Can the Theory of Planned Behavior help explain attendance to follow-up care of childhood cancer survivors?

Abstract

Objective

Childhood cancer survivors are at high risk for late effects. Regular attendance to long-term follow-up care is recommended and helps monitoring survivors' health. Using the Theory of Planned Behavior (TPB) we aimed to 1) investigate the predictors of the intention to attend follow-up care, and 2) examine the associations between perceived control and behavioral intention with actual follow-up care attendance in Swiss childhood cancer survivors.

Methods

We conducted a questionnaire survey in Swiss childhood cancer survivors (diagnosed with cancer aged <16 years between 1990 and 2005; ≥5 years since diagnosis). We assessed TPB-related predictors (attitude, subjective norm, perceived control), intention to attend follow-up care, and actual attendance. We applied structural equation modeling to investigate predictors of intention, and logistic regression models to study the association between intention and actual attendance.

Results

Of 299 responders (166 (55.5%) females), 145 (48.5%) reported attending follow-up care. We found that subjective norm, i.e. survivors' perceived social pressure and support, (Coef.0.90, p<0.001) predicted the intention to attend follow-up; attitude and perceived control did not. Perceived control (OR=1.58, 95%CI:1.04–2.41) and intention to attend follow-up (OR=6.43, 95%CI:4.21-9.81) were positively associated with attendance.

Conclusions

To increase attendance, an effort should be made to sensitize partners, friends, parents and health care professionals on their important role in supporting survivors regarding follow-up care. Additionally, interventions promoting personal control over the follow-up attendance might further increase regular attendance.

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