Interventions For Young Women Research Articles

Influence of running on incidental and integral vitality and fatigue: An intensive longitudinal intervention in young Women's daily life.

Exercise intensity and perceived autonomy are important factors for the affective response toward exercise and adherence. Dual-mode theory suggests an inverted-J response curve of affect with increased exercise intensity, but little is known about how different running programs affect the affective response and subsequent incidental affect in daily life. This ambulatory assessment study examines the short- to long-term effects of two 8-week running interventions (affect-based vs. polarized-prescribed) on subjective vitality and perceived fatigue in young female novices. Participants engaged in 3 × 30 minute running sessions weekly in their natural environments and completed electronic diaries three times daily. Autoregressive multilevel models indicate small effects of training intensity on immediate affective subjective vitality (ß = -2.37; p= .03; f2= 0.02) but negligible non-significant effects on fatigue (ß = 0.26; p= 0.12; f2= 0.002). Novices experienced increased vitality throughout the day when their running was evaluated positively (ß = 0.23; p= .03; f2= 0.04), with effects lasting over two days before returning to baseline (ß = -0.26; p< .001; f2= 0.004). However, no significant long-term effects were observed over 8 weeks in vitality or fatigue. Results indicate between- and within-person variations, but limited sample power does not allow differentiating between programs. This study supports the dual-mode theory and highlights the importance of distinguishing affective response from incidental affect.

A two-week exercise intervention improves cold symptoms and sleep condition in cold-sensitive women

BackgroundWe examined whether an aerobic exercise intervention in young women with cold sensitivity symptoms improves sleep quality and decreases cold complaints. Furthermore, we examined the association with increased foot skin temperature (Tsk) before falling asleep and decrease in sensitivity to cold in the brain.MethodsWe recruited 16 female adult volunteers who had cold sensitivity and were not engaged in daily exercise training, and they were divided into an exercise group (EXE) and a control group (CON). EXE was given a 2-week exercise intervention that consisted mainly of walking and jogging. Before and after the intervention, temperature sensation and body temperature parameters were measured just before bedtime; electroencephalogram measurements were taken during sleep; and subjective sleep surveys, including Oguri-Shirakawa-Azumi (OSA) sleep inventory (middle-aged and aged version) and visual analogue scale (VAS), were conducted immediately after waking up. All experiments were performed in the winter season.ResultsIn EXE, overall and foot warmth and comfort increased (p < 0.05) after the 2-week exercise intervention. The exercise intervention also decreased (p < 0.05) the scores for cold feeling in the fingertips, feet, and toes. In the OSA sleep inventory, factor IV (refreshing) and factor V (sleep length) were increased (p < 0.05) by the exercise intervention. Subjective sleep quality evaluated by VAS increased (p < 0.05) with exercise intervention. The exercise intervention in EXE shortened middle awake time after sleep onset (p < 0.05) and prolonged deep sleep length (p < 0.05). The exercise intervention increased (p < 0.05) alpha-wave power before sleep. In CON, all variables remained unchanged throughout the 2-week control period.ConclusionShort-term aerobic exercise alleviated peripheral extremity cold sensitivity symptoms and improved subjective sleep quality. Our findings suggest that these improvements were not due to increased Tsk at rest before bedtime but to decreased sensitivity to cold in the brain that was expressed as increased alpha activity.

Effects of an educational physical activity intervention in young women with newly diagnosed breast cancer: Findings from the Young and Strong Study.

Obesity and inactivity are poor prognostic factors in breast cancer, but less is known regarding physical activity (PA) and weight patterns in young breast cancer survivors. The Young and Strong Study was a cluster-randomized trial evaluating education and support interventions for young women (age <45 years) with newly diagnosed breast cancer. Sites were randomized 1:1 to a Young Women's Intervention (YWI) or a contact-time control physical activity intervention (PAI). Changes in PA and weight were compared between groups using general estimating equations to evaluate clustered binary and Gaussian data. A total of 467 patients enrolled between July 2012 and December 2013 across 54 sites. Median age at diagnosis was 40years (range, 22-45). At baseline, median body mass index (BMI) was 25.4kg/m2 (range, 16.1-61.1), and participants reported a median of 0minutes (range, 0-2190) of moderate/vigorous PA/week. PA increased significantly over time in both groups (p<.001), with no difference between groups at any time point. BMI increased modestly but significantly (p<.001) over time in both groups. Provider attention to PA was observed in 74% of participants on PAI and 61% on YWI (p=.145) and correlated with PA at 12months (median 100min/week of PA in participants with provider attention to PA vs. 60min/week in those without, p=.016). In a cohort of young women with breast cancer, rates of obesity and inactivity were high. PA and BMI increased over time and were not impacted by an educational PA intervention. Findings provide important information for developing lifestyle interventions for young breast cancer survivors.

Effects of a Lifestyle Intervention in Young Women with GDM and Subsequent Diabetes.

The purpose of this study was to examine whether a 9-month intensive lifestyle intervention could lead to weight loss and improve cardiovascular risk factors among young women with both gestational diabetes mellitus (GDM) and newly diagnosed diabetes. A total of 83 young women, who had GDM and were subsequently diagnosed as type 2 diabetes at an average of 2.6 years after delivery, participated in a 9-month intensive lifestyle intervention and a follow-up survey at 6-9 years postintervention. After the 9-month intervention, these women had a weight loss of 2.90 kg (-4.02% of initial weight), decreased waist circumference (-3.12 cm), body fat (-1.75%), diastolic blood pressure (-3.49 mmHg), fasting glucose (-0.98 mmol/L) and HbA1c (-0.72%). During the 6-9 years postintervention period, they still had lower weight (-3.71 kg; -4.62% of initial weight), decreased waist circumference (-4.56 cm) and body fat (-2.10%), but showed a slight increase in HbA1c (0.22%). The prevalence of using glucose-lowering agents increased from 2.4% at baseline to 34.6% after the 9-month lifestyle intervention, and to 48.4% at 6-9 years postintervention. A 9-month intensive lifestyle intervention can produce beneficial effects on body weight, HbA1c and other cardiovascular risk factors among young women with previous GDM who subsequently developed new diabetes.

Pre-Menstrual Dysphoric Disorder (PMDD) in Young People: What We Know About It, the Role of CBT as a Treatment Option, and the Development of High-Quality Psychoeducation Material for Clinical Use

AimsWe aim to explain more about PMDD in young people and explore the evidence looking at the role of CBT as an intervention. We aim to develop high-quality psychoeducation material with the involvement of young people, to be able to offer clinically relevant information and empower young people with PMDD.MethodsA literature search was conducted in 2019 and updated in February 2022 using the Cochrane Library, Psych-info, MEDLINE, Cinahl, EMBASE and Google Scholar, to look at the evidence available for CBT in young people with PMDD or PMS. The search included PMS as well as PMDD due to the heterogeneity in definitions used in studies.Focus groups with young people are underway to develop high quality written psychoeducation material about PMDD.ResultsThere were no specific studies looking at CBT as an intervention in young women under the age of 18 with PMS or PMDD. There was one intervention study with a treatment arm of psychoeducation in 62 young people under 18 with PMS versus a no treatment group (Taghizadeh 2013), with improvement in symptoms after 3 months from baseline reported.There were more studies available in women over the age of 18. The search identified 3 meta- analyses in 2009 and 2012 (Busse 2009, Lusty, 2009; Kleinstauber 2012) and a more recent systematic review (Landolt 2020). Kleinsteiber et al included 22 RCTs, with a median age of 39, and broadly showed CBT to have a small to medium positive effect size, although any conclusions were limited due to the small numbers involved in the individual trials and methodological flaws. Landolt 2020 looked at CBT or elements of CBT as an intervention arm over the last 30 years or so in woman of all ages. Variations of CBT including virtual, group, couple and psychoeducation alone were included, and all were reported to have favourable outcomes.ConclusionThere is a huge gap in research looking at PMDD in the adolescent population. Translating research from adults is not ideal. Increasing awareness and developing psychoeducation is a step in the right direction.

Abstract P096: Developing A Lifestyle-Based Cardiovascular Health Tool For Teens

Purpose: Previous studies have shown that young women have low awareness of heart disease, despite cardiovascular (CV) disease being the number one cause of death in women. While CV risk assessment tools exist for adults, there are no similar tools specifically for adolescents. This project focuses on developing a lifestyle-based CV health prediction tool and behavior intervention for young women. Methods: We report a qualitative case study of four hour-long semi-structured interviews with young women aged 13-21 years participating in a larger study to develop the new CV health tool. Patients were recruited from a primary care practice in Atlanta, GA. Participants completed the Healthy Heart Score survey, an existing web-based CV prediction tool developed for adults, while providing feedback on how to adapt the tool for young women. Topics included conditions to engage with the tool (e.g. at school or doctor’s office), app architecture (including layout, word choice, and use of visuals), and suggestions for improvement of the tool. We used qualitative coding and thematic analyses to synthesize data. Results: Prior to engaging with the Heart Healthy Score tool, participants initially demonstrated minimal knowledge of heart attacks/strokes (“I don’t know about preventing” [heart attacks and strokes]) and of their own risk (“I’ve never associated… young women with [heart disease]”). As participants used the tool, their knowledge of heart healthy choices and awareness of their own choices increased, cueing action (“I definitely need to get my health… together now before it’s too late”). Throughout the survey, teens had varied emotional reactions, from shame/embarrassment about health (“I… got upset because… I shouldn’t be eating this much”), to surprise/shock (“I thought I ate way more fruits and vegetables''), to enthusiasm to engage with app in the future (“I might like to use this tool because it’ll … help me [have] a better way of understanding … what to eat, what is healthy”). Participant recommendations to improve the tool for future use with teens focused on the importance of using examples and visual representations (“All the examples … really help me … figure out … how much I’m eating”, “I don’t really have a good idea of… what ounces really look like… a little visual would help [figure] that out”), and the importance of goal-setting and motivational language to incentivize teens to engage with the tool (“Instead of just telling you what you need to do to become better, they give you… an actual goal”). Conclusions: Through this case study, young women demonstrate a knowledge gap about heart disease risk and healthy choices. Adapting a CV health assessment tool for teens, with added examples, visuals, and motivational language, will allow teens to reflect on their own lifestyle choices, increase awareness of their risk for future heart disease, and ultimately serve as an impetus for behavior change.

Feasibility study of the Home-based Exercises for Responsible Sex (HERS) intervention to promote correct and consistent condom use among young women

BackgroundMale condoms are effective in preventing common sexually transmitted infections (STIs) and unintended pregnancy, if used correctly and consistently. However, condom use errors and problems are common and young people report negative experiences, such as reduced pleasure. The Kinsey Institute Home-Based Exercises for Responsible Sex (KIHERS) is a novel condom promotion intervention for young women, which aims to reduce condom errors and problems, increase self-efficacy and improve attitudes towards condoms, using a pleasure-focussed approach. The study objective was to test the operability, viability and acceptability of an adapted version of the KIHERS intervention with young women aged 16–25 years in the United Kingdom (UK) (Home-Based Exercises for Responsible Sex-UK (HERS-UK).MethodsA repeated-measures single-arm design was used, with a baseline (T1) and two follow-up assessments (T2 and T3), conducted 4 weeks and 8 weeks post intervention over a 3-month period. Participants were provided a condom kit containing different condoms and lubricants and were asked to experiment with condoms alone using a dildo and/or with a sexual partner. Ten process evaluation interviews were conducted post intervention.ResultsFifty-five young women received the intervention; 36 (65%) completed T2 and 33 (60%) completed T3. Condom use errors and problems decreased, self-efficacy increased and attitudes towards condoms improved significantly. The proportion of participants who reported using a condom for intercourse in the past 4 weeks increased from T1 (20; 47%) to T2 (27; 87%) and T3 (23; 77%) and using lubricant with a condom for intercourse increased from T1 (6; 30%) to T2 (13; 48%)) and T3 (16; 70%). However, motivation to use condoms did not change. Cronbach’s alpha scores indicated good internal consistency of measures used. Qualitative data provided strong evidence for the acceptability of the intervention.ConclusionsHERS-UK was implemented as intended and the recruitment strategy was successful within a college/university setting. This feasibility study provided an early indication of the potential effectiveness and acceptability of the intervention, and the benefits of using a pleasure-focussed approach with young women. Measures used captured change in outcome variables and were deemed fit for purpose. Future research should explore cost-effectiveness of this intervention, in a large-scale controlled trial using a diverse sample and targeting young women most at risk of STIs.

Abstract PD12-08: Young, empowered &amp; strong (YES): A web-based education and supportive care intervention for young women with breast cancer across the care continuum

Abstract Background: Young women diagnosed with breast cancer have unique physical and psycho-social needs that are often unaddressed. Patient-centered models of care, including eHealth strategies, can help empower young women to self-manage symptoms and psychosocial concerns, as well as support informational needs throughout the cancer care trajectory. Methods: YES (Young, Empowered and Strong) is an interactive web-based portal designed with patient-reported outcome questionnaires (PROs) that trigger delivery of young breast cancer patient-specific education and symptom management materials. Personal journal and messaging components are also available. We piloted the YES portal among young women (&amp;lt;45 years) with newly diagnosed early breast cancer (EBC), breast cancer survivors (BC-S) and women living with metastatic breast cancer (MBC), for whom PROs were deployed weekly (EBC, MBC) or every 4 weeks (BC-S) over 12-weeks. At study completion, the use, feasibility and acceptability of the YES portal was assessed via a survey and a structured interview. Results: Thirty women were enrolled between April and June 2019: 10 EBC, 10 BC-S and 10 MBC. Mean age at diagnosis and enrollment was 36 (range 25-44) and 39 (range 31-44) years respectively and 13% (4/30) were non-white. Nearly all participants were receiving treatment (96%, 27/28) including 54% (15/28), endocrine therapy and 43% (12/28), chemotherapy. Overall, 61% (180/296) of PROs deployed were completed, with completion rates highest for EBC patients (EBC: 70%, BC-S: 63%, MBC: 52%). Of 37 PROs domains, the most frequently triggered were sexual health (EBC: 90%, BC-S: 90%, MBC: 90%), anxiety (EBC: 80%, BC-S: 90%, MBC: 90%) and fatigue (EBC: 90%, BC-S: 80%, MBC: 90%). Physical domains and young breast cancer specific domains commonly addressed in clinic (i.e., fertility, genetic testing) were less frequently triggered. The post-pilot survey was answered by 15 participants: 8/15 reported the information shared through YES was helpful, 6/14 felt the portal helped monitor side effects and 8/14 felt the portal helped manage side-effects. Nineteen women completed post-pilot interviews: most women with EBC and MBC said the portal increased symptom awareness and complemented information communicated by providers; the BC-S group more frequently commented that features of the YES portal focusing on symptom monitoring/management would have been more useful when they were earlier in their care (newly diagnosed or undergoing more active treatment). Conclusions: YES, a novel eHealth intervention designed to support young women with breast cancer, is feasible and acceptable to young women across the breast cancer care continuum. The nearly universal triggering of information and support for sexual and mental health suggests sub-optimal management of these issues in the clinical setting and the potential role for self-management through an eHealth platform for this population. Future efforts will aim to evaluate whether provision of information through the YES portal reduces symptom burden and unaddressed needs and concerns in young women with breast cancer. Citation Format: Tal Sella, Craig Snow, Hannah Freeman, Phillip D Poorvu, Shoshana M Rosenberg, Ann H Partridge. Young, empowered &amp; strong (YES): A web-based education and supportive care intervention for young women with breast cancer across the care continuum [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PD12-08.

Physiological Approach on the Physical Fitness and Postural Balance Effects of a Whole-Body Vertical Vibration Intervention in Young Women

Physiological Approach on the Physical Fitness and Postural Balance Effects of a Whole-Body Vertical Vibration Intervention in Young Women

Abstract P2-13-17: Fertility concerns and treatment decision-making among young women with breast cancer

Abstract BACKGROUND Fertility can be diminished by adjuvant chemotherapy or by age-related decline in ovarian reserve in young women with breast cancer (BC). We sought to better understand the burden of concern about fertility, utilization of fertility preservation strategies, and the impact of fertility concerns on treatment decision-making among young women newly diagnosed with BC enrolled in a large multi-site study. METHODS The Young and Strong study was a cluster-randomized study that tested the effect of an educational and supportive care intervention for young women with BC (≤45) and their oncologists, at community and academic sites across the US. Patients were surveyed following diagnosis at enrollment (within 3 months of diagnosis), and at 3, 6 and 12 months thereafter. The surveys included sociodemographic and psychosocial measures (HADS anxiety and depression; Perceived Stress Scale), as well as a modified Fertility Issues Survey, which assessed fertility concerns and preservation. Treatment and tumor pathology data were abstracted from the medical record. Logistic regression was used to identify sociodemographic, clinical, and psychosocial factors that were associated with fertility concern. Variables with p ≤ 0.20 in univariable analyses were evaluated in the multivariable model using stepwise selection; variables achieving significance at p &amp;lt; 0.05 were included in the final model. RESULTS Of 467 women enrolled from 54 sites (14 academic, 40 community), 419 had evaluable data regarding treatment decision-making. Median age of participants at diagnosis was 40 yrs (range 22-45), 11% were African American, 80% were married/lived with a partner, and 75% had children. 35% of tumors were stage I, 51% stage II, and 14% stage III; 82% of women were treated with chemotherapy. At the time of treatment decision-making, 133 (32%) were concerned about fertility, varying by age, with fertility concern reported by 73%, 28% and 13% of those age ≤35, 36-40 and &amp;gt;40 (p&amp;lt;.01), respectively. 67 (16%) said their treatment decisions had been affected by fertility concerns, including 62 of the 133 (47%) with fertility concern. 12/419 (3%) chose one chemotherapy regimen over another, 4 (1%) chose not to take hormonal medication, and 32 (8%) chose or may choose to take it for less than 5 years. 251 (60%) reported having discussed fertility issues with their physician before starting therapy, including 117/133 (88%) of women with fertility concern. 29 (7%), including 27/133 (20%) of the concerned, took special steps to lessen the chance of infertility: 14 underwent cryopreservation of embryos, 14 cryopreservation of eggs and 12 took GnRH agonist or pursued other strategies. In the multivariable model, history of difficulty becoming pregnant (versus none, OR=3.86, 95%CI: 1.84-8.1) was associated with greater concern about fertility. Older age (OR=.75 per 1-year increase, 95%CI: 0.69-0.81) and having more than one child at diagnosis (versus never delivered, OR=0.14, 95%CI: 0.05-0.40) were associated with less concern about fertility. Race, being partnered, high-education, income, symptoms of depression, stress or anxiety at diagnosis, tumor stage, hormone receptor status and receipt of chemotherapy were not independently associated with concern about fertility in the multivariable model. CONCLUSION In a geographically and ethnically diverse study of young women with newly diagnosed BC in the U.S., many were concerned about fertility, with potential impact on their treatment decisions. For the majority of women, these concerns were discussed with their providers, though only a minority underwent fertility preservation strategies prior to treatment. Citation Format: Elisabeth Etaix, Yue Zheng, Shoshana Rosenberg, Kathryn J Ruddy, J Russel Hoverman, Karen M Emmons, Ann H Partridge. Fertility concerns and treatment decision-making among young women with breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-13-17.

Outcomes of a brief mental health and resilience pilot intervention for young women in an urban slum in Dehradun, North India: a quasi-experimental study

BackgroundMental illness is a leading cause of the disease burden among young people. Poor mental health is linked to childhood adversity such as gender inequality, poverty and low educational attainment. Psycho-social assets in adolescents can moderate these impacts and be strengthened. The aim of this study was to assess the effectiveness of a brief mental health and resilience intervention among disadvantaged young women in urban North India.MethodsWe used an uncontrolled repeated measures design to evaluate the effectiveness of the 15-module mental health and resilience curriculum among young women residing in a slum in Dehradun, Uttarakhand. Standardised psychometric assessments were done to assess outcomes of the intervention at three time-points: pre-intervention (T1), post-intervention (T2), and 8-months post-intervention (T3), covering domains of self-efficacy, resilience, anxiety, depression and gender attitudes.ResultsYoung women completing the intervention (n = 106) had all left school before 10th class. A statistically significant improvement in all psychometric measures was found at T2. These improvements were sustained at T3 in the areas of anxiety, depression and gender equality attitudes, while the measures of resilience and self-efficacy had declined to baseline.ConclusionsThis intervention delivered by community-based peers among highly disadvantaged young women can lead to sustained improvements in anxiety and depression and attitudes to gender equality. While other studies in LMIC have shown increased adolescent resilience through peer-led curriculums, this study demonstrates improvements in mental health and gender attitudes can endure 8-months post-intervention. This low-cost, brief intervention can improve mental health resiliency and self-efficacy among disadvantaged young people. Further research should explore how to bring sustained improvements in resilience.

Assessing Acceptability and Perceptions of a Novel Condom Use Intervention for Young Women

ABSTRACTObjectives: To assess the acceptability of a novel condom use intervention for women, the Home-Based Exercises of Responsible Sex, that focuses on condom use experience, application skills, and self-efficacy. Method: Two hundred eighty women (M age 22.63, SD = 3.65) completed an online survey containing questions on condom use errors, experiences, ability, and self-efficacy, and on intervention acceptability. Results: Eighty-one percent reported that the intervention was acceptable. Significant positive predictors of acceptability were condom use ability (β = .18) and self-efficacy (β = .20). Discussion: Findings suggest that the intervention is acceptable and that different options for completing the intervention should be offered.

Assessment of an Electronic Intervention in Young Women with Heavy Menstrual Bleeding

Study Objective, Design, Setting, Participants, Interventions, and Main Outcome MeasuresBleeding disorders (BD) occur in up to 50% of adolescents with heavy menstrual bleeding (HMB). This presents unique challenges to health care providers because of the complexity of treating the condition and such complexity can result in difficulty with patients understanding basic information about their condition, limit communication with medical providers, and patient compliance. The aim of the study was to use an electronic approach to enhance patient compliance with medications used to treat their HMB, and to provide educational access to adolescents with BD. This was a prospective cohort study involving patients in a Young Women's Bleeding Disorder Clinic at a single children's hospital. Subjects were given an iPod Touch (Apple Inc, Cupertino, CA) device (ITD), preloaded with the iPeriod (Winkpass Creations) application. Participants recorded information about their BD that they learned about on BD Web sites, and menses, and medications. Electronic and charted data were collected to monitor compliance with prescribed treatment regimens. All ITD allowed Wi-Fi access to allow teens to explore BD Web sites and knowledge was assessed. ResultsTwenty-three of 45 subjects completed the study. The mean age was 14.1 ± 1.9 years. Subjects who were compliant with the ITD (group 1), charted on baseline symptoms, menstrual flow (83.3%), cramps (100%, 23/23), breakthrough bleeding (95.6%, 22/23), mood (95.6%, 22/23), and medication use (91.7%) for a mean of 9.3 ± 3.1 months. Subjects who were nonusers (group 2) did not report on symptoms, their condition, or medication use in the device (n = 22). More than 75% (17/23) of subjects in group 1 used hormones alone or hormones with antifibrinolytic agents to control HMB. No subjects stopped or missed medications who were in group 1 intentionally, and also there were 9 enrollees within this same group who missed a medication related to awaiting the prescription to be filled from pharmacy. In group 2, 17 enrollees missed medications, resulting in 19% (4/22) of these enrollees being admitted to hospital for 1-2 days. In addition, enrollees in group 2 missed more medications on average compared with group 1. No subjects in group 1 required admission for HMB treatment failure during the study period, compared with those in group 2 (P = .006). All subjects in group 1 reported accessing Web sites using their ITD to learn about their BD. Groups 1 and 2 did not differ in the number of medications that were prescribed during the time frame (P = .77) or the number of follow-up clinic visits (P = .49). Furthermore, those in group 1 reported fewer breakthrough bleeding episodes than those in group 2 according to clinic notes (P = .03). Users of the ITD were given a set of knowledge questions. Group 2 subjects were not consistent users of the ITD use and did not complete the knowledge questions. Group 1 and 2 could not be compared with regard to knowledge as a result. ConclusionITD is an excellent tool for adolescents with HMB and BD to allow self-monitoring, provider monitoring, and improve educational access through engaging technology; compliance with device use was associated with several parameters suggestive of improved clinical outcomes.

An evaluation of a cognitive educational program tailored for young women with mental illness: A qualitative interview study

Mental illness is a growing problem in numerous industrialized countries. Young women in particular report problems such as anxiety, worry and depression. The aim of this study was to evaluate a cognitive educational program offered to young women with mental illness by listening to how they discussed their own social skills and capability to obtain work or education. Five women in the age range of 18–26 years, who had been unemployed for at least four months, diagnosed as suffering from mental illness, and who also participated in a cognitive educational program were interviewed. The text from the interviews was analyzed using content analysis. The analysis resulted in the construction of the following theme: ‘Being together in an inspiring educational program supports the women’s own ability to devise a holistic life puzzle’ . The participants’ answers were grouped into the following categories: ‘Perceptions of the educational program’ and ‘Social network’ with four subcategories. Being together with others in the same situation would appear to support the women’s own abilities, especially in an environment characterized by strict routines and nearness. These findings indicate the need to develop interventions for young women with mental illness which encourage spaces for collective support.

Abstract P1-10-18: Contraception use in young women with breast cancer

Abstract Background: Young women with breast cancer need highly effective contraception given the potential implications of unplanned pregnancy for optimal treatment, and the teratogenic risks. We sought to determine the contraceptive methods used by young women after diagnosis (dx) of breast cancer and factors associated with use of less effective methods or no contraceptive method, which confers a 6-90% annual risk of pregnancy in sexually active women in contrast to highly effective methods (risk &amp;lt;1%). Methods: As part of a randomized trial conducted in 54 sites to test an education and support intervention for young women with breast cancer and their oncologists, we surveyed women about their pre-dx, current, and planned contraceptive use, and about communication with their providers regarding contraception. Women enrolled within 3 months of dx; contraception items were included on 3- and 12-month post-enrollment surveys. Intrauterine device (IUD) use, tubal sterilization, hysterectomy or bilateral salpingo-oophorectomy (hyst/BSO) after dx, or male partner vasectomy were classified as highly effective methods; all other methods and non-use were categorized as less effective. We excluded women not at risk of pregnancy: hyst/BSO prior to dx, or no indication for contraception. We used logistic regression to explore factors associated with use of less effective methods. Results: Of 424 women who completed the 3-month post-enrollment survey, median age at dx was 39 (range 22-45). 312 women at risk of pregnancy were included in this analysis, including 291 reporting sexual activity with a male partner within the last 6 months, and 21 reporting no recent sexual activity but reporting use of birth control. 123 women (39%) used highly effective contraceptive methods prior to dx; after dx, 161 (52%) reported current use of or a plan to use a highly effective method. 19 women (6%) reported use of a hormonal birth control method since dx; 7 (2%) reported withdrawal as their only contraceptive method; 25 (8%) reported no contraception. 30% of women did not recall a discussion of avoiding pregnancy or need for contraception during treatment with their providers. In multivariable analyses (N=310), desire for additional biologic children (OR 7.54, 95% CI 3.88-14.66) and provider discussion of contraception and pregnancy (OR 2.13 95% CI 1.20-3.78) were associated with use of less effective contraception. Age, race/ethnicity, disease stage, and partner status were not significantly associated with use of less effective methods. Conclusion: About half of women who are at risk of pregnancy reported use or planned use of less effective contraceptive methods or no method of contraception following dx of breast cancer. Women with breast cancer and their providers may benefit from targeted education on contraceptive options and method effectiveness. Citation Format: Rosenberg SM, Dutton CR, Ligibel J, Barry W, Ruddy KJ, Sprunck-Harrild K, Emmons KM, Partridge AH. Contraception use in young women with breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-10-18.

Managing psychosocial issues faced by young women with breast cancer at the time of diagnosis and during active treatment.

This review examines recent literature on the psychosocial needs of and interventions for young women. We focus on the active treatment period given the toxicity of treatment, the incidence of anxiety, and depressive symptoms in these women during treatment. This review summarizes research relevant to addressing their social and emotional concerns. Young women undergoing treatment for breast cancer remain understudied despite unique needs. Psychoeducational interventions help to relieve symptoms and emotional distress during treatment, but effects do not appear to persist over the longer term. In the clinical context, the performance of prognostic-risk prediction models in this population is poor. Surgical decision-making is often driven by fear of recurrence and body image rather than prognosis, and decision aids may help young women to synthesize information to preserve their role in the treatment process. First, shared decision-making, second, balancing body image, fear of recurrence, and recommended treatment, and third, palliative care for metastasis are essential research priorities for the clinical setting. In the larger social context, unique family/partner dynamics as well as financial and insurance concerns warrant particular attention in this population.

Effects of a Multi-Disciplinary Lifestyle Intervention on Cardiometabolic Risk Factors in Young Women with Abdominal Obesity: A Randomised Controlled Trial.

BackgroundYoung women are under-represented in cardiovascular disease research, with obesity and cardiometabolic risk factor interventions generally targeting older adults. Furthermore, appropriate study designs for young women remain uncertain. This study aimed to assess the impact of a 12 week multi-disciplinary lifestyle intervention on cardiometabolic risk factors in premenopausal women with abdominal obesity.MethodsWomen aged 18–30 y with abdominal obesity [waist circumference (WC) ≥ 80 cm] were randomised to a 12 week lifestyle intervention (n = 26) of physical activity, nutrition education and cognitive behavioural therapy, or a wait-list control group (n = 17). Both groups completed anthropometric, biochemical, nutrition and fitness testing, at pre (0 weeks) and post (12 weeks), with intervention participants completed follow-up testing at 24 weeks.ResultsResults from a linear mixed model showed no between-group differences, other than increased physical activity in the intervention group, at post. In the intervention group alone, positive within-group changes were observed in WC, waist-hip-ratio (WHR), waist-height-ratio (WHtR), resting heart rate, blood pressure, predicted VO2max, and total energy intake. Most changes were maintained at 24 weeks post-intervention. Similar within-group improvements were observed in control participants in WC, WHR, WHtR, and systolic blood pressure but no changes were detected in physical activity and nutrition.ConclusionsCardiometabolic risk factors were decreased as a result of a lifestyle intervention in young women with abdominal obesity. It is difficult to describe observations in the control group without greater understanding of the behaviour of wait-list participants.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12612001017819

Exploring treatment preferences for psychological services after abortion among college students

Objective: This study reports on the preferences for psychological treatment after abortion among college students who experienced psychological distress and desired mental health services, and provides validation of the Post Abortion Questionnaire (PAQ) as a measure of abortion intervention preferences. Background: The current study is part of a larger programme of research to develop an effective behavioural intervention for young women who seek treatment for psychological distress after abortion. Based upon an earlier study which found that college women who sought psychological treatment after abortion experienced moderate to severe symptoms of acute and chronic post-traumatic stress disorder, this study aimed to identify the components of a behavioural intervention to reduce distress after abortion that a college population would prefer. Methods: Participants were N = 45 self-selected college students from Canada and the United States who experienced psychological stress after abortion and desired psychological treatment. Data were collected from January 2007 to January 2010, and included demographic and reproductive data as well as preferences for interventions to reduce psychological distress after abortion. The study was conducted at the McGill University Student Health Services in Montreal. Results: Principal Components Analyses was used to analyse service components of the PAQ, which identified types of services that students desired, including assistance for unanticipated guilt, spiritual distress, coping, and education to understand their abortion experience. Conclusion: These findings provide evidence to develop targeted post-abortion psychological services for this population, which are generally not available in the clinical setting.

Evaluation of a Computer-Tailored Osteoporosis Prevention Intervention in Young Women

Purpose The purpose of this study was to evaluate the effectiveness of a theory-based computer-tailored osteoporosis prevention program on calcium and vitamin D intake and osteoporosis health beliefs in young women. Additionally, this study tested whether adding bone density testing to the intervention improved the outcomes. Methods One hundred (n = 100) women aged 19 to 25 years were randomly assigned to one of 2 groups. One group (n = 50) received the computer-tailored program with brief counseling and the second group (n = 50) received the same intervention plus bone density testing of the heel (quantitative ultrasound [QUS]) feedback. Results Participants within both groups statistically significantly increased calcium and vitamin D intake from baseline to 1 month after the interventions. Both groups also experienced statistically significant decreases in perceived barriers to obtaining adequate vitamin D intake. Discussion The theory-based computer-tailored osteoporosis prevention program resulted in significant improvements in osteoporosis beliefs and calcium and vitamin D intakes. The bone density test did not improve results. Translation to Health Education Practice Though future research is needed, this preliminary study holds promise for health education practice to use theory to plan osteoprotective computer programs for young women.

Abstract OT2-4-02: Young and strong: A randomized trial to evaluate a program for young women with breast cancer

Abstract Young women with newly diagnosed breast cancer face substantial challenges including higher risk of disease recurrence and likelihood of harboring a genetic mutation compared with older women. Many young women are also very concerned about their future fertility and this population often feels isolated from other breast cancer survivors due to their age and life stage. Some worry that their doctors are unsure of how to treat them. To address these issues, we developed a comprehensive program at our institution to coordinate and enhance the care, support, and education for young women with breast cancer. The Young and Strong study is a randomized clinical trial (RCT) to evaluate a virtual, exportable, scalable version of this program designed to improve the quality of care and the psychosocial well-being of this vulnerable population. The specific aims of this program are: 1) To develop, pilot, and refine an exportable and sustainable educational and support intervention for young women with breast cancer and their oncology providers (Young Women's Intervention; YWI). 2) To determine the effect of the YWI compared to a contact-time control intervention focused on promoting physical activity (Physical Activity Intervention; PAI) on attention to fertility issues in a RCT: “Young and Strong”. We initially conducted 4 focus groups (n = 36) and 20 key informant interviews, and developed, piloted, and refined the YWI as well as the PAI. Based on this successful work, we launched the Young and Strong study in June 2012 as a cluster-randomized trial at a total of 54 sites (40 community and 14 academic sites across the United States). Randomization is 1:1 between sites, and stratified by practice type (community vs. academic). Each community site will enroll 5-10 participants, each academic site 15 participants. Total recruitment will be 410-610 pts. The primary objective is to evaluate whether YWI, as compared to PAI, is associated with greater attention to fertility issues, assessed via medical record review. In addition, participants will complete assessments at baseline, 3, 6, and 12 months that assess satisfaction with care, psychosocial well-being, physical activity and anthropomorphic changes. Young and Strong activated in June 2012 and all sites have been identified. As of 6/11/2013 the study has been initiated at 53 out of 54 sites, and total of 282 women have enrolled on the study. Eligibility Criteria: 1. Women age 18-45 years at diagnosis 2. Stage I-III invasive breast cancer without known recurrence or metastatic disease 3. Newly-diagnosed (within 3 months of initial diagnosis) 4. Have 1st appt. with a medical oncologist at participating site after the site opens to enrollment 5. Able to read and write in English For further information, contact Ann Partridge, MD, MPH at 888-814-3324. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr OT2-4-02.