Dalnim Cho

Background: Survivors of young adult (YA) cancer often experience substantial stress during the transition to survivorship, which may impair sleep. Although the stress–sleep link is well established, its role within survivor–spouse dyads remains unclear. Emotional intimacy may influence how couples regulate stress and affect sleep. This study examined dyadic associations between stress and sleep among survivors of YA cancer and their spouses and significant others (hereafter spouses) and tested emotional intimacy as a moderator. Methods: A total of 103 survivor of YA cancer–spouse dyads completed self‐reported measures of stress, emotional intimacy, and sleep quality. An actor‐partner interdependence moderation model was used to test how each person's stress was related to their own and their spouse's sleep quality and the moderating role of emotional intimacy. Results: In our model, higher stress was associated with poorer sleep quality among both survivors ( β = 0.405, p < 0.001) and spouses ( β = 0.172, p = 0.041), indicating significant actor effects, whereas no partner effects from stress were observed. Emotional intimacy moderated the stress‐sleep association among survivors ( β = −0.224, p = 0.004), but not among spouses ( β = −0.012, p = 0.892). Conclusions: Stress emerged as a key intrapersonal determinant of sleep quality for both survivors of young adult cancer and their spouses, indicating that stress management may benefit sleep in both groups. Emotional intimacy buffered stress‐related sleep disruption among survivors, but not spouses, highlighting role‐specific mechanisms. Tailored approaches may improve sleep and quality of life.

Prostate cancer (PCa) disproportionately affects Black men and men of low socioeconomic status, who are more likely to experience higher incidence, disease progression, and mortality. Despite this, cardiovascular disease remains a leading cause of death among men with localized disease. Therefore, lifestyle interventions, particularly diet-based, provide an opportunity to drastically improve outcomes. Little is known about how underserved men with PCa and their families perceive barriers to dietary change, including adaptation of the cardioprotective Mediterranean diet (MD). This qualitative study explored dietary knowledge, cultural influences, and willingness to participate in dietary interventions among Black and Hispanic men with localized PCa at a county hospital. Six focus groups were conducted in English or Spanish with 31 total participants (men and their partners) recruited from a safety-net county hospital. Thematic analysis was guided by the health belief model and theory of planned behavior. Four themes emerged: First, the attitudes toward healthy diet and physician advice; second, the positive and negative influence of family, friends, and culture; third, the emotional and spiritual influences on dietary behavior; and finally, structural barriers and their impact on self-efficacy. Findings underscore the critical role of buy-in from family, the importance of education and instruction, and the value of maintaining space for emotion and spirituality. These results support the development of partner-engaged, culturally tailored dietary interventions for medically underserved populations with PCa.

Background: Prostate cancer is the most common noncutaneous malignancy among men and disproportionately affects those with low socioeconomic status, particularly men from racial and ethnic minority populations. Purpose: This study describes the development of a culturally tailored Mediterranean diet intervention for medically underserved Black and Hispanic men with prostate cancer, using the Intervention Mapping Adaptation (IM ADAPT) framework. Methods: Conducted at a county safety-net hospital in a large urban area, which serves a population with high medical needs and low socioeconomic status, the project aimed to ensure the intervention was culturally relevant and evidence-based. A collaborative process was used, involving community scientists and patient stakeholders to identify dietary barriers and preferences, while existing interventions were reviewed for cultural fit. Guided by the six steps of the IM ADAPT framework, stakeholder feedback was incorporated throughout the adaptation process. The result was a culturally adapted intervention that included tailored dietary modifications, food provision strategies, and educational materials specifically designed for Black and Hispanic men. Results: Completion of the IM ADAPT steps yielded a culturally adapted Mediterranean diet intervention incorporating tailored dietary recommendations, provision of food, and distribution of educational materials designed to meet the specific needs of Black and Hispanic men. Conclusions: The IM ADAPT framework enabled the development of a culturally tailored, evidence-based dietary intervention ready for pilot testing among medically underserved men with prostate cancer. This approach may serve as a replicable model for designing interventions for other racial and ethnic minority populations affected by cancer.

Although prostate cancer (PCa) survivors' health is closely interrelated with that of their spouses/significant others (hereafter spouses), little is known about this interdependence among Black PCa survivors. This study examined the concordance of health behaviors (physical activity (PA), diet quality) and body mass index (BMI) within survivor-spouse dyads, and how each individual's PA and diet quality relate to the other's BMI. Ninety-three Black PCa survivor-spouse dyads completed a survey on PA and diet quality. Height and weight were also self-reported and used to calculate BMI. We assessed PA, diet quality, and BMI concordance using intraclass correlation coefficients (ICCs). Actor and partner effects of PA and diet quality on BMI were tested via actor-partner interdependence models. The mean BMI of PCa survivors and spouses was 31.10 kg/m² and 30.52 kg/m², respectively. ICCs were 0.000 for PA (negligible), 0.453 for diet quality (high), and 0.093 for BMI (small-to-medium). A significant actor effect showed that higher PA among PCa survivors was associated with lower BMI (β = -0.236, p = 0.012). Meanwhile, no significant partner effects were observed. The high concordance in diet quality suggests that engaging spouses may be a promising strategy to improve Black PCa survivors' dietary behaviors. Enhancing Black survivors' PA remains critical for effective weight management. Future research should identify modifiable factors that affect spouses' BMI to inform the development of dyadic, weight-management interventions for Black PCa survivors and their spouses. Such efforts may help reduce the disproportionate survivorship burden among Black men.

Objective: Lymphomas are one of the primary cancers that affect adolescents and young adults (AYAs). We examined the feasibility of two group‐based interventions—one meditation‐based and one education‐based—for AYAs with lymphoma. We also explored their potential benefits for reducing psychological distress and cancer‐related symptom burden. Methods: Patients aged 18–39 years with lymphoma undergoing chemotherapy were randomized to either the meditation or psychoeducation intervention. Both received 5 weekly sessions (60 min each) delivered in a group setting via videoconferencing. Participants were assessed at baseline (T1), 6 weeks (T2), and 12 weeks (T3). Results: Participants were randomized to the meditation ( n = 28) or psychoeducation intervention ( n = 32) with a consent rate of 51.4%. Session attendance was similar across interventions, with 60.7% in the meditation intervention and 56.3% in the psychoeducation intervention attending all 5 sessions (χ ² (4) = 0.65). Assessment completion rates in the meditation intervention were 75% at T2 and 64% at T3; in the psychoeducation intervention, rates were 78% at both time points. From T1 to T3, the psychoeducation intervention showed significant improvements in cancer‐related symptom severity (mean difference = 0.75, p = 0.041) and interference (mean difference = 1.07, p = 0.028). Conclusions: Videoconference‐delivered, group‐based supportive care for AYAs with lymphoma during active cancer treatment appears feasible and may help reduce symptom burden or prevent further worsening of quality of life. Virtual delivery enhances accessibility and scalability across diverse clinical settings. Strategies to improve adherence and retention are needed to optimize engagement in this population. Clinical trial registration: ClinicalTrials.gov Identifier NCT04270266.

Background:Family and friends play a dual role in supporting and hindering young adults’ decisions about the human papillomavirus (HPV) vaccine. However, the mechanisms by which anticipated HPV vaccination stigma from these social circles affects vaccination intent remain largely understudied. This study applied the Information–Motivation–Behavioral Skills model to examine how anticipated HPV vaccination stigma from family and friends influences vaccination intent and its underlying mechanisms.Methods:Unvaccinated young adults (N = 728) ages 18 to 26 years in Texas completed a survey to assess anticipated HPV vaccination stigma from family and friends, vaccination intent, and mediators. Two parallel path analyses evaluated the association between anticipated HPV vaccination stigma from family and friends and vaccination intent, with self-efficacy, beliefs about sexual activity and vaccination need, and intent to consult a doctor as hypothesized skill- and belief-based mediators, controlling for demographics.Results:Indirect effects showed that stronger anticipated HPV vaccination stigma from family and friends was linked to weaker vaccination intent through reduced self-efficacy and a strengthened belief that limited sexual activity reduces vaccination need (total indirect effect for family: β = −0.050, P = 0.003). Stronger anticipated stigma from friends—not family—predicted weaker intent through reduced intent to consult a doctor (total indirect effect for friends: β = −0.079, P = 0.005).Conclusions:Anticipated HPV vaccination stigma undermines vaccination intent by weakening vaccination skills and reinforcing beliefs that discourage vaccination, with its influence differing by source.Impact:Tailored messaging is needed to equip young adults with the confidence and resources to overcome HPV vaccination stigma from family and friends, with each source addressed uniquely.

Supplemental Table 2 displays covariances among variables included in Path Analysis 1, which examined anticipated HPV vaccination stigma from friends. Standardized coefficients, p-values, and 95% confidence intervals are shown for both the saturated model (all pathways) and the trimmed model (significant pathways only).

Supplemental Table 1 presents all study variables, including the number of items per scale, item-level prompts, response ranges, aggregation methods, and internal consistency reliability (Cronbach’s α, where applicable).

Supplemental Table 4 summarizes total and specific indirect effects for age and sexual activity status in the trimmed model of Path Analysis 2 (anticipated HPV vaccination stigma from family). Both standardized and unstandardized coefficients are reported, along with p-values and 95% confidence intervals for unstandardized effects.

Supplemental Table 3 presents covariances among variables included in Path Analysis 2, which examined anticipated HPV vaccination stigma from family. The table reports standardized coefficients, p-values, and 95% confidence intervals for both the saturated model (including all pathways) and the trimmed model (including only significant pathways).