Re-Engage: A Novel Nurse-Led Program for Survivors of Childhood Cancer Who Are Disengaged From Cancer-Related Care

Abstract

Background: Survivors of childhood cancer often experience treatment-related chronic health conditions. Survivorship care improves survivors’ physical and mental health, yet many are disengaged from care. Innovative models of care are necessary to overcome patient-reported barriers to accessing survivorship care and to maximize survivors’ health. Methods: We piloted a novel survivorship program, called “Re-engage,” a distance-delivered, nurse-led intervention aiming to engage, educate, and empower survivors not receiving any cancer-related care. Re-engage involves a nurse-led consultation delivered via telephone/online to establish survivors’ medical history and needs. Participants completed questionnaires at baseline, 1 month postintervention, and 6-month follow-up. Results: A total of 27 survivors who had not accessed survivorship care in the last 2 years participated (median age, 31 years; interquartile range [IQR], 27–39 years); of which, 82% were at high-risk for treatment-related complications. Participation in Re-engage was high (75%) and there was no attrition once survivors enrolled. At 1 month postintervention, 92% of survivors reported that Re-engage was “beneficial,” which all survivors reported at 6-month follow-up. Survivors’ overall satisfaction with their care increased from 52% before Re-engage to 84% at 1 month postintervention. Survivors’ mean self-efficacy scores remained similar from baseline to 1 month postintervention (b = −0.33, 95% CI, −1.31 to 0.65), but increased significantly from baseline to 6-month follow-up (b = 1.64, 95% CI, 0.28–3.00). At 6-month follow-up, 73% of survivors showed an increase in health-related self-efficacy compared with baseline. Conclusions: Re-engage is a highly acceptable and feasible intervention and promotes health-related self-efficacy, which is integral to survivors being advocates for their own health. Further empirical work is needed to evaluate the long-term efficacy of Re-engage.Trial registration: ACTRN12618000194268

The lived experience of children and adolescents with cancer

“…Interventions are also needed to engage, educate and empower survivors to manage their own health (eg the Re-engage program, recently renamed Engage) 14 and meet survivors' unmet information needs related to late effects, as well as parents' unmet information needs, particularly related to their child's fertility. 15 Improving survivors' adherence to health behaviour guidelines is critical, as there now exists strong evidence that positive health behaviours are fundamental, effective prevention strategies to lower the prevalence of late effects of cancer.…”

The COVID‐19 pandemic: Distance‐delivered care for childhood cancer survivors

“…To maintain the availability of survivorship care in Sydney, Australia, we are implementing “ Re‐engage ,” an existing intervention with promising pilot data 8 . Re‐engage offers distanced‐delivered multidisciplinary medical review to childhood cancer survivors, supported by nurse‐led telehealth 8 .…”

“…To maintain the availability of survivorship care in Sydney, Australia, we are implementing “ Re‐engage ,” an existing intervention with promising pilot data 8 . Re‐engage offers distanced‐delivered multidisciplinary medical review to childhood cancer survivors, supported by nurse‐led telehealth 8 . Re‐engage was originally designed for childhood cancer survivors, who had not received cancer‐related care in over 2 years, by overcoming some of the barriers related to accessing hospital‐based clinical care.…”

“…Re‐engage was originally designed for childhood cancer survivors, who had not received cancer‐related care in over 2 years, by overcoming some of the barriers related to accessing hospital‐based clinical care. The Re‐engage pilot results indicate that survivors readily adopt the intervention (76% uptake; 0% attrition), perceive Re‐engage as beneficial (100% endorsement), and are highly satisfied with the amount and quality of information received (96% endorsement) 8 . Critically, survivors who participated in Re‐engage were diagnosed with, on average, 10 untreated late effects, and more than 50% required specialist referral for cardiac, metabolic, and mental health issues 9 .…”

Patterns and Predictors of Healthcare Use among Adolescent and Young Adult Cancer Survivors versus a Community Comparison Group

“…The Youth Cancer Services provide survivorship care tailored to AYAs diagnosed between the ages of 15 and 25 years, across pediatric hospitals (for AYAs diagnosed between 15 and 17 years old) and adult hospitals (for AYAs diagnosed at 18 years and older) [ 30 ]. The positive, age-appropriate communication and support experiences that these services can facilitate appear to lead to improved quality of life [ 21 , 24 , 31 ] and may foster greater engagement into long-term cancer survivorship than traditional, medically-driven models of care by accounting for the particular psychosocial needs of AYAs [ 27 , 29 , 32 , 33 , 34 , 35 ].…”