood Cancer Survivors' Self-Efficacy and Quality of Life.

Abstract

We evaluated a survivorship program Engage, aimed at improving childhood cancer survivors' health-related self-efficacy and their health-related quality of life (HRQoL). Engage provides (1) a telehealth nurse-led health assessment, (2) a remote multidisciplinary case review, (3) personalized recommendations and care plan for survivors and their primary care physician (PCP), and (4) a telehealth nurse-led consultation to promote survivors' understanding of the recommendations. We recruited survivors >5 years postdiagnosis of any age who had not received cancer-related care in the past 24 months. We assessed survivors' outcomes pre-intervention and at 1-, 6-, 12-, and 24-month follow-ups. Seventy-eight survivors participated: 62% male, median age = 30 years, and 14% lived regionally/rurally. Participating survivors' self-efficacy scores improved from baseline to 1 month and were maintained at 6-, 12-, and 24-month follow-ups (<i>P</i> < .001). Survivors' HRQoL remained similar from baseline to postintervention, as did the proportion of survivors reporting a regular PCP or engaging in health/risky behaviors (eg, exercise). Survivors' distress, anxiety, and anger significantly decreased pre- to 6 months postintervention. Survivors' satisfaction with care increased by 28% (<i>P</i> < .001) and was maintained across follow-up (<i>P</i> = .002). Information needs reduced from baseline to 1 month postintervention (<i>P</i> = .023) although they were similar at further follow-up. Survivors' self-efficacy, satisfaction with care, and some psychosocial outcomes improved after participating in Engage. Further effort is needed to improve survivors' primary care engagement and health behaviors.