Oluwaseyi Adetutu Lawal

PURPOSE: Sleep, fatigue, and pain are common symptoms in cancer survivors. Mindfulness-based cancer recovery (MBCR) and Tai Chi/Qigong (TCQ) are beneficial for these conditions, but have not been studied together. The Mindfulness and Tai Chi for Cancer Health (MATCH) study was designed to incorporate innovative design features, including patient choice, while evaluating two interventions for distressed cancer survivors with predefined secondary outcomes, including sleep, fatigue, and pain. METHODS: Participants chose one of the two interventions or chose to be randomly assigned into either intervention, then were further randomly assigned into immediate intervention or waitlist groups. We evaluated the efficacy of MBCR and TCQ, whether participants' choices affected intervention effects, and correlations among changes in sleep, fatigue, and pain. RESULTS: Participants (N = 587) were on average 60.7 years, with multiple types and stages of cancer. At postintervention, compared with waitlist controls, the TCQ group had an average improvement of 1.9 points on the sleep quality scale, which remained statistically significant compared with controls after adjustment for age, sex, cancer stage, and preference ( P = .004). Compared with waitlist controls, both MBCR and TCQ groups had significantly improved fatigue with mean improvements of 3.66 and 3.42 points, respectively (MBCR: P = .036. TCQ: P = .043) and over 1 point of change on pain interference (MBCR: P = .029. TCQ: P = .002). MBCR and TCQ did not differ from one another. Preference status did not affect outcomes. Significant correlations were observed among changes in sleep, fatigue, and pain interference, suggesting mild to moderate associations. CONCLUSION: Compared with waitlist controls, MBCR and TCQ both improved fatigue and pain interference at post-intervention, and TCQ also improved sleep quality. Correlations across outcomes highlight the importance of addressing clusters of cancer symptoms within a whole-person health framework.

Background: With this study, we aimed to investigate the longitudinal relationships between lifestyle behaviors and physical health in childhood, adolescent, or young adult (CAYA) cancer survivors attending the Long‐Term Survivor's Clinic (LTSC) in Calgary, Canada. Methods: Survivors attended the LTSC once or twice a year and completed a questionnaire at each visit. Among survivors of any cancer diagnosis who were aged ≥ 11 years at the time of assessment, physical health was captured using two outcomes: the number of self‐reported physical health problems and the number of physical health‐related medications used. Self‐reported lifestyle behaviors, including physical activity, alcohol, tobacco, and cannabis use, and sleep quality were scored as healthy (1) or unhealthy (0), and combined into a sum score ranging from 0 to 5. Multivariable, generalized linear mixed models (GLMM) were estimated to assess the association between lifestyle behaviors (sum score and individual behaviors) and physical health outcomes, irrespective of time. To address our second research question, cross‐lagged GLMMs, incorporating a time component, were estimated to assess directionality between lifestyle sum score and the number of physical health problems. Results: In total, 766 responses from 312 CAYA cancer survivors (median age at follow‐up 23.8 years; 49% male; 37% diagnosed with leukemia) were included. A healthier lifestyle sum score and sufficient physical activity were associated with fewer physical health problems (estimate −0.15, SE 0.06, p ‐value 0.02 and estimate −0.23, SE 0.11, p ‐value 0.04, respectively). No significant associations were found between lifestyle and the number of medications used. Lifestyle behaviors at an earlier time did not predict better physical health at a later time and vice versa. Conclusions: Findings confirm an association between a healthy lifestyle and fewer physical health problems. Additional studies are warranted to further elucidate directional pathways between a survivor's lifestyle and physical health.

Introduction: Childhood cancer survivors (CCS) are at lifelong risk for late adverse health outcomes. Healthy behaviors, including physical activity, substance avoidance, adequate sleep, and sun protection, are critical to mitigating these risks. Yet, data on their prevalence and determinants in this population remain limited. This study aims to describe health behaviors among adolescent and young adult (AYA) CCS in Alberta, Canada, compare them with population‐based controls, and identify associated factors for suboptimal health behaviors. Methods: This is a longitudinal cohort study of 312 CCS aged ≥ 11 years enrolled in the Long‐Term Survivor Clinic at the Alberta Children's Hospital between July 2021 and July 2025. Self‐reported questionnaires captured health behavior outcomes and covariates. Comparisons were made with Canadian Community Health Survey (CCHS) controls. Risk factors were determined using Bayesian analyses. Results: Among 312 participants (median age 22.1 years [interquartile range 8.78]; 50.6% female) at baseline, 31% did not meet physical activity recommendations, 13% reported current tobacco use, 29% reported current cannabis use, 0.1% reported poor sleep quality, and 47% reported only sometimes or rarely using sunscreen, with 14% never using sunscreen. Only 5.8% reported ever using artificial tanning devices. Compared with controls, CCS had higher rates of insufficient physical activity and e‐cigarette use but lower rates of alcohol and medicinal cannabis use. Older age predicted artificial tanning, while male sex was associated with tobacco use and lower sunscreen adherence. Treatment intensity was not associated with any of the health behaviors. Conclusion: In this study, age and sex rather than treatment intensity predicted health behaviors. Emerging behaviors, such as e‐cigarette and medicinal cannabis use, highlight gaps in current survivorship care and the need for standardized counseling frameworks. Overall, the integration of routine health behavior assessments and targeted interventions addressing these behaviors and associated factors is warranted to optimize long‐term AYA survivorship outcomes.

PURPOSE: Many cancer survivors have high levels of distress and psychosocial symptoms. Two mind-body interventions for treating these problems are Mindfulness-Based Cancer Recovery (MBCR) and Tai Chi/Qigong (TCQ). However, while both interventions show efficacy compared with usual care, they have never been studied together. This trial was the first, to our knowledge, to incorporate innovative design features including patient choice while evaluating two interventions to treat distressed cancer survivors. METHODS: A preference-based multisite randomized comparative effectiveness trial design with broad pragmatic inclusion criteria was used. Participants with a preference for either MBCR or TCQ received their preferred intervention, while those without a preference were randomly assigned 1:1 into either intervention. Furthermore, participants were all randomly assigned 2:1 into immediate intervention or waitlist control. Total mood disturbance (TMD) on the Profile of Mood States after intervention was the primary outcome. RESULTS: Five hundred eighty-seven participants provided baseline data, 75% were female, with an average age of 60.7 years. Of 12 cancer types, the most prevalent were breast (40.7%), prostate (11.2%), and GI (9.7%) cancers. Most had stage 0-II (50.1%) diagnoses, with 17% having more advanced disease. Approximately two thirds had a preference, with 57% of those choosing TCQ and 43% choosing MBCR. The remaining 36% were equally randomly assigned. Choosing a specific program or choosing to be randomly assigned had no significant effect on outcomes. Both the combined random assignment and preference MBCR and TCQ groups improved more than their respective waitlists on TMD scores with small to medium effects. The largest improvements occurred for MBCR on subscales of tension, anger, and vigor and in TCQ on anger, depression, and vigor. CONCLUSION: This large, pragmatic trial demonstrated both mindfulness and TCQ interventions improved mood in distressed cancer survivors, whether they chose a program or chose to be randomly assigned.

PurposeThe Seattle Angina Questionnaire (SAQ) is a widely used patient-reported measure of health status in patients with coronary artery disease. Comparisons of SAQ scores amongst population groups and over time rely on the assumption that its factorial structure is invariant (i.e., equivalent). This study evaluates the measurement invariance of the SAQ across different demographic and clinical groups as well as over time.MethodsData were obtained from the Alberta Provincial Project on Outcome Assessment in Coronary Heart Disease registry, a population-based registry of patients who received coronary angiogram in Alberta, Canada. Health-related quality of life was measured using the 16-item Canadian version of the SAQ (SAQ-CAN). Multi-group confirmatory factor analysis was used to assess configural, weak, strong, and strict measurement invariance (MI) across age groups, sex, disease type, treatment, and over time. Model fit was assessed using the comparative fit index (CFI), and root mean square error of approximation (RMSEA).ResultsOf the 8101 patients who completed the measure at baseline, 1300 (16.1%) were at least 75 years old, while 1755 (21.7%) were female, 5154 (63.6%) were diagnosed with acute coronary syndrome, while 1177(14.5%) received coronary artery bypass graft treatment. There was evidence of strict invariance across age, sex, and disease groups, but partial strict invariance was established across treatment sub-groups and over time.ConclusionSAQ-CAN is a valid measure for comparing health-related quality of life of coronary artery disease patients across population groups and over time.

Background: The Seattle Angina Questionnaire (SAQ) is a widely-used patient-reported outcomes measure in patients with heart disease. This study assesses the validity and reliability of the SAQ in a Canadian cohort of individuals with stable angina. Methods and results: Data are from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry, a population-based registry of patients who received cardiac catheterization in Alberta, Canada. The cohort consists of 4052 patients undergoing cardiac catheterization for stable angina and completed the SAQ within 2 weeks. Exploratory factor analysis and confirmatory factor analysis (CFA) were used to assess the factorial structure of the SAQ. Internal and test–retest reliabilities of a new measure (i.e., SAQ-CAN) was measured using Cronbach α and intraclass correlation coefficient, respectively. CFA model fit was assessed using the root mean square error of approximation (RMSEA) and comparative fit index (CFI). Construct validity of the SAQ-CAN was assessed in relation to Hospital Anxiety and Depression Scales (HADS), Euro Quality of life 5 dimension (EQ5D), and original SAQ. Of the 4052 patients included in this analysis, 3281 (80.97%) were younger than 75 years old, while 3239 (79.94%) were male. Both exploratory and confirmatory factor analyses revealed a four-factorial structure consisting of 16 items that provided a better fit to the data (RMSEA = 0.049 [90% CI = (0.047, 0.052)]; CFI = 0.975). The 16-item SAQ demonstrated good to excellent internal reliability (Cronbach’s α range from 0.77 to 0.90), moderate to strong correlation with the Original SAQ and EQ5D but negligible correlations with HADS. Conclusion: The SAQ-CAN has acceptable psychometric properties that are comparable to the original SAQ. We recommend its use for assessing coronary health outcomes in Canadian patients with Coronary Artery Disease.

Objective: No validated tools exist to assess satisfaction with epilepsy surgery. We aimed to develop and validate a new measure of patient satisfaction with epilepsy surgery, the 19‐item Epilepsy Surgery Satisfaction Questionnaire (ESSQ‐19).Methods: An initial 31‐item measure was developed based on literature review, patient focus groups, thematic analysis, and Delphi panels. The questionnaire was administered twice, 4‐6 weeks apart, to 229 adults (≥18 years old) who underwent epilepsy surgery ≥1 year earlier, at three centers in Canada and one in Sweden. Participants also completed seven validated questionnaires to assess construct validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) assessed the factorial structure of the questionnaire. Cronbach alpha and intraclass correlation coefficients (ICCs) assessed the internal consistency and test‐retest reliability of the ESSQ‐19. Spearman and polyserial correlations assessed construct validity.Results: Median age of participants and time since surgery were 42 years (interquartile range [IQR] = 32‐54) and 5 years (IQR = 2‐8.75), respectively. EFA and CFA yielded 18 items that segregated into four domains (mean score [SD]), namely, seizure control (76.4 [25]), psychosocial functioning (67.3 [26]), surgical complications (84 [22]), and recovery from surgery (73 [24]), one global satisfaction item, and a summary global score (74 [21]). The domain and summary scores demonstrated good to excellent internal reliability (Cronbach ⍺ range = .84‐.95) and test‐retest reliability (ICC range = 0.71‐0.85). Construct validity was supported by predicted correlations with other instruments.Significance: The ESSQ‐19 is a new, valid, and reliable measure of patient satisfaction with epilepsy surgery that can be used in clinical and research settings.