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Randomized Controlled Trial
. 2013 Mar;7(1):1-19.
doi: 10.1007/s11764-012-0249-3. Epub 2012 Dec 5.

Development of a comprehensive health-related needs assessment for adult survivors of childhood cancer

Cheryl L Cox  1 , Deborah A Sherrill-Mittleman, Barth B Riley, Melissa M Hudson, Lauren J Williams, Wendy M Leisenring, Margie G Zacher, Les L Robison
Affiliations
Randomized Controlled Trial

Development of a comprehensive health-related needs assessment for adult survivors of childhood cancer

Cheryl L Cox et al. J Cancer Surviv. 2013 Mar.

Abstract

Purpose: Examine the construct validity, stability, internal consistency, and item-response performance of a self-report health needs assessment for adult survivors of childhood cancer.

Methods: A 190-item mailed survey was completed by 1,178 randomly selected (stratified on age, diagnosis, time since diagnosis) Childhood Cancer Survivor Study participants (mean age, 39.66 [SD 7.71] years; time since diagnosis, 31.60 [SD 4.71] years). Minorities and rural residents were oversampled at a 2:1 ratio.

Results: The final instrument included 135 items comprising nine unidimensional subscales (Psycho-emotional, Health System Concerns, Cancer-Related Health Information, General Health, Survivor Care and Support, Surveillance, Coping, Fiscal Concerns, and Relationships). Confirmatory factor analysis (n = 1,178; RMSEA = 0.020; 90 % CI = 0.019-0.020; CFI = 0.956; TLI = 0.955) and person-item fit variable maps established construct validity. Across subscales, Cronbach's alpha was 0.94-0.97, and the 4-week test-retest correlations were 0.52-0.91. In a Rasch analysis, item reliability was 0.97-0.99, person reliability was 0.80-0.90, and separation index scores were 2.00-3.01. Significant subscale covariates of higher need levels included demographics, diagnosis, and treatment exposures.

Conclusions: The Childhood Cancer Survivor Study Needs Assessment Questionnaire (CCSS-NAQ) is reliable and construct-valid, has strong item-response properties, and discriminates need levels.

Implications for cancer survivors: The CCSS-NAQ potentially can be used to: (1) directly assess adult childhood cancer survivors' self-reported health-related needs, (2) identify individuals or subgroups with higher-level needs, (3) inform prevention and direct intervention strategies, and (4) facilitate prioritization of health-care resource allocation.

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Conflict of interest statement

CONFLICT OF INTEREST:

The authors declare that they have no conflicts of interest.

Figures

FIG. 1
FIG. 1
Flow chart of the study sample
See this image and copyright information in PMC

References

    1. Hewitt M, Weiner SL, Simone JV. Childhood Cancer Survivorship: improving care and quality of life. Washington, DC: National Academies Press; 2003. - PubMed
    1. Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, et al. SEER cancer statistics review 1975–2004. Vol. 2007. Bethesda, MD: National Cancer Institute; 2007. [Accessed 24 Sept 2012]. based on November 2006 SEER data submission, posted to the SEER Web site. http://seer.cancer.gov/csr/1975_2004/
    1. Mertens AC, Liu Q, Neglia JP, Wasilewski K, Leisenring W, Armstrong GT, et al. Cause-specific late mortality among 5-year survivors of childhood cancer: the Childhood Cancer Survivor Study. J Natl Cancer Inst. 2008;100:1368–79. - PMC - PubMed
    1. Oeffinger KC, Mertens AC, Sklar CA, Kawashima T, Hudson MM, Meadows AT, et al. Chronic health conditions in adult survivors of childhood cancer. N Engl J Med. 2006;355:1572–82. - PubMed
    1. Hewitt M, Greenfield S, Stovall E. Committee on Cancer Survivorship: Improving care and quality of life: Institute of Medicine and National Research Council. Washington, DC: National Academies Press; 2005. pp. 187–321.

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