DESCRIPTION (provided by applicant): During adolescence, individuals become increasingly autonomous in setting and pursuing personal goals that are important for their well-being and transition to adulthood. When cancer occurs during adolescence, these critical developmental processes may be compromised. Little research has demonstrated the impact of having cancer in adolescence and no research has specifically assessed the impact of health on pursuit of personal goals in adolescents with cancer. However, some research with adults with chronic illness has measured the impact of health on personal goal pursuit (i.e.. health-related hindrance) and the subsequent adverse effects on well-being. Thus, assessing the health-related hindrance of adolescents with cancer is an innovative approach to understanding the adverse impact of cancer during adolescence. Additionally, understanding potential risk and resilience factors of hindered goal pursuit of adolescents with cancer will highlight targets of intervention to help adolescents continue to pursue goals that are important for their well- being and transition to adulthood. The specific aims of the study are to demonstrate the relationship of health-related hindrance to adolescent well-being, evaluate differences among adolescents with and without cancer with respect to health-related hindrance, and identify disease-related risk factors and psychosocial resilience factors related to HRH in adolescents with cancer. Questionnaire data will be collected from adolescents with cancer ages 13 to 19 and never ill matched controls. The study is compatible with goals of the NCI to increase research with adolescents, understand adverse outcomes of diagnosis, and identify ways to promote resiliency. Long-term goals of this study are to inform future longitudinal research on the impact of health-related hindrance of goals in survivors and intervention research to enhance resiliency in adolescence and early adulthood. Relevance to Public Health: Cancer in adolescence is more common and the rate of incidence has increased more rapidly than that of children. Fortunately, the 10-year survival rate of pediatric cancer is approaching 75%, which represents a dramatic increase in just a few decades. Research on psychosocial outcomes of survivors has also increased and has found that: (1) childhood cancer survivors are more likely to have worse mental health and quality of life than control samples and (2) they may experience difficulty achieving developmental milestones related to education, career, interpersonal relationships, and individuation from parents. However, research has not yet linked diagnosis during a specific developmental period and later psychosocial outcomes. The proposed research plans to demonstrate the important impact of cancer on personal goal pursuit during adolescence, which will be the basis for future related research linking health-related hindrance of goals in adolescence to later adverse outcomes for childhood cancer survivors.
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