Objective-While much research has sought to identify disparities in cancer incidence, survival, and treatment, little research has sought to identify disparities in mental health outcomes among cancer survivors. The present study aimed to identify disparities in mental health outcomes between rural and nonrural cancer survivors.Methods-Cancer survivors who met eligibility criteria were identified through the Kentucky SEER Cancer Registry. Rural status was determined by 2003 USDA Rural-Urban Continuum Codes. 116 (n = 54 rural, 62 nonrural) survivors with diagnoses of breast (n=42), hematologic (n=39) or colorectal (n=35) cancer completed mail-back questionnaires and/or a telephone interview.Results-Rural cancer survivors reported poorer mental health functioning (Effect size; ES = .45 SD), greater symptoms of anxiety (ES = .70) and depression (ES = .47), greater distress (ES = . 41), and more emotional problems (ES = .47) than nonrural cancer survivors. Rural and nonrural cancer survivors did not differ consistently in regard to positive mental health outcomes, such as benefit finding. The pattern of results was maintained when adjusted for education and physical functioning.Conclusions-Clinically important disparities in mental health outcomes were evident between rural and nonrural cancer survivors. Interventions aimed at raising access and utilization of mental health services may be indicated for cancer survivors in rural areas. Keywordscancer; oncology; healthcare disparities; mental health; rural health Cancer disparity research has focused primarily on identifying population-based characteristics linked to cancer incidence, survival, and treatment [1][2][3][4]. While the mental health (MH) of cancer survivors is of great significance [5][6], little research has examined the link between population-based characteristics and MH outcomes among cancer survivors. In particular, there is scant research examining whether geographic residence, that is whether an individual resides in a rural or nonrural area, has significant bearing on an individual's MH following cancer diagnosis. Since over 10 million cancer survivors live in the United States (U.S.) [7], and roughly 20% of the population resides in rural areas, one can estimate the presence of approximately 2 million rural cancer survivors. With such a large number of rural cancer survivors, it is important to consider whether rural residence might be an important predictor of MH in cancer survivors. There are several reasons to believe residing in a rural area, characterized by low population density and geographic isolation [8][9], might influence adjustment after cancer diagnosis. First, disparate rates of comorbidity [9] and variation in cancer treatment received by rural and nonrural residents [10][11], may place rural cancer survivors at risk for poor physical functioning, which might have negative implications for MH. Second, few MH professionals (e.g., psychologists, psychiatrists), long travel distances to healthcare providers, low rates of ins...

Results demonstrated that multiple protective and risk factors contribute to the psychological well-being and distress of university students. Health promotion practitioners should adopt strategies that strengthen the personality characteristics and values associated with university students' psychological health.

Tobacco use after cancer diagnosis is associated with adverse cancer outcomes, yet reliable prevalence estimates for this behavior are lacking. We conducted a systematic literature review of the prevalence of current tobacco use among individuals with a history of lung or head/neck cancer (CRD #42012002625). An extensive search of electronic databases (MEDLINE, EMBASE, Cochrane Library, CINAHL, PsycINFO, Web of Science) identified 7,777 potentially relevant papers published between 1980 and 2014, and 131 of these yielded pertinent information. Aggregating results across heterogeneous study designs and diverse patient samples, the overall mean prevalence rate of current tobacco use (mostly cigarette smoking) was 33.0% (median=31.0%). Among current tobacco users at cancer diagnosis, the mean prevalence rate of current tobacco use (mostly cigarette smoking) was 53.8% (median=50.3%). In many cases, an operational definition of “current” tobacco use was absent, and biochemical verification of self-reported smoking status was infrequent. These and other observed methodological limitations in the assessment and reporting of cancer patients’ tobacco use underscore the necessity of uniform tobacco use assessment in future clinical research and cancer care.

Purpose Most breast cancer survivorship research focuses on the general population of survivors. Scant research investigates the potentially unique experiences of minorities, especially during and after the difficult transition from primary treatment to post-treatment. This qualitative study explored African American breast cancer survivors’ and caregivers’ quality-of-life in the post-treatment period with a focus on social and spiritual well-being. Methods Participants included a convenience sample of African American women with stage I-III breast cancer (N=23) who completed treatment 6–24 months before enrollment. Primary caregivers (N=22) included friends, spouses and other family members (21 complete dyads). Participants completed separate semi-structured telephone interviews. Template analysis was used to evaluate themes related to religiousness and spirituality, both across and within dyads. Results After treatment, religiousness and spirituality played a major role in both survivors’ and caregivers’ lives by: 1) providing global guidance, 2) guiding illness management efforts and 3) facilitating recovery. Participants described a spiritual connectedness with God and others in their social networks. Dyad members shared the goal of keeping a positive attitude and described positive growth from cancer. Few future concerns were expressed due to the belief that survivors were healed and “done” with cancer. Beyond practical and emotional support, provision of spiritual assistance was common. Conclusions Results highlight the principal, positive role of religiousness and spirituality for African American breast cancer survivors and caregivers after treatment. Findings emphasize the need to assess the importance of religious and spiritual beliefs and practices, and if appropriate, to provide resources that promote spiritual well-being.