"Going on 18" Examining Survey Responses from Adolescent and Young Adult Cancer Patients

dc.creatorSpradley, Parkeren_US
dc.creatorElledge, Danielen_US
dc.description.abstractPurpose: Cancer survival rates among adolescents and young adults (AYAs) (aged 15-39 years) have improved at a lower rate than pediatric and older adult populations since 1975. This disparity in survival rate improvement is termed the “AYA gap” in cancer care. AYAs have lower enrollment in clinical trials and are diagnosed at later stages of cancer compared to other age groups. Young adults underutilize healthcare compared to older adults, which leads to worse health outcomes. Financial instability and low medical decision-making confidence have been identified as obstacles to healthcare use in young adults and are increasingly recognized as barriers to AYA cancer care. Cancer requires a high frequency of expensive treatments for optimal management, and identifying and addressing the financial and medical decision-making treatment challenges unique to AYAs may improve survival rates. The purpose of this project is to examine AYA cancer patients’ survey responses related to financial status and medical decision-making confidence. Methods: A site-developed “Going on 18” questionnaire was administered to AYA patients at Cook Children’s Hospital in Fort Worth, TX between 6/2021 and 8/2022. The survey asked questions about demographics, socioeconomic factors, education, mental health, relationships, and thoughts about becoming a young adult. Four questions were selected as determinants of financial status. The frequencies of responses to these questions and the relative percentages of each response were calculated for each categorical variable. Two questions were selected as indicators of feelings toward increased medical responsibility. The content of the subjective responses to these questions was analyzed by authors to separate them into positive, negative, and mixed or neutral attitudes. Results: 25 participants completed the survey. AYA cancer patients feel mostly confident and enthusiastic about their increased medical decision-making responsibilities, stable in their financial situation (71%), and believe they understand their insurance benefits (73%). However, AYAs are remaining financially dependent on their parents into early adulthood (70%). Conclusions: Patients identified specific responsibilities associated with turning 18, expressed feelings of freedom, and are willing to learn. Their responses suggest they want to be in charge of their care and would be receptive to an intervention that provides education and encourages them to think critically about their medical responsibilities. Reliance on parents to manage financial matters may limit participants’ knowledge of treatment-related expenses. Although participants reported high levels of financial stability and understanding of benefits, this result may be due to a lack of involvement in insurance matters. Therefore, patients, especially those who will become financially independent upon turning 18, may still benefit from interventions related to financial responsibilities.en_US
dc.title"Going on 18" Examining Survey Responses from Adolescent and Young Adult Cancer Patientsen_US