Informal Cancer Research Articles

Patterns of dietary quality, physical activity, and sleep duration among cancer survivors and caregivers.

Fruit and vegetable intake (FVI), moderate-to-vigorous physical activity (MVPA), and sleep duration are each independently associated with cancer-related and general health outcomes among cancer survivors. Past research suggests that health behaviors cluster among cancer survivors, with caregivers demonstrating similar patterns. This analysis examined co-occurrence of FVI, MVPA, and sleep duration among cancer survivors and informal cancer caregivers and identified sociodemographic and clinical correlates of health behavior engagement. Using data from the Health Information National Trends Survey (HINTS), an exploratory latent profile analysis (LPA) was conducted among those self-reporting a history of cancer or identifying as a cancer caregiver. The LPA model was fit with daily self-reported FVI (cups/d), MPVA (minutes/d) and sleep duration (hours/d). Multinomial logistic regression models were used to predict profile membership based on sociodemographic and clinical characteristics. Four health behavior profiles were identified (Least Engaged-No MVPA, Least Engaged-Low MVPA, Moderately Engaged, and Highly Engaged). The largest profile membership was Least Engaged-No MVPA, capturing 37% of the sample. Profiles were most distinguished by MVPA, with the lowest variance in sleep duration. Participants reporting higher FVI also often reported greater MVPA and longer sleep duration. Profile membership was significantly associated with age, relationship status, education, income, rurality, alcohol use, self-efficacy, psychological distress, BMI, and cancer type. This study identified four health behaviors patterns and sociodemographic correlates that distinguished those patterns among cancer survivors and caregivers drawn from a nationally representative sample. Results may help identify for whom health behavior interventions could be of greatest benefit.

Comprehensive needs assessment tool for informal cancer caregivers (CNAT-ICs): Instrument development and cross-sectional validation study

BackgroundGrowing cancer incidence and its subsequent burden is a worldwide concern. Needs assessment for caregivers has recently received growing attention, as it identifies specific unmet needs. The remaining tools have been established within the healthcare context of Western countries and have been studied only in some Asian populations; it seems appropriate to develop needs assessment tools that apply to a wider ethnic and socio-cultural context. ObjectiveThis study planned to adapt and examine the psychometric properties of the CNAT-C for the Sri Lankan informal caregivers for wider applicability. DesignAn instrument development and cross-sectional validation study was conducted. SettingApeksha Hospital Maharagama, Sri Lanka (National Cancer Institute). ParticipantsA sample of 226 informal caregivers (ICs) providing palliative care for patients with advanced cancer was selected. MethodsA CNAT-C (41 items; seven factors) was incorporated and used after a cross-cultural adaptation following WHO guidelines after the permission and pilot test. ICs completed the socio-demographic and clinical details along with the validated Centre for Epidemiological Studies-Depression (CES-D), and the World Health Organization-Quality of Life-Brief (WHOQOL-BREF). Internal consistency and test-retest were used to check the reliability. Convergent and divergent validity of the Sinhala version of CNAT (S-CNAT) was confirmed using the CES-D scale and WHOQOL-BREF. Construct validity was evaluated using the exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). ResultsMost of the participants were female (60 %) and married (72 %), and the mean age was 41.78 (SD+14.54). Face and content validity were established during the cross-cultural adaptation. Cronbach's alpha was 0.903 for the overall S-CNAT and the test-retest reliability was 0.965. The S-CNAT was associated positively with the CES-D while negatively with the WHOQOL-BREF. Both EFA and CFA discovered a structure contained seven factors (35 items); domain named as healthcare staff/nurses’ support and information, physical/practical needs, medical officers’ support, psychological needs, social/family support, spiritual/religious support, and hospital facilities/service. ConclusionsThe Sinhala version of CNAT is shown to have adequate validity and reliability in assessing the comprehensive and multidimensional/unmet needs of informal caregivers of patients with advanced cancer (S-CNAT-ICs). It would be a helpful tool to determine the unmet needs of ICs and guide future interventions to meet those needs and enhance or maintain the quality of life for patients and their informal caregivers.

Using expressive writing to improve cancer caregiver and patient health: A randomized controlled feasibility trial

PurposeThis study examined the feasibility and preliminary efficacy of Expressive Writing (EW) in improving informal cancer caregiver (IC) and patient health, and enhancing ICs’ emotion regulation. MethodFifty-eight breast cancer ICs and patients participated in a randomized controlled feasibility trial of remote EW. ICs were randomly assigned to the EW or control group and completed 3 weekly writing sessions. ICs and patients completed health and emotion regulation assessments at baseline, intervention completion, and 3 months post-intervention. Screening, recruitment, assessment process, randomization, retention, treatment adherence, and treatment fidelity were computed for feasibility. Effect sizes were calculated using the PROMIS Depression Short Form, RAND Short Form 36 Health Survey, Breast Cancer Prevention Trial Hormonal Symptom checklist, healthcare utilization, and the Emotion Regulation Questionnaire for efficacy. ResultsOf the 232 interested individuals, 82 were screened, and 60 enrolled (6 monthly). Two individuals withdrew and 19 were lost to follow-up, leaving 39 individuals. ICs completed at least one assessment and two sessions, and patients completed at least two assessments. All sessions were administered as intended. ICs generally followed instructions (88%–100%), wrote the full time (66.7%–100%), and were engaged (M(SD) = 3.00(1.29)-4.00(0.00)). EW had small-to-medium effects in improving IC health (g = −0.27–0.04) and small-to-large effects in improving patient health (g = −0.28-0.86). EW moderately decreased suppression (g = 0.53–0.54) and slightly increased reappraisal, at least 3 months post-intervention (g = −0.34-0.20). ConclusionsRemote EW may be feasible with cancer ICs and improve cancer IC and patient health. However, it can benefit from additional retention strategies and rigorous testing.Trial registration: CenterWatch Clinical Trials Listing Service (#TX217874); ClinicalTrials.gov (#NCT06123416).

Spiritual well-being levels of formal and informal cancer caregivers in Turkish society and influencing factors: A comparative study

Purpose: This study aimed to compare the spiritualwell-being levels of formal and informal caregiversof cancer patients.Materials and Methods: This study using a crosssectional survey was conducted with formal (n=52)and informal caregivers (n=52), who met theinclusion criteria, were included in the sample. Thedata of the study were collected using web-based andself-reported questionnaires.Results: The scores of spiritual well-being in alldimensions of formal and informal caregivers are ata moderate level. There was a difference between informal and formal caregivers in the belief andpeace sub-dimension scores. Moreover, there was nodifference in total score averages of the spiritualwell-being scale. It was found that there was nostatistically significant difference between themaccording to age groups, gender, marital status,having a child, and income status.Conclusions: This study provides that the careprocess of cancer patients may affect the spiritualwell-being of formal and informal caregivers.Keywords: cancer, formal caregivers, informalcaregivers, spiritual well-being, oncology nursing

Abstract IA016: Best practice strategies for SOGI data collection: Lessons learned from conducting and implementing the Ask SOGI study

Abstract Background: Collection of reliable data on Sexual Orientation and Gender Identity (SOGI) is essential for improving cancer care for Sexual and Gender Minority (SGM) populations that experience health disparities. To address gaps in reliable SOGI data collection, the National Cancer Institute (NCI) funded a series of awards to enhance sexual orientation and gender identity (SOGI) data collection at cancer centers. In August 2022, we launched the “We Ask Because We Care: Enhancing Sexual Orientation and Gender Identity Data Collection in New Mexico Cancer Center” (Ask SOGI) research intervention at the University of New Mexico Comprehensive Cancer Center (UNMCCC). Methods: Our research team used a mixed methods framework that included a cancer center-wide readiness assessment survey and focus groups to: 1) identify potential barriers to the systematic collection of patient SOGI data, incorporate National Academy of Science Engineering Medicine (NASEM) recommended SOGI measures into the UNMCCC Electronic Health Records; 2) tailor future staff/provider-cultural competency/cultural humility educational interventions, and 3) design a patient-facing “We Ask Because We Care” campaign to encourage welcoming and comfortable care for SGM patients and their informal cancer caregivers. Results: Although the study is on-going, initial survey findings suggest that staff and provider concerns regarding the appropriate method and time for asking patients about their SOGI may inhibit data collection at the cancer center. Respondents desired cancer center led education and training for staff and faculty that would include appropriate points and methods for SOGI data collection, demonstrations of SOGI integration and utilization into the electronic health record, and strategies to encourage conversational confidence so staff and providers can engage patients and their caregivers in sensitive topics. Moreover, SGM patients and caregiver focus group participant reviewers of the emerging “We Ask Because We Care” campaign were positive about the visual images, and acknowledged the importance of such efforts for creating affirmative spaces for SGM persons experiencing cancer. Conclusion: Interventions that address multilevel staff and provider, as well as patient and caregiver concerns regarding discussions of sexual orientation and gender identity data collection may increase more consistent collection of SOGI data that can be used to enhance cancer care and health disparities research. Citation Format: Miria Kano, Dolores Guest, Amy Farnbach Pearson, Mikaela Kosich, Kendal A. Jacobson, Shiraz Mishra, Andrew Sussman, Bernard Tawfik, Zoneddy Dayao, NFN Scout, Cathleen Willging. Best practice strategies for SOGI data collection: Lessons learned from conducting and implementing the Ask SOGI study [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr IA016.

Social determinants of health, psychological distress, and caregiver burden among informal cancer caregivers of cancer survivors during treatment.

This study compared three ethnic/racial groups of informal cancer caregivers on social determinants of health and tested social determinants of health as predictors of psychological distress and caregiver burden. This study was a secondary analysis of baseline data of a sequential multiple assignment randomized trial (SMART) testing symptom management interventions with caregiver-survivor dyads. Caregivers completed baseline measures of social determinants of health (SDoH), functional limitations, psychological distress, and caregiver burden. Hispanic, non-Hispanic White, and non-Hispanic other races caregivers were compared on these variables. Multivariate tests of associations between SDoH and caregiver burden and psychological distress were conducted in structural equation modeling with caregiver burden and psychological distress as latent variables. Hispanic caregivers reported significantly higher caregiver burden, specifically for finances, family, and schedules. Caregiver burden was significantly predicted by having income barely or not meeting needs, being female, socially isolated, married, Hispanic, and having poor physical functioning. Significant predictors of caregivers' psychological distress: being female, being socially isolated, and having poor physical functioning. Hispanic caregivers experience significant challenges associated with caregiver burden, especially if they are female, socially isolated, and have poor physical functioning. Assessment of these SDoH is important in caregiver health to provide supportive care during caregiving. NCT03743415 www.clinicaltrials.gov.

Unsung Heroes of Cancer Care: Loneliness, Social Support, and Quality of Life in Informal Cancer Caregivers During COVID-19 Pandemic

Unsung Heroes of Cancer Care: Loneliness, Social Support, and Quality of Life in Informal Cancer Caregivers During COVID-19 Pandemic

Reinforcing or Disrupting Gender Affirmation: The Impact of Cancer on Transgender Embodiment and Identity

There is a pressing need for greater understanding and focus on cancer survivorship and informal cancer caring of trans people (binary and non-binary), across tumor types, to inform culturally safe trans inclusive cancer information and care. This qualitative study, part of the mixed methods Out with Cancer project, examined experiences of trans embodiment and identity after cancer diagnosis and treatment. We drew on open-ended survey responses from 63 trans cancer survivors and 23 trans cancer carers, as well as interviews and a photo-elicitation activity with a subset of 22 participants (15 cancer survivors, 7 cancer carers). Reflexive thematic analysis identified three themes: Cancer enhances trans embodiment, through experiences of gender euphoria following cancer treatment, and acceleration of decisions about gender affirmation; cancer erases or inhibits gender affirmation; trans embodiment is invisible or pathologized in cancer care. These findings demonstrate that trans embodiment and identity, as well as the process of gender affirmation, may be disrupted by cancer or informal cancer caring. Conversely, cancer and cancer treatment can positively impact the embodied identity and lives of trans people, despite the anxiety and strain of negotiating medical procedures. However, if healthcare professionals operate within a cis-heteronormative framework and do not understand the meaning of embodied change following cancer treatment for trans individuals, these positive benefits may not be realized.

The Experience of Informal Newcomer Cancer Caregivers with Limited Language Proficiency: A Scoping Review.

This scoping review explored what is known about the experiences of informal cancer caregivers (CGs) who are newcomers with limited language proficiency. A literature search was performed in seven databases and the search yielded 11,289 articles. After duplicate removal and title and abstract screening, 216 articles underwent full text review and 57 articles and were synthesized. Most studies (n = 41, 72%) were qualitative and were published in North America (n = 35, 61%). Most CG participants were female (69%) and only 19 studies explicitly identified the CG country of origin. Of those that did, 26% originated from Asia, with most migrating from East Asia. Significant challenges were experienced by newcomer CGs and chief among these were related to communication challenges with HCPs that were exacerbated by a lack of availability of medical interpreters and the complexity of oncology health information. Efforts are needed to better integrate newcomer CGs into cancer care.

Implementation of e-Mental Health Interventions for Informal Caregivers of Adults With Chronic Diseases: Mixed Methods Systematic Review With a Qualitative Comparative Analysis and Thematic Synthesis.

Informal caregivers commonly experience mental health difficulties related to their caregiving role. e-Mental health interventions provide mental health support in a format that may be more accessible to informal caregivers. However, e-mental health interventions are seldom implemented in real-world practice. This mixed methods systematic review aimed to examine factors associated with the effectiveness and implementation of e-mental health interventions for informal caregivers of adults with chronic diseases. To achieve this aim, two approaches were adopted: combinations of implementation and intervention characteristics sufficient for intervention effectiveness were explored using qualitative comparative analysis, and barriers to and facilitators of implementation of e-mental health interventions for informal caregivers were explored using thematic synthesis. We identified relevant studies published from January 1, 2007, to July 6, 2022, by systematically searching 6 electronic databases and various secondary search strategies. Included studies reported on the effectiveness or implementation of e-mental health interventions for informal caregivers of adults with cancer, chronic obstructive pulmonary disease, dementia, diabetes, heart disease, or stroke. Randomized controlled trials reporting on caregivers' mental health outcomes were included in a crisp-set qualitative comparative analysis. We assessed randomized controlled trials for bias using the Risk of Bias 2.0 tool, and we assessed how pragmatic or explanatory their trial design was using the Pragmatic Explanatory Continuum Indicator Summary 2 tool. Studies of any design reporting on implementation were included in a thematic synthesis using the Consolidated Framework for Implementation Research to identify barriers to and facilitators of implementation. Overall, 53 reports, representing 29 interventions, were included in the review. Most interventions (27/29, 93%) focused on informal cancer or dementia caregivers. In total, 14 reports were included in the qualitative comparative analysis, exploring conditions including the presence of peer or professional support and key persuasive design features. Low consistency and coverage prevented the determination of condition sets sufficient for intervention effectiveness. Overall, 44 reports were included in the thematic synthesis, and 152 barriers and facilitators were identified, with the majority related to the intervention and individual characteristic domains of the Consolidated Framework for Implementation Research. Implementation barriers and facilitators in the inner setting (eg, organizational culture) and outer setting (eg, external policies and resources) domains were largely unexplored. e-Mental health interventions for informal caregivers tend to be well-designed, with several barriers to and facilitators of implementation identified related to the intervention and individual user characteristics. Future work should focus on exploring the views of stakeholders involved in implementation to determine barriers to and facilitators of implementing e-mental health interventions for informal caregivers, focusing on inner and outer setting barriers and facilitators. PROSPERO (International Prospective Register of Systematic Reviews) CRD42020155727; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020155727. RR2-10.1136/bmjopen-2019-035406.

Exploring healthcare professionals' experiences with informal family cancer caregiving.

Caring for a family member with cancer is often associated with significant cognitive, emotional, and physical demands. Although considerable research has explored informal cancer caregiver role burden, research has seldom focused on the experiences of individuals who hold the dual role of informal caregiver and healthcare professional. This qualitative study begins to explore this dual role experience. Participants (N = 12) who had at least 1 year of prior professional experience and cared for a family member with cancer were recruited conveniently from a large university-affiliated hospital in Montreal, Quebec. Individual face-to-face semi-structured interviews were conducted. Using thematic analysis, key themes were developed from verbatim transcripts: (1) salient dual role advantages, (2) significant challenges related to this role, (3) changes in professional practice as a consequence of informal caregiving, and (4) important palliative and end-of-life care access issues. Whereas professional knowledge helped advocate on behalf of patients, the dual role often came with over-solicitation from others, enhanced sense of responsibility, increased burden, and significant distress. Further study of critical ramifications linked to jointly enacting informal and professional caregiving across various health contexts should continue to inform supportive care strategies for this understudied yet increasingly prevalent segment of the caregiver population.

Improving Sexual and Gender Minority Cancer Care: Patient and Caregiver Perspectives From a Multi-Methods Pilot Study.

Improving Sexual and Gender Minority Cancer Care: Patient and Caregiver Perspectives From a Multi-Methods Pilot Study.

Mapping the Lay of the Land: Using Interactive Network Analytic Tools for Collaboration in Rural Cancer Prevention and Control.

Cancer mortality rates in the United States are higher in rural than urban areas, especially for colorectal cancer. Modifiable cancer risks (e.g., tobacco use, obesity) are more prevalent among U.S. rural than urban residents. Social network analyses are common, yet rural informal collaborative networks for cancer prevention and control and practitioner uses of network findings are less well understood. In five service areas in rural Missouri and Illinois, we conducted a network survey of informal multisector networks among agencies that address cancer risk (N = 152 individuals). The survey asked about contact, collaborative activities, and referrals. We calculated descriptive network statistics and disseminated network visualizations with rural agencies through infographics and interactive Network Navigator platforms. We also collected feedback on uses of network findings from agency staff (N = 14). Service areas had more connections (average degree) for exchanging information than for more time-intensive collaborative activities of co-developing and sustaining ongoing services and programs, and co-developing and sharing resources. On average, collaborative activities were not dependent on just a few agencies to bridge gaps to hold networks together. Users found the network images and information useful for identifying gaps, planning which relationships to establish or enhance to strengthen certain collaborative activities and cross-referrals, and showing network strengths to current and potential funders. Rural informal cancer prevention and control networks in this study are highly connected and largely decentralized. Disseminating network findings help ensure usefulness to rural health and social service practitioners who address cancer risks.

HSR22-181: CancerSupportSource®-Caregiver: Development of a Multidimensional Distress Screening Measure for Family and Informal Cancer Caregivers

"HSR22-181: CancerSupportSource®-Caregiver: Development of a Multidimensional Distress Screening Measure for Family and Informal Cancer Caregivers" published on 31 Mar 2022 by National Comprehensive Cancer Network.

Understanding and Supporting Informal Cancer Caregivers.

Opinion statementInformal caregivers invest a significant amount of time and effort to provide cancer patients with physical, psychological, information, and social support. These challenging tasks can harm their own health and well-being, while a series of social-ecological factors may also influence the outcomes of cancer caregiving. Several instruments have been developed to help clinicians and researchers understand the multi-dimensional needs and concerns of caregivers. A growing body of evidence indicates that supportive interventions including psychoeducation, skills training, and therapeutic counseling can help improve the burden, information needs, coping strategies, physical functioning, psychological well-being, and quality of life of caregivers. However, there is difficulty in translating research evidence into practice. For instance, some supportive interventions tested in clinical trial settings are regarded as inconsistent with the actual needs of caregivers. Other significant considerations are the lack of well-trained interdisciplinary teams for supportive care provision and insufficient funding. Future research should include indicators that can attract decision-makers and funders, such as improving the efficient utilization of health care services and satisfaction of caregivers. It is also important for researchers to work closely with key stakeholders, to facilitate evidence dissemination and implementation, to benefit caregivers and the patient.

Association of cancer caregiver stress and negative attribution style with depressive symptoms and cortisol: a cross-sectional study.

PurposeWe examined the effect of informal cancer caregiver stress and negative attribution style (NAS) on depressive symptoms and salivary cortisol.MethodThe sample came from a hospital bone marrow unit and caregiver support organizations and included 60 informal cancer caregivers (51.7% partners) of individuals with cancer (provided care for a median of 27.5 h per week for 12 months) and 46 non-caregiver participants. In this cross-sectional study, participants completed questionnaires assessing NAS and depressive symptoms and provided saliva samples to measure cortisol.ResultsLinear regressions demonstrated that cancer caregiver stress (p = 0.001) and the cancer caregiver stress by NAS interaction (p = 0.017), but not NAS alone (p = 0.152), predicted depressive symptoms. Caregivers independent of their NAS and non-caregivers high in NAS reported high depression while non-caregivers low in NAS reported low depression. Neither cancer caregiver stress (p = 0.920) nor NAS alone (p = 0.114), but their interaction, predicted cortisol (p = 0.036). Higher NAS was associated with a higher cortisol in both groups while non-caregivers had higher cortisol than caregivers.ConclusionsIf the findings can be replicated, consideration of NAS in existing interventions to support informal cancer caregivers in managing chronic stress appears warranted.

Abstract PO-095: Improving informal caregivers and cancer survivors' psychological distress, symptom management and health care use follow-up interviews

Abstract Purpose: Adolescents and young adults (AYAs) experience disparately higher burden of negative psychological outcomes (e.g., depression, anxiety, stress) during the first six months of cancer compared to older patients and caregivers (i.e., dyads). This is due to their unfamiliarity with severe illness, multiple caregiving responsibilities, and developmental transitions of young adulthood. We aimed to receive feedback about adaptation of a telephone-based interpersonal psychotherapy intervention for AYA cancer dyads. Methods: We conducted semi-structured telephone interviews to elicit feedback about the intervention. Participants ages 18-39 years were eligible if they completed the 12-week intervention study (N=7). Participants were asked to share 1) their overall experience with the intervention content and delivery methods, 2) suggestions on how the intervention content and delivery could be improved, and 3) topics they found especially helpful or 4) they felt should have been included. The interviews were recorded, transcribed, and quality checked. We categorized qualitative feedback through interpretive description. Results: We interviewed 7 participants: 5 women and 2 men; 3 of whom were cancer survivors and 4 were caregivers. The interviews lasted between 5-20 minutes (average=10.5 minutes). Most participants enjoyed the content and found the information provided extremely helpful. Some participants continue to use the information provided after their participation. They explained that although some content was not relevant to them during their participation, it has since become relevant and has helped them navigate later stages of their cancer care. Participants felt that the study team was courteous and would have liked to speak to them more often, if given the opportunity. Suggestions for improving the intervention content delivery were providing a digital version of the handbook that they could access on a kindle or other eBook device, and a website or app with more information related to the intervention. Another suggestion was to provide the option to have video calls, instead of only phone calls, with the counselors, as face-to-face interactions would have helped them feel more connected during their sessions. Stand out topics included a sleep topic which included tips on how to fall asleep faster and stay asleep longer, and family topics which included family bonding tips. A topic that should have been included was how to improve self-confidence with intimate relationships. Conclusions: During their cancer experience, AYA cancer dyads are at a unique stage of life and are undergoing developmental transitions of young adulthood (e.g., completing higher education, establishing a career, developing intimate relationships) which results in disparities in their cancer survival and care. These disparities may be addressed through the adaptation of targeted interventions, specifically those that incorporate technology into the delivery of psychotherapy for addressing psychological sequela of cancer. Citation Format: Jennifer Traslavina Jimenez, Ashley Green, Keely Smith, Echo L Warner, Terry Badger, Alla Sikorskii, Chris Segrin. Improving informal caregivers and cancer survivors' psychological distress, symptom management and health care use follow-up interviews [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-095.

Abstract PO-019: General social media use amongst young adult cancer patients and caregivers

Abstract Purpose: Our purpose was to describe the social media platforms and experiences of adolescent and young adult (AYA) cancer patients and caregivers. We aimed to identify the general social media use of this group in order to determine the information seeking and sharing behaviors within the AYA cancer experience. Methods: From March 2021 to July 2021, we recruited participants through online repositories (e.g., ResearchMatch), and posted flyers on social media and at a large adolescent and young adult (AYA) conference. Eligible participants included 1) cancer patients who were between the ages of 18-39 and were diagnosed within this age range, use social media weekly, and speaks English and 2) informal cancer caregivers between the ages of 18-39, use social media weekly, and speaks English. Semi-structured interviews were conducted with participants over the telephone. We summarized sociodemographic and cancer factors, then categorized qualitative and quantitative data about general social media usage into platform use, differences between platform experiences, and information found. Results: There were 50 participants who completed an online screening form regarding social media platform usage, 17 of whom completed the study (36.0% participation rate). Of the 17 participants, Facebook (88.2%), Instagram (82.3%), and Twitter (76.5%) were the most common social media platforms used. Participants described that when using social media during cancer their preferred platforms were Facebook and Instagram, respectively, because of their ease of use and accessibility. This allowed a large population of cancer patients to be active on these platforms. Facebook was used most frequently for finding support through “groups”, from which participants could seek advice, anecdotes, or support from other cancer patients. On Instagram, participants most often interacted with cancer information through cancer specific pages like “Stupid Cancer” or “The Cancer Patient”. These pages target the adolescent-young adult age group. Participants felt as if the aspect of humor, the sharing of survival stories, research findings and opportunities, and fellow cancer survivors within the comments or through direct messages helped support them. The anecdotes/stories that were shared on social media often detailed a patient's treatment regimen, survivorship, and daily life, which helped patients and caregivers analyze their own cancer experiences and routines. Conclusions: Adolescents and young adults are diagnosed at a developmentally unique time in life, where they may seek support and comfort through social media platforms. By studying the types of platforms used, the reasons for using social media, and patterns of social media use this work provides a foundation for targeting AYA cancer patients and caregivers for social media interventions. Citation Format: Keely K. Smith, Ashley Green, Jennifer Traslavina Jimenez, Terry Badger, Echo L. Warner. General social media use amongst young adult cancer patients and caregivers [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-019.

Predictors of unhealthy physical and mental days among informal cancer caregivers: results from the 2019 Behavioral Risk Factor Surveillance System survey.

Patients with cancer and cancer survivors commonly rely upon family members and friends to act as caregivers to help manage cancer treatment and the late effects of that treatment. Informal caregivers provide a variety of supportive functions for cancer patients, including emotional, informational, and functional support, and practical assistance with skilled care activities. We examined predictors of unhealthy physical and mental days among informal cancer caregivers. Unhealthy days are an estimate of the overall number of days during the previous 30days when the respondent felt that either his or her physical or mental health was not good. Data were used from the 2019 Behavioral Risk Factor Surveillance System (BRFSS), a cross-sectional, population-based study. The participants were adults aged ≥ 18years who provided regular care or assistance to a friend or family member who had cancer in the past 30days. On average, caregivers who had a household income of less than $25,000 per year reported more (p < 0.05) unhealthy physical and mental days (during the last 30days). Average reported number of mental unhealthy days was the highest for those who provided care for 2 or more years and 40 or more hours per week. Caregivers of Hispanic ethnicity had a greater risk of reporting unhealthy physical and mental days among those who provided care for 2 or more years. Among those who were providing care for 40 + h a week, caregivers from less wealthy households (income less than $50,000) were at greater risk of experiencing a larger number of unhealthy mental days. Informal cancer caregiving can be a stressful experience with potentially negative consequences for both psychological and physical health. Of particular concern are caregivers who are low-income or have limited financial resources.

An Evaluation of Natural Environment Interventions for Informal Cancer Caregivers in the Community.

Home-based informal caregiving by friends and family members of patients with cancer is be-coming increasingly common globally with rates continuing to rise. Such caregiving is often emo-tionally and cognitively demanding, resulting in mental exhaustion and high perceived burden. Support for caregivers may be fostered by engagement with the natural environment. Interaction with nature is associated with mental health benefits such as stress reduction and improved well-being. The purpose of this paper was to evaluate the state of the science regarding the use of nat-ural environment interventions to support caregivers of cancer patients in the community. A comprehensive scoping review using the Arksey and O’Malley framework and the Preferred Re-porting Items for Systematic Reviews and Meta-analyses assessed natural environment therapies and mental health outcomes among cancer caregivers. Databases searched included CINAHL, PubMed, Scopus, Cochrane, and Alt HealthWatch. Findings recovered a total of five studies over a 10-year period that met criteria, demonstrating a lack of empirical evidence addressing this po-tential resource to support caregivers. Often, study appraisal was not on nature exposure, but ra-ther other aspects of the projects such as program evaluation, exercise, or complementary thera-pies. Both qualitative and quantitative designs were used but sample sizes were small. Caregivers experienced beneficial results across the various studies and future work could enhance these findings.