Kristin Morrill Nisbet

The purpose of this systematic review is to summarize what is known about the implementation of interventions targeting resiliency in caregivers of pediatric cancer patients to inform translation of effective strategies to the general population. Studies primarily conducted in North America evaluated various intervention strategies, predominantly delivered individually, to improve caregivers’ coping skills, emotional well-being, and quality of life. Despite methodological diversity, including pilot and non-pilot designs, interventions generally reported positive impacts on psychosocial outcomes such as anxiety, depression, and resilience. Challenges identified include participant attrition, logistical barriers, and varying resource availability across study sites, highlighting implementation considerations for broader application. Recommendations include enhancing intervention specificity and addressing diversity gaps in participant demographics and intervention settings to optimize effectiveness and generalizability. Future research directions emphasize mechanistic pathways, implementation strategies, and adaptation frameworks to tailor interventions for diverse populations facing significant stressors beyond pediatric cancer caregiving.

The specific aim of this project was to test a model of neighborhood disadvantage and social isolation as potential correlates of physical and psychological symptoms in a sample of cancer survivors who are either in, or have recently completed, treatment. Participants were 846 cancer survivors who were currently in treatment (N = 400) or who had recently completed treatment (N = 446). The sample was 80% women with a mean age of 58.72 (SD = 12.81) years. The most common type of cancer represented in the sample was breast (51%). Participants completed measures of physical and psychological symptoms and social isolation and social support. These data were merged with the 2021 American Community Survey indicators of neighborhood disadvantage by zip code and county. After controlling for Hispanic ethnicity, education, and household income, survivors who resided in disadvantaged neighborhoods, as indicated by the fraction of residents living in poverty, receiving income assistance, without health insurance, and with less than a high school education, reported higher psychological and physical symptoms. Similarly, social isolation was positively associated with psychological symptoms and physical symptoms. Residing in a disadvantaged neighborhood and feeling socially isolated may represent independent risk factors for psychological morbidity and physical symptom burden among cancer survivors.

Objective: This study aimed to explore cancer survivors' and caregivers' presenteeism (work performance) and absenteeism (missed work), and associations with work performance in the prior year and psychological symptoms (depressive and anxiety symptoms, symptom severity). Methods: Cross-sectional baseline data of a larger trial were analyzed to explore associations between absenteeism and presenteeism with prior work performance and psychological symptoms. Results: Among survivors (N = 309) and caregivers (N = 306), increased depressive and anxiety symptoms were associated with decreased work performance; survivors' anxiety was associated with absenteeism. Prior work performance was associated with better current work performance among survivors and caregivers. In survivors only, prior work performance was associated with reduced current absenteeism. Conclusions: Experiencing depressive and anxiety symptoms may decrease survivors' and caregivers' work performance. Addressing these symptoms may help survivors and caregivers improve work performance.

This study compared three ethnic/racial groups of informal cancer caregivers on social determinants of health and tested social determinants of health as predictors of psychological distress and caregiver burden. This study was a secondary analysis of baseline data of a sequential multiple assignment randomized trial (SMART) testing symptom management interventions with caregiver-survivor dyads. Caregivers completed baseline measures of social determinants of health (SDoH), functional limitations, psychological distress, and caregiver burden. Hispanic, non-Hispanic White, and non-Hispanic other races caregivers were compared on these variables. Multivariate tests of associations between SDoH and caregiver burden and psychological distress were conducted in structural equation modeling with caregiver burden and psychological distress as latent variables. Hispanic caregivers reported significantly higher caregiver burden, specifically for finances, family, and schedules. Caregiver burden was significantly predicted by having income barely or not meeting needs, being female, socially isolated, married, Hispanic, and having poor physical functioning. Significant predictors of caregivers' psychological distress: being female, being socially isolated, and having poor physical functioning. Hispanic caregivers experience significant challenges associated with caregiver burden, especially if they are female, socially isolated, and have poor physical functioning. Assessment of these SDoH is important in caregiver health to provide supportive care during caregiving. NCT03743415 www.clinicaltrials.gov.

Introduction: Treatment delays are significantly associated with increased mortality risk among adult cancer patients; however, factors associated with these delays have not been robustly evaluated. This review and meta-analysis will evaluate factors associated with treatment delays among patients with five common cancers. Methods and analysis: Scientific databases including Ovid MEDLINE, Elsevier Embase, EBSCOhost CINAHL Plus Full Text, Elsevier Scopus and ProQuest Dissertations and Theses Global will be searched to identify relevant articles published between January 2000 and October 2021. Research articles published in the USA evaluating factors associated with treatment delay among breast, lung, prostate, cervical or colorectal adult cancer patients will be included. The primary outcome of the meta-analysis will be the pooled adjusted and unadjusted odds of treatment delay for patient, disease, provider and system-level factors defined according to specified time intervals. The secondary outcomes will be mean or median treatment delay for each cancer site according to first treatment and the influence of factors on the pooled mean treatment delay for each cancer site (via meta-regression analyses). Results from qualitative and mixed-methods studies will be narratively synthesised. Three reviewers will independently screen records generated from the search and two reviewers will independently extract data following a consensus agreement. Statistical heterogeneity will be assessed with a standard I ² test and funnel plots will be conducted to evaluate publication bias. Risk of bias will be assessed independently by two authors using validated tools according to the article’s study design. Ethics and dissemination: Formal ethical approval is not required because the work is being carried out on publicly accessible studies. The findings of this review will be disseminated through a peer-reviewed scientific journal, academic conferences, social media, and key stakeholders. PROSPERO registration number: CRD42021293131.

Background. Obesity rates in Hispanic women residing in the United States (U.S.) are disproportionately high, increasing the risk of obesity-related disease and mortality. The effectiveness of interventions targeting weight loss in this population remains largely unknown. Purpose. The purpose of this review was to systematically evaluate the evidence related to the effectiveness of weight loss interventions conducted among U.S. Hispanic women and provide guidance for future research. Methods. Bibliographic databases (n=10, from each databases inception to July 2, 2019) were searched using the PRISMA guidelines for systematic reviews. Randomized controlled trials (RCTs) and quasi-experimental studies with weight change outcomes were included. Results were described in a narrative synthesis. Results. 5,423 articles were assessed for eligibility based on inclusion criteria; 15 studies were included in the final review. Nine trials were RCTs and six were quasi-experimental studies; all but six were pilot studies. Most studies recruited overweight or obese women with no existing medical conditions and did not follow participants beyond the intervention. All trials were delivered in-person. Intervention strategies and content and weight change outcomes were highly variable. Conclusions. RCTs with statistically powered sample sizes are needed to robustly test the effects of weight loss interventions in this population.