Social Health, Activity Behaviors, and Quality of Life among Young Adult Cancer Survivors: A longitudinal Study Administrative Supplement

Abstract This application is being submitted in response to the Notice of Special Interest (NOSI) identified as "NOT-CA- 24-041.” A growing population of survivors of young adult (YA) cancers experiences long-term risks across multiple health domains, including impaired social connection, poor health behaviors, financial toxicity,

infertility, early onset chronic conditions, and second cancers. Access to and receipt of high-quality survivorship care is therefore of paramount importance for YAs, who have many life-years to live. The parent study (1R37CA256867-01) characterizes trajectories of social health in YAs from diagnosis through treatment

and beyond, investigates the longitudinal association between social health and activity behaviors in YA survivors, and explores the effects of sociodemographics and clinical characteristics on the relationship between social health, activity behaviors, and quality of life. Importantly, survivorship care also targets and

aims to improve these outcomes. Therefore, data on YAs’ access to, utilization, and quality of survivorship care after completion of active treatment will enhance exploratory analyses of the parent study. In addition, the growing number of survivorship clinics developed to serve older or younger populations may or may not

adequately address the unique issues survivors of YA cancers face. Understanding the degree to which existing survivorship programs that serve YAs align with new National Standards for Survivorship Care (“National Standards”) can inform the development of similar survivorship programs to serve this at-risk

demographic. Further, little to no existing research comprehensively characterizes access to survivorship care among racially and ethnically diverse survivors of YA cancers, who experience disparities in survivorship outcomes. A nuanced understanding of access from the perspective of diverse survivors of YA cancers is

needed to guide efforts to increase access and address health inequities. To address these gaps, we propose a mixed methods study to characterize survivorship care delivery to YAs at an academic comprehensive cancer center which includes a large safety net hospital. Aim 1: Assess the extent to which there is alignment

between the National Standards for Survivorship Care and an academic cancer center survivorship program that serves diverse YAs. Aim 2: Assess survivorship care utilization and access, including barriers and facilitators, among diverse survivors of YA cancers obtaining care within a) an academic cancer center

survivorship program and b) the surrounding community. Aim 3: Develop a brief report that synthesizes findings and identifies multi-level gap areas for future development and disseminate to NCI and stakeholders. Findings of this study will illuminate opportunity areas for YA cancer survivorship care delivery in alignment

with the new National Standards, and, thereby, inform efforts to develop and implement high-quality survivorship programs that serve and engage diverse YA survivors.