Project Summary/Abstract
Children and adolescents/young adults (AYAs) with cancer are a vulnerable population, susceptible to numerous late effects
that may diminish their long-term psychosocial, physical, spiritual, and emotional health. Fostering positive psychosocial
constructs—such as hope or optimism—during treatment and maintenance has been shown to correlate with improved rates
of survival and quality of life in patients with cancer. To strengthen psychosocial care for children and AYAs with cancer,
providers of childhood and AYA cancer care must be equipped with robust evidence gathered from high-quality patient
reported outcome measures (PROMs). However, a necessary first step to improving psychosocial care via evidence-based
PROMs is to systematically investigate the quality of existing PROMs. The long-term goal of this proposal is to use the
meta-analytic technique to facilitate improved treatment outcomes in pediatric and AYA patients with cancer who undergo
and survive treatment. The overall objective is to determine which PROMs are most appropriate and robust for the key
psychosocial constructs in pediatric and AYA patients with cancer. This objective ultimately aims to improve psychosocial
care for young cancer patients. The rationale for the proposed work is that pediatric and AYA patients with cancer are
susceptible to numerous late effects that result from treatment and extend into survival. To accomplish the overall objective,
I propose the following specific aims: (1) Identify key psychosocial constructs for pediatric and AYA patients with cancer;
(2) Conduct a psychometric systematic review, meta-analysis, and risk of bias evaluation of PROMs that assess the key
psychosocial constructs identified; (3) Apply comprehensive meta-analysis methodology to obtain a pooled reliability
estimate for these PROMs, and conduct exploratory meta-regression to understand test or sample characteristics that account
for variation in the reliability estimates across studies. This proposal is significant because it represents an evidence-based,
methodological investigation of key psychosocial constructs and corresponding PROMs that aims to advance and strengthen
psychosocial care for children and AYAs with cancer. This proposal is innovative because of its scope, methods, approach,
and expected outcomes. Because I am using evidence-based, robust methodology for conducting and displaying the data of
this scoping review, systematic review, and meta-analysis, I expect my study to result in the vertical advancement of
pediatric and AYA oncology patient care. Furthermore, because these evidence-based approaches will be applied to an area
of medicine in need of standardized PROMs in order to continue the upward trend in patient outcomes, my results are
expected to have a positive impact on national and worldwide cancer outcomes. Furthermore, my data will fulfill important
aspects of the National Cancer Institute mission statement by advancing scientific knowledge and helping people live longer,
healthier lives. My mentorship team, which includes my primary sponsor, whose novel mentorship methods have resulted
in 87 published studies in high impact factor journals and 277 medical student authorships in the last 4 years; my co-
sponsor, a National Cancer Institute-funded AYA oncologist; and carefully selected expert research consultants, is ideally
suited to accomplish my training and career goals.
