Addressing sexual dysfunction after risk-reducing salpingo-oophorectomy: effects of a brief, psychosexual intervention.

INTRODUCTION: Women at high risk for ovarian cancer due to BRCA1 or BRCA2 mutation or family history are recommended to undergo risk-reducing salpingo-oophorectomy (RRSO) after age 35 or completion of childbearing. This potentially life-saving surgery leads to premature menopause, frequently resulting in distressing and unaddressed sexual dysfunction. AIM: To pilot a novel sexual health intervention for women with BRCA1/2 mutations who previously underwent RRSO a using a single-arm trial. Feasibility and primary outcomes including sexual dysfunction and psychological distress were assessed. METHODS: This single-arm trial included a one-time, half-day educational session comprised of targeted sexual health education, body awareness and relaxation training, and mindfulness-based cognitive therapy strategies, followed by two sessions of tailored telephone counseling. Assessments were completed at baseline and 2 months postintervention. MAIN OUTCOME MEASURE: Study end points include feasibility and effectiveness as reported by the participant. RESULTS: Thirty-seven women completed baseline and postintervention assessments. At baseline, participants had a mean age of 44.4 (standard deviation [SD] = 3.9) years and mean duration of 3.8 (SD = 2.7) years since RRSO. Overall sexual functioning (P = 0.018), as well as desire (P = 0.003), arousal (P = 0.003), satisfaction (P = 0.028), and pain (P = 0.018), improved significantly. There were significant reductions in somatization (P = 0.029) and anxiety scores (P < 0.001), and, overall, for the Global Severity Index (P < 0.001) of the Brief Symptom Inventory. Sexual self-efficacy and sexual knowledge also improved significantly from baseline to postintervention (both P < 0.001). Women were highly satisfied with the intervention content and reported utilizing new skills to manage sexual dysfunction. CONCLUSIONS: This intervention integrates elements of cognitive behavioral therapy with sexual health education to address a much-neglected problem after RRSO. Results from this promising single-arm study provide preliminary data to move toward conducting a randomized, controlled trial.

A multi-state study on mental health evaluation for children entering foster care.

When compared with the general United States child population, children entering foster care have elevated rates of mental health problems. This study examines: (1) state approaches to mental health evaluations for children entering foster care for the first time, (2) the consistency of these approaches with professional guidelines, and (3) whether the specific instruments endorsed are supported by available evidence. Semi-structured qualitative interviews and a document review of available protocols/policies were conducted for 47 states and the District of Columbia. All states endorsed mental health evaluations; variation existed between states in approach, timeframe, administrator, and specific instruments endorsed.

Using Appearance-Based Messages to Increase Sun Protection in Adolescent Young Adult Cancer Survivors: A Pilot Study of Ultraviolet Light Photography.

Despite risk for secondary skin cancers, many adolescent and young adult (AYA) cancer survivors do not practice recommended sun protection (SP). Ultraviolet light photography (UVP), which demonstrates the negative impact of sun exposure on physical appearance, has been shown to increase SP in community AYA samples. This study of 58 AYA cancer survivors demonstrates that UVP is acceptable and not distressing to this population. Follow-up data on 23 AYAs demonstrated that those given UVP significantly improve their SP behaviors, while those receiving standard educational materials do not. Results demonstrate UVP is a promising tool for increasing SP in AYA survivors.

Effects of a gift certificate incentive and specialized delivery on prostate cancer survivors' response rate to a mailed survey: a randomized-controlled trial.

OBJECTIVES: Most men diagnosed with prostate cancer become long-term survivors, but are at risk for medical late-effects that can affect their long-term health. Mailed surveys are well suited to study late-effects in this population, but low response rates can compromise survey validity. This study investigated whether an unconditional $5.00 gift certificate incentive or Priority Mail delivery increased prostate cancer survivors' response to mailed surveys. MATERIALS AND METHODS: 976 participants (mean age = 66.8 years), 2-8 years post-diagnosis, were randomized to one of four groups: Incentive; Priority Mail; Incentive & Priority Mail; or Control. After an introductory letter, initial study packets were mailed based on randomization; 46 days later, a second study packet was mailed to all non-responders by First-Class Mail. RESULTS: The first mailing yielded a significant variation in response rates across groups (χ(2) = 9.34; p = 0.025). Priority Mail (64.7%; p = 0.008) and Incentive & Priority Mail (63.6%; p = 0.016) groups had significantly higher response rates than Controls (52.9%). After the second mailing, the overall response rate increased significantly from 59.6% to 71.4% (p < 0.001); however, response rates no longer differed across groups (range, 69.3% [Incentive group] to 73.9% [Priority Mail group]). CONCLUSIONS: Long-term prostate cancer survivors' response rates to mailed surveys increased with the use of Priority Mail and a repeat survey mailing, but the unconditional gift certificate incentive was not supported in this population. By identifying and applying specialized survey methods, studies targeting survivors of prostate cancer and other geriatric cancers may improve response rates, thus limiting a source of potential bias.