Date of Award

Fall 2019

Document Type


Degree Name

Doctor of Philosophy (PhD)


Health Services Research

Committee Director

Richardean Benjamin

Committee Member

Tina Gustin

Committee Member

Hadiza Galadima

Committee Member

Matthew Hoch


Significant advancements in the treatment of childhood cancers have helped to increase the 5-year survival rate from 56% in the early 1970s to approximately 80-85% in the early 2000s (Greenlee, Murray, Bolden, & Wingo, 2000; Hampton, 2005). Treatment modalities such as chemotherapy and radiation have led to many serious long-term side effects, known as late effects. Between 60% and 90% of survivors develop some form of long-term chronic condition due to their treatment and up to 40% of those conditions will be life-threatening (Howlader, N. et al., 2013). While the majority of young adult survivors of childhood cancer are at risk for developing a late effect, most of them are not participating in recommended screening protocols to identify late effects (Schultz et al., 2010). Current research has identified individual patient characteristics associated with survivors' screening practices, but limited research has assessed the health beliefs of pediatric cancer survivors. The purpose of this study was to examine the factors that influence young adult survivors of childhood cancer participation in screening for late-effects.

A mixed method’s design was used for this study. The quantitative portion in phase one used a modified version of Champion’s Health Belief Model (Champion’s Health Belief Model Scale). Participants could self-select to participate in the quantitative portion, followed by structured interviews analyzed using a grounded theory approach. Ninety-two participants were enrolled in phase one of the study, and 28 participants completed phase two, structured phone interviews. Four models were assessed using Firth Logistic Regression. Findings showed three non-modifiable variables, age at time of survey (p