Background Childhood cancers typically require rigorous treatment at specialized centers in urban areas, which can create substantial challenges for families residing in remote communities. We evaluated the impact of residence and travel time on the burden of care for families of childhood cancer patients. Procedure We conducted a cross-sectional, self-administered survey of 354 caregivers of pediatric cancer patients at a children’s hospital serving a seven state area. Measures included the impact of cancer treatment on relocation, employment, schooling and finances. We evaluated these domains by rural/urban residence and travel time (>1 hour and >2 hours) to the hospital in multivariable regression models. Results Of the 29% of caregivers who reported moving residences since their child was diagnosed, 33% reported that the move was due to their child’s cancer. Rural and remote (e.g., >1 hour travel time) caregivers missed more days of work during the first month after diagnosis than did urban and local caregivers, however, these differences did not persist over the first six months of therapy. One-third of caregivers reported quitting or changing jobs as a direct result of their child being diagnosed with cancer. Rural respondents had greater out-of-pocket travel expenses and reported a significantly greater perceived financial burden. Rural patients missed more school days and were at an increased risk of having to repeat a grade. Conclusions Childhood cancer has an appreciable impact on the lives of patients and caregivers. The burden is greater for those living far from a treatment center.

Latinas have the highest incidence of cervical cancer. Latino parents' perceptions of the human papillomavirus (HPV) and willingness to have their sons and daughters vaccinated in Utah is largely unknown. Latino parents/guardians of children ages 11-17 years were recruited from two community organizations (N = 52) to participate in a mini-survey and focus group. Guided by the social ecological framework, a Latina facilitator conducted five focus groups that were recorded, transcribed and translated. Descriptive statistics were calculated from the mini-survey. Two members of the research team performed inductive content analysis of the focus group transcriptions separately. Discrepancies were discussed and resolved during bi-weekly meetings with group members who were present during the focus groups. Parents reported low HPV vaccine knowledge, high vaccine costs, and lack of strong provider recommendations as the main barriers to vaccine receipt. Language appropriate educational resources and consistent provider recommendations may enrich Latino parents' perceptions about the HPV vaccine.

Background: Childhood cancer survivors may be at increased risk of hospitalization because of cancer-related late effects. Methods: Using data from population-based research resources in Utah, we identified childhood and adolescent cancer survivors who were diagnosed from 1973 to 2005 (N = 2,571). We selected a comparison cohort based on birth year and sex (N = 7,713). Hospitalizations from 1996 to 2010, excluding pregnancy and delivery, were determined from discharge records. Multivariable regressions were used to evaluate hospitalization admissions, length of stay, and diagnosis for survivors starting five years from diagnosis versus the comparison cohort. Results: When follow-up began in 1996, there were N = 1,499 survivors and N = 7,219 comparisons who were alive and eligible for follow-up. Average follow-up for survivors was 13.5 years (SD = 8.5) and for the comparison 14.0 years (SD = 8.7; P = 0.05). Survivors were hospitalized, on average, 1.62 (SD = 3.37) times contrasted to 0.79 (SD = 1.73) for the comparison cohort. In multivariable analyses, the hazard ratio (HR) of any hospitalization since 1996 was higher for survivors than the comparison cohort [HR, 1.52, 95% confidence interval (CI), 1.31–1.66]. Survivors experienced a higher hospital admission rate [rate ratio (RR) = 1.67; 95% CI, 1.58–1.77] than the comparison cohort. The number of hospitalizations was highest for neuroblastoma (RR = 2.21; 95% CI, 1.84–2.66) and bone tumors (RR = 2.55; 95% CI, 2.14–3.02) in reference to the comparison cohort. Survivors were hospitalized because of blood disorders more often (HR, 14.2; 95% CI, 6.3–32.0). Conclusions: The risk of hospitalization and lengths of stay are elevated among childhood cancer survivors. Impact: Research to identify strategies to prevent and manage survivors’ health problems in outpatient settings is needed.

BackgroundTo assess the demographic and attitudinal factors associated with HPV vaccine initiation and completion among 18–26 year old women in Utah.MethodBetween January 2013 and December 2013, we surveyed 325 women from the University of Utah Community Clinics about their HPV vaccine related beliefs and behaviors. Odds ratios (ORs) were estimated from logistic regression models to identify variables related to HPV vaccine initiation and series completion.ResultsOf the 325 participants, 204 (62.8 %) had initiated the vaccine and 159 (48.9 %) had completed the 3-dose series. The variables associated with HPV vaccine initiation were lower age (OR = 1.18 per year); being unmarried (OR = 3.62); not practicing organized religion (OR = 2.40); knowing how HPV spreads (OR = 6.29); knowing the connection between HPV and cervical cancer (OR = 3.90); a belief in the importance of preventive vaccination (OR = 2.45 per scale unit); strength of doctor recommendation (OR = 1.86 per scale unit); and whether a doctor’s recommendation was influential (OR = 1.70 per scale unit). These variables were also significantly associated with HPV vaccine completion.ConclusionThe implications of these findings may help inform policies and interventions focused on increasing HPV vaccination rates among young women. For example, without this information, programs might focus on HPV awareness; however, the results of this study illustrate that awareness is already high (near saturation) in target populations and other factors, such as strong and consistent physician recommendations, are more pivotal in increasing likelihood of vaccination. Additionally, our findings indicate the need for discussions of risk assessment be tailored to the young adult population.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-016-0323-5) contains supplementary material, which is available to authorized users.