Testing the effects of a decision-making and risk-reduction program for cancer-surviving adolescents.

PURPOSE/OBJECTIVES: To test the effects of a decision-making and risk-reduction program for cancer-surviving adolescents.

DESIGN

Prospective clinical trial using a quasi-experimental pretest/post-test design with repeated measures.

SETTING

Two survivor follow-up clinics and a camp for children and adolescents with cancer located in upstate New York.

SAMPLE

A convenience sample of 64 survivors (13-21 years of age). The intervention group consisted of 21 survivors who attended a workshop, and the comparison group consisted of 43 survivors who did not attend the workshop.

METHODS

Intervention-integrated information specific to survivorship, decision-making skills, risk behaviors, and social support from peers and healthcare professionals. The educational component of the program lasted one day (five one-hour units), and the social component lasted overnight. A single, semistructured interview at the time of the previous yearly evaluation visit was used for baseline data. Testing was conducted during home visits at 1, 6, and 12 months.

MAIN RESEARCH VARIABLES

Decision making, risk motivation, and risk behaviors (i.e., smoking, alcohol use, and illicit drug use).

FINDINGS

The effect of the intervention for improving decision making was significant at 1-month postintervention, marginally significant at 6-months postintervention, and highly significant at 12-months postintervention. The effect of the intervention for motivation toward alcohol use was significant at 1-month postintervention and marginally significant at 6-months postintervention; however, the intervention had no effect on smoking motivation at any of the three time intervals. The effect of the intervention for improving smoking behavior was marginally significant at 6-months postintervention and was marginally significant at 12-months postintervention for alcohol use.

CONCLUSIONS

The intervention had a dampening effect on the upward trajectory of substance use, a path that is well-known to increase with age for both genders in the general population. This short, five-hour program for improving decision making and affecting substance use of teen survivors shows promise; however, a larger sample is needed to enhance findings.

IMPLICATIONS FOR NURSING PRACTICE

Besides tailoring risk-behavior information based on actual or potential late effects of treatment to each teen survivor during follow-up visits, oncology professionals need to provide booster programs to refine decision-making skills within meaningful decision context for teen survivors as a means of reducing risk behaviors.