Re-Engage: A Novel Nurse-Led Program for Survivors of Childhood Cancer Who Are Disengaged From Cancer-Related Care
Background: Survivors of childhood cancer often experience treatment-related chronic health conditions. Survivorship care improves survivors’ physical and mental health, yet many are disengaged from care. Innovative models of care are necessary to overcome patient-reported barriers to accessing survivorship care and to maximize survivors’ health. Methods: We piloted a novel survivorship program, called “Re-engage,” a distance-delivered, nurse-led intervention aiming to engage, educate, and empower survivors not receiving any cancer-related care. Re-engage involves a nurse-led consultation delivered via telephone/online to establish survivors’ medical history and needs. Participants completed questionnaires at baseline, 1 month postintervention, and 6-month follow-up. Results: A total of 27 survivors who had not accessed survivorship care in the last 2 years participated (median age, 31 years; interquartile range [IQR], 27–39 years); of which, 82% were at high-risk for treatment-related complications. Participation in Re-engage was high (75%) and there was no attrition once survivors enrolled. At 1 month postintervention, 92% of survivors reported that Re-engage was “beneficial,” which all survivors reported at 6-month follow-up. Survivors’ overall satisfaction with their care increased from 52% before Re-engage to 84% at 1 month postintervention. Survivors’ mean self-efficacy scores remained similar from baseline to 1 month postintervention (b = −0.33, 95% CI, −1.31 to 0.65), but increased significantly from baseline to 6-month follow-up (b = 1.64, 95% CI, 0.28–3.00). At 6-month follow-up, 73% of survivors showed an increase in health-related self-efficacy compared with baseline. Conclusions: Re-engage is a highly acceptable and feasible intervention and promotes health-related self-efficacy, which is integral to survivors being advocates for their own health. Further empirical work is needed to evaluate the long-term efficacy of Re-engage.
Trial registration: ACTRN12618000194268
To view members of the BSU Implementation Group, see supplemental eAppendix 1 (available with this article at JNCCN.org).
Submitted September 4, 2019; accepted for publication February 18, 2020.
Author contributions: Study concept, design, and protocol: All authors. Design of participant documents: Signorelli, Wakefield, Johnston, Fardell, Brierley, Schaffer, Thornton-Benko, Girgis, Wallace, Cohn. Data collection: Signorelli, Johnston, Fardell, Brierley, Schaffer, Thornton-Benko, Cohn. Data analysis: Signorelli. Manuscript preparation: All authors. Final approval of manuscript: All authors.
Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.
Funding: This pilot study received financial support from the Australian Federation of Graduate Women Inc. Barbara Hale Fellowship, The Kids’ Cancer Project, and a Cancer Council NSW Program Grant (PG16-02) with the support of the Estate of the Late Harry McPaul. The Behavioural Sciences Unit (BSU) is proudly supported by the Kids with Cancer Foundation. The BSU’s survivorship research program is also funded by the Kids Cancer Alliance. Dr. Signorelli is supported by The Kids’ with Cancer Project and is a Barbara Hale Scholar of 2017. Dr. Fardell is supported by The Kids’ Cancer Project. Dr. Wakefield is supported by a Career Development Fellowship from the National Health and Medical Research Council of Australia (APP1143767). Dr. Girgis is supported by Cancer Institute NSW funding. None of the above funding bodies were involved in the study design or writing of the manuscript, nor were they involved in the analysis and interpretation of the results.
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