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Grant Details

Grant Number: 3R01CA077780-04S1 Interpret this number
Primary Investigator: Emmons, Karen
Organization: Dana-Farber Cancer Institute
Project Title: Smoking Cessation Among Childhood Cancer Survivors
Fiscal Year: 2002
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Abstract

Childhood cancer survivors represent a large and rapidly increasing group due to successes in cancer therapy over the last several decades. However, the treatments for childhood cancers tend to damage vital organs, and there is an increased risk of second cancers in childhood cancer survivors who may already have an innate susceptibility to neoplasia. Therefore, it is extremely important that preventable risk factors of cardiac, pulmonary, neoplastic, and other major diseases be minimized among this high-risk population. Interventions to reduce smoking prevalence among childhood cancer survivors are a critical component of efforts to reduce their preventable cancer morbidity and mortality. We recently completed Partnership for Health (PFH), the first large-scale smoking cessation intervention study to be conducted with childhood cancer survivors. The PFH intervention yielded a doubling of quit rates in the intervention group, compared to a self-help control group. PFH was conducted in the context of the Childhood Cancer Survivor Study (CCSS), a large epidemiologic cohort study of the late effects of treatment for childhood cancers. CCSS is a consortium of 22 cancer centers that enrolled over 14,000 patients into this surveillance program. The CCSS institutions are all members of the Children's Oncology Group (COG), which is our partner in this dissemination effort. As a result of the success of PFH, we plan to disseminate the intervention directly to the 235 COG institutions that provide on-going follow-up to the majority of childhood cancer survivors in the US and Canada. Our initial discussions with several COG members suggest that few of its member institutions currently offer smoking cessation services. The 235 COG institutions provide care to over 95% of North American children with cancer. The focus of this supplement will be on the process of dissemination of the PFH intervention to COG institutions, and the evaluation of the effectiveness of our dissemination efforts guided by a well-delineated theoretical framework. In addition to evaluating the relationship of organizational characteristics to program adoption, we will conduct a randomized control trial to determine whether providing assistance with the more labor-intensive aspects of implementation increases adoption and effective implementation. Outcomes include: intervention adoption (percent of cancer centers that adopt the program), quality of implementation (number of components implemented and level of implementation of each), and delivery of the intervention to survivors (number of survivors enrolled in the dissemination effort). COG's infrastructures and clinical trials network has resulted in dramatic improvements in cure rates for pediatric cancers. The proposed project will begin an effort to build on this success related to clinical therapeutic outcomes, and transfer it to cancer prevention outcomes.

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Publications

Long-term smoking cessation outcomes among childhood cancer survivors in the Partnership for Health Study.
Authors: Emmons KM, Puleo E, Mertens A, Gritz ER, Diller L, Li FP
Source: J Clin Oncol, 2009 Jan 1;27(1), p. 52-60.
EPub date: 2008 Dec 1.
PMID: 19047296
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A process evaluation of a telephone-based peer-delivered smoking cessation intervention for adult survivors of childhood cancer: the partnership for health study.
Authors: Park ER, Puleo E, Butterfield RM, Zorn M, Mertens AC, Gritz ER, Li FP, Emmons KM
Source: Prev Med, 2006 Jun;42(6), p. 435-42.
EPub date: 2006 Apr 19.
PMID: 16626797
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Peer-delivered smoking counseling for childhood cancer survivors increases rate of cessation: the partnership for health study.
Authors: Emmons KM, Puleo E, Park E, Gritz ER, Butterfield RM, Weeks JC, Mertens A, Li FP
Source: J Clin Oncol, 2005 Sep 20;23(27), p. 6516-23.
EPub date: 2005 Aug 22.
PMID: 16116148
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A qualitative exploration of health perceptions and behaviors among adult survivors of childhood cancers.
Authors: Park EB, Emmons KM, Malloy NW, Seifer E
Source: J Cancer Educ, 2002 Winter;17(4), p. 211-5.
PMID: 12556058
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Smoking among participants in the childhood cancer survivors cohort: the Partnership for Health Study.
Authors: Emmons KM, Butterfield RM, Puleo E, Park ER, Mertens A, Gritz ER, Lahti M, Li FP
Source: J Clin Oncol, 2003 Jan 15;21(2), p. 189-96.
PMID: 12525509
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Predictors of smoking initiation and cessation among childhood cancer survivors: a report from the childhood cancer survivor study.
Authors: Emmons K, Li FP, Whitton J, Mertens AC, Hutchinson R, Diller L, Robison LL
Source: J Clin Oncol, 2002 Mar 15;20(6), p. 1608-16.
PMID: 11896111
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