Can health beliefs help in explaining attendance to follow-up care? The Swiss Childhood Cancer Survivor Study

Objective: Improved treatment has increased the survival of childhood cancer patients in recent decades, but follow-up care is recommended to detect and treat late effects. We investigated relationships between health beliefs and follow-up attendance in adult childhood cancer survivors. Methods: Childhood cancer survivors aged younger than 16 years when diagnosed between 1976 and 2003, who had survived for more than 5 years and were currently aged 201 years, received a postal questionnaire. We asked survivors whether they attended follow-up in the past year. Concepts from the Health Belief Model (perceived susceptibility and severity of future late effects, potential benefits and barriers to follow-up, general health value and cues to action) were assessed. Medical information was extracted from the Swiss Childhood Cancer Registry. Results: Of 1075 survivors (response rate 72.3%), 250 (23.3%) still attended regular followup care. In unadjusted analyses, all health belief concepts were significantly associated with follow-up (po0.05). Adjusting for other health beliefs, demographic, and medical variables, only barriers (OR50.59; 95%CI: 0.43–0.82) remained significant. Younger survivors, those with lower educational background, diagnosed at an older age, treated with chemotherapy, radiotherapy, or bone marrow transplantation and with a relapse were more likely to attend follow-up care. Conclusions: Our study showed that more survivors at high risk of cancer- and treatmentrelated late effects attend follow-up care in Switzerland. Patient-perceived barriers hinder attendance even after accounting for medical variables. Information about the potential effectiveness and value of follow-up needs to be available to increase the attendance among childhood cancer survivors.

Parent-Child Dynamics and Emerging Adult Religiosity: Attachment, Parental Beliefs, and Faith Support

Parental religiosity has been shown to predict child and adolescent religiosity, but the role of parents in emerging adult religiosity is largely unknown. We explored associations among emerging adult religiosity, perceived parental religiosity, perceived similarity to mother's and to father's religious beliefs, parental faith support, and parental attachment. Participants were 481 alumni of two Christian colleges and completed surveys online. Emerging adult religiosity (measured by Christian orthodoxy and intrinsic religiosity) was high and similar to parents' religiosity. Perceived similarity to parents' religious beliefs, faith support, and attachment to fathers predicted emerging adult religiosity. However, parental religiosity alone was a weak predictor and functioned as a negative suppressor variable when combined with similarity to parents' beliefs and faith support. Findings underscore the importance of parental support and parent-child relationship dynamics more than the level of parental religiosity and point to possibly unique roles for mothers and fathers in emerging adult religiosity.