Background/rationale: Childhood cancer survivors frequently face obstacles impacting survivorship care engagement. We developed the ‘Engage’ telehealth program, designed to improve survivors’ health-related self-efficacy (HRSE) and quality of life (QoL). Preliminary studies demonstrated that the ‘Engage’ intervention is acceptable to survivors and feasible to deliver. This study aimed to evaluate program’s the potential effectiveness (primary endpoint:12 months post-intervention).
Sample and setting: 103 survivors of cancer diagnosed <16 years and >5 years prior, treated at two Australian hospitals, at least two years post-treatment.
Procedures: The ‘Engage’ program has five elements: (1) an online health/lifestyle assessment; (2) telehealth nurse-led consultation; (3) multidisciplinary team case review; (4) individualized education, recommendations, and care planning for both survivors and their primary care providers; and (5) two follow-up telehealth consultations to reinforce key information. We measured survivors’ outcomes pre- and post-intervention (1, 6, and 12-months).
Results: Survivors were 53% female, median age=24 years, 30% living rurally, 56% brain cancer diagnosis. Survivors’ HRSE significantly improved at 1-, 6-, and 12-months post-intervention from baseline (all p<0.001), with peak improvement at 6-months (46% increase from baseline). QoL remained similar from baseline to 1- and 6-months post-intervention, improving significantly at 12-month post-intervention (p<0.011). Participants reported that ‘Engage’ helped “build my confidence and…take more charge of my own health”. Participant satisfaction with care increased significantly, from 68% pre-intervention to 96% at 12-months (p<0.001), with 82% reporting Engage had helped them to access survivorship care. Compared with baseline, anxiety (p=0.037), anger (p=0.037) and self-reported need for help (p=0.040) decreased significantly at 12-months post-intervention. Distress, depression, fatigue and financial toxicity remained similar over time.
Conclusion and clinical implications: The Engage remote survivorship program appears to enhance self-efficacy, QoL, and some mental health concerns in the long-term, underscoring the promise of personalised telehealth approaches to address childhood cancer survivors’ treatment-related health issues.