"Just for pregnant women, not for you": a qualitative evaluation of the sexual and reproductive healthcare experiences of transgender and gender diverse cancer survivors.

Purpose: To identify opportunities to improve sexual and reproductive health (SRH) care for transgender and gender diverse (TGD) cancer survivors by describing (1) challenges experienced when navigating SRH care and (2) strategies to help overcome these challenges.

Methods: We enrolled a purposive sample of 17 adult TGD cancer survivors and 5 co-survivors. We aimed for a diverse sample across cancer experience, age, racial/ethnic background, sexual orientation, and gender identity.

"Infertility Isn't a Choice!": Conversations on Twitter about the Financial Burden of Oncofertility Care.

This study aimed to evaluate how the adolescent and young adult (AYA) cancer community utilized Twitter to discuss the financial challenges of oncofertility care and to advocate for change. Tweets related to oncofertility and finances ( = 166), collected over a 12-week time period encompassing AYA Cancer Awareness Week, were thematically analyzed. Conversations highlighted how the high cost of care contributed to already high emotional and social distress.

Prevalence and predictors for fertility-related distress among 1010 young adults 1.5 years following cancer diagnosis - results from the population-based Fex-Can Cohort study.

Background: Cancer treatment during reproductive ages may negatively impact fertility and there is a need of firm knowledge about the prevalence and predictors of fertility-related distress. The aim was to examine fertility-related distress in a population-based sample of young women and men recently treated for cancer and to identify predictors for this outcome.

Material And Methods: This nationwide cohort study included 1010 individuals (694 women and 316 men), mean age 34.

Health Care Provider Perceptions of Using Social Media to Improve Sexual Health for Adolescent and Young Adult Cancer Survivors.

This study explored (1) health care provider (HCP) perceived barriers and facilitators to social media communication about sexual health with adolescent and young adult survivors, and (2) strategies that can help HCPs navigate social media use for this purpose. Thematic analysis of 11 semistructured HCP interviews resulted in four themes and suggests that social media platforms offer a promising avenue to foster sexual health communication but that resources and training are needed to improve HCP capacity to use this approach ethically and effectively. Future studies are needed to determine specific communication strategies and whether these strategies would lead to improved outcomes.

Feasibility of Mindful After Cancer: Pilot Study of a Virtual Mindfulness-Based Intervention for Sexual Health in Cancer Survivorship.

Background: Mindfulness-based interventions (MBIs) are increasingly recognized as an effective strategy for supporting female cancer survivors experiencing sexual health concerns.

Aim: To examine the feasibility of a sexual health MBI, Mindful After Cancer, which was adapted to meet the needs of breast and gynecologic cancer survivors in a community setting and for delivery via videoconference.

Methods: A mixed-methods approach was used to evaluate the acceptability, feasibility, and appropriateness of the 8-week virtual MBI.

Active Engagement, Protective Buffering, and Depressive Symptoms in Young-Midlife Couples Surviving Cancer: The Roles of Age and Sex.

Objective: Cancer researchers have found midlife couples to have poorer outcomes compared to older couples due to the off-time nature of the illness for them. It is unknown if young couples (aged 18-39), who are under-represented in cancer studies and overlooked for supportive programs, are at further risk. This study explored the moderating roles of survivor age and sex on the associations between active engagement and protective buffering and depressive symptoms in couples surviving cancer.

Adapting a Theory-Informed Intervention to Help Young Adult Couples Cope With Reproductive and Sexual Concerns After Cancer.

Objective: Most young adults diagnosed with breast or gynecologic cancers experience adverse reproductive or sexual health (RSH) outcomes due to cancer and its treatment. However, evidence-based interventions that specifically address the RSH concerns of young adult and/or LGBTQ+ survivor couples are lacking. Our goal is to develop a feasible and acceptable couple-based intervention to reduce reproductive and sexual distress experience by young adult breast and gynecologic cancer survivor couples with diverse backgrounds.

Dyadic support across contraceptive decision-making among young adult breast cancer survivors and their partners.

Objective: The purpose of this study is to explore the role of dyadic support across the contraceptive decision-making process between young adult breast cancer (YABC) survivors and their partners.

Research Approach: Semi-structured interviews with YABC survivors and their partners.

Participants: Twenty-five young adult breast cancer survivors and their partners ( = 50).

Open Communication and Physical Intimacy in Young and Midlife Couples Surviving Cancer Beyond the First Year of Diagnosis.

Objectives: To assess the association between levels of dyadic coping (e.g., collaboration, communication) and sexual satisfaction in young and midlife couples surviving cancer beyond the first year of diagnosis.

Challenges experienced and resources identified by young to midlife couples 1-3 years post-cancer diagnosis.

Objective: The purpose of this study was to explore what young to midlife couples viewed as their strengths as a couple and the greatest challenges in their experience with cancer 1-3 years post-diagnosis.

Methods: We used qualitative content analysis to extract common themes from open-ended questions from 42 cancer survivors and their partners (aged 27-58). Patterns of themes by age and gender of the survivor were also explored.

Adaptation and feasibility of a multimodal mindfulness-based intervention to promote sexual health in cancer survivorship.

Sexual health concerns after cancer are common and distressing, and mindfulness-based interventions (MBIs) are effective in supporting women experiencing these concerns. The goals of this study were to: (i) systematically adapt and document modifications to a mindfulness-based sexual health intervention for cancer survivors in a community setting and (ii) assess feasibility, appropriateness, and acceptability, and to identify strategies to increase reach for future implementation and dissemination. Following the ADAPT-ITT model, we first conducted key informant interviews with 10 female cancer survivors and four healthcare providers to obtain feedback on perceived need and feasibility of the intervention approach, and preferences for content, structure, and delivery format.

Measuring sediment grain size across the catchment to reef continuum: Improved methods and environmental insights.

Sediments collected within freshwater, estuarine and marine habitats were used to trial various chemical and physical pre-treatments to develop a systematic protocol for grain-size analysis using laser diffraction. Application of this protocol mitigates the influence of bio-physical processes that may transform grain-size distributions, enabling the characterisation and quantification of 'primary' mineral sediments across the complex freshwater-marine continuum to be more reliably assessed. Application of the protocol to two Great Barrier Reef (Australia) river catchments and their estuaries reveals the ecologically relevant <20 μm fraction comprises a larger component of exported sediment than existing methods indicate.

Patient-Centered Communication to Address Young Adult Breast Cancer Survivors' Reproductive and Sexual Health Concerns.

Women faced with a diagnosis of breast cancer as young adults commonly experience negative effects of cancer and cancer treatment on their reproductive and sexual health (RSH) that are inadequately addressed by their healthcare providers (HCPs). The objectives of this study were to 1) identify approaches to improving RSH communication from YA breast cancer survivors' perspectives, 2) identify facilitators and barriers to the approaches identified, and 3) identify specific strategies to improve patient-centered RSH communication. We conducted individual telephone interviews with 29 women who were diagnosed with breast cancer under age 40 years.

Higher reproductive concerns associated with fertility consultation: a cross-sectional study of young adult male cancer survivors.

Purpose: This study examined associations between fertility consultation (FC) and multiple dimensions of reproductive concerns among young adult (YA) male cancer survivors.

Methods: One hundred and seventy YA male cancer survivors (age 18 to 35) across the USA completed an online survey between 2016 and 2018. Participants reported demographics, receipt of FC, and reproductive concerns.

Measuring the Multidimensional Reproductive Concerns of Young Adult Male Cancer Survivors.

The aims of this study were to adapt the multidimensional Reproductive Concerns After Cancer (RCAC) scale for use with young adult (YA) male cancer survivors, defined as current age 18-35 years and at least 1 year postdiagnosis, and to examine the factor structure, reliability, and validity of the newly adapted RCAC-Male (RCAC-M) scale. We conducted cognitive interviews with 10 YA male cancer survivors to inform modifications to RCAC item wording. Online surveys were then completed by 170 YA male cancer survivors.

Navigating sexual health in cancer survivorship: a dyadic perspective.

Purpose: This qualitative study examined how young adult breast cancer survivors (YABCS) and their partners appraised and managed their sexual health and intimate relationships after cancer.

Methods: We conducted concurrent, individual telephone interviews with 25 YABCS and their male partners. We utilized a thematic, inductive analysis to examine individual interviews, followed by analysis within and across couples to identify dyadic themes.

Revisiting the Reproductive Concerns After Cancer (RCAC) scale.

Objective: The aims of this study were to examine the factor structure and reliability of the multidimensional Reproductive Concerns After Cancer (RCAC) scale in a sample of female cancer survivors during their reproductive years, younger than age 45.

Methods: Female reproductive-aged survivors (N = 238; current age, 18 to 44 y) with a variety of cancer diagnoses completed a web-based survey that included the RCAC scale. Three structural models were examined via confirmatory factor analysis: (a) one-factor, (b) higher-order with one second-order factor and six first-order factors, and (c) oblique six-factor.

Contraceptive utilization and counseling among breast cancer survivors.

Purpose: To explore contraceptive counseling and utilization among breast cancer survivors.

Methods: We enrolled reproductive-aged women with a history of breast cancer for a cross-sectional study. Participants were recruited via the Athena Breast Health Network and via the Young Survival Coalition's social media postings.

Efficacy of a web-based women's health survivorship care plan for young breast cancer survivors: a randomized controlled trial.

Purpose: Breast cancer survivorship care plans (SCP) have limited content addressing women's health issues. This trial tested if young breast cancer survivors who receive a web-based, women's health SCP were more likely to improve on at least one of the four targeted issues (hot flashes, fertility-related concerns, contraception, and vaginal symptoms) compared to attention controls.

Methods: A randomized controlled trial recruited female survivors ages 18-45 at diagnosis, 18-50 at enrollment, completed primary cancer treatment, and had a significant women's health issue: moderate or higher fertility-related concerns; ≥ 4 hot flashes/day with ≥ 1 of moderate severity; ≥ 1 moderate vaginal atrophy symptoms; or not contracepting/using less effective methods.

Applying behavioral theory to understand fertility consultation uptake after cancer.

Objective: The objective of this study was to examine the association between theoretical constructs from the Health Belief Model and fertility consultation status after cancer.

Methods: Reproductive-aged female cancer survivors self-reported their use of fertility consultation, perceived severity of and susceptibility to infertility, perceived barriers to and effectiveness of fertility consultation, and cues to action from family/peers and doctors, as well as demographics and cancer characteristics. Logistic regression was used to analyze the association between theoretical constructs and fertility consultation status.

Design of a randomized controlled trial on the efficacy of a reproductive health survivorship care plan in young breast cancer survivors.

Background: Young breast cancer survivors (YBCS) have unmet needs for managing hot flashes, fertility-related concerns, sexual health, and contraception.

Purpose: Describe the design and participant characteristics of a randomized controlled trial testing the efficacy of the survivorship care plan on reproductive health (SCP-R) intervention on improving hot flashes, fertility-related concerns, sexual health, and contraception in YBCS.

Methods: SCP-R is a web-based intervention with text message support encompassing evidence- based practices on four reproductive health issues.

Fertility counseling before cancer treatment and subsequent reproductive concerns among female adolescent and young adult cancer survivors.

Background: Fertility counseling before cancer treatment has been advocated by clinical guidelines, though little is known about its long-term impact on the unique reproductive concerns of female adolescent and young adult (AYA) cancer survivors. The goal of this study was to measure the association between fertility counseling by fertility specialists before cancer treatment and subsequent reproductive concerns.

Method: A cross-sectional analysis was performed among 747 AYA survivors aged 18-40 years who had been recruited from cancer registries and physician and advocacy group referrals between 2015 and 2017.