Date of Award
Doctor of Philosophy (PhD)
PURPOSE: Cancer survivors have complex journeys following the completion of active treatment. The Institute of Medicine and other high-profile organizations have recommended and mandated the use of a survivorship care plan (SCP) despite mixed evidence supporting the impact of SCPs on key survivor-level outcomes. The purpose of this dissertation was to understand the complex relationship linking the delivery of SCPs and to relevant survivorlevel outcomes. STUDY GROUP: This dissertation focuses on breast and colorectal cancer survivors because they comprise nearly 30% of the entire cancer survivor population in the US and are the two most prevalent cancers in men and women. METHODS: The first paper was a cross-sectional study using structural equation modeling to assess hypothesized pathways linking SCPs to survivor-level outcomes among a nationally representative sample of colorectal and breast cancer survivors from the Health Information National Trends Survey (HINTS). The second paper involved semi-structured interviews with safety-net breast and colorectal cancer survivors to elucidate the experiences with and relevant outcomes of survivorship care planning. The third paper used an adapted-mixed methods approach to provide a high-level synthesis of relevant survivor-level outcomes. RESULTS: The first paper found no total or direct effects linking the receipt of a SCP to survivor-level outcomes. Paper two found that the participants reported positive experiences with the survivorship care planning process and stated that their oncology care team prepared them for life post-treatment. The third paper modified a conceptual framework for survivorship care planning research by emphasizing the role of communication and distinguishing outcomes specific to the care planning process versus outcomes that likely require a survivor-level intervention. CONCLUSION: These findings emphasize the central role of patient-centered communication in the survivorship care planning process and identified survivor-level characteristics and determinants that are likely to impact outcomes across the survivorship continuum.
AUSTIN, JESSICA DANIELLE, "UNDERSTANDING THE RELATlONSHIPS BETWEEN SURVIVORSHIP CARE PLANS AND SURVIVOR LEVEL OUTCOMES AMONG BREAST AND COLORECTAL CANCER SURVIVORS" (2019). UT School of Public Health Dissertations (Open Access). 208.