To determine whether treatment of anal high-grade squamous intraepithelial lesions (HSIL), vs active monitoring, is effective in reducing incidence of anal cancer in persons living with HIV, the US National Cancer Institute funded the Phase III ANal Cancer/HSIL Outcomes Research (ANCHOR) clinical trial. As no established patient-reported outcomes (PRO) tool exists for persons with anal HSIL, we sought to estimate the construct validity and responsiveness of the ANCHOR Health-Related Symptom Index (A-HRSI). The construct validity phase enrolled ANCHOR participants who were within two weeks of randomization to complete A-HRSI and legacy PRO questionnaires at a single time point. The responsiveness phase enrolled a separate cohort of ANCHOR participants who were not yet randomized to complete A-HRSI at three time points: prior to randomization (T1), 14–70 (T2), and 71–112 (T3) days following randomization. Confirmatory factor analysis techniques established a three-factor model (i.e., physical symptoms, impact on physical functioning, impact on psychological functioning), with moderate evidence of convergent validity and strong evidence of discriminant validity in the construct validity phase (n = 303). We observed a significant moderate effect for changes in A-HRSI impact on physical functioning (standardized response mean = 0.52) and psychological symptoms (standardized response mean = 0.60) from T2 (n = 86) to T3 (n = 92), providing evidence of responsiveness. A-HRSI is a brief PRO index that captures health-related symptoms and impacts related to anal HSIL. This instrument may have broad applicability in other contexts assessing individuals with anal HSIL, which may ultimately help improve clinical care and assist providers and patients with medical decision-making.

This paper describes the development and implementation of a robust lesbian, gay, bisexual, transgender, and queer (LGBTQ) cultural competence curriculum for training health and human service providers across New York State. Between 2013-2018, The National LGBT Cancer Network developed and published Best Practices in Creating and Delivering LGBTQ Cultural Competency Trainings for Health and Social Service Agencies and designed a training curriculum. They also conducted Train the Trainer sessions, and evaluated pre- and post- curriculum knowledge, attitudes, self-efficacy and intentions of individuals who attended educational sessions conducted by the certified trainers. Most respondents improved from pretest to posttest, with significant improvements in knowledge, attitudes, self-efficacy and intentions. An increase in self-efficacy was significantly associated with pre- to posttest improvement in respondent intention. Future research should focus on what components specifically bolster self-efficacy and intention. Increasing the number of health and human service providers who are trained to address the needs of this population is an important step toward providing culturally competent care.

Although smoking cessation apps have become popular, few have been tested in randomized clinical trials or undergone formative evaluation with target users. We developed a cessation app targeting tobacco-dependent cancer patients. Game design and behavioral rehearsal principles were incorporated to help smokers identify, model, and practice coping strategies to avoid relapse to smoking. In this randomized pilot trial, we examined feasibility (recruitment and retention rates), acceptability (patient satisfaction), quitting self-confidence, and other cessation-related indices to guide the development of a larger trial. We randomized 42 English-speaking cancer patients scheduled for surgical treatment to either the Standard Care (SC; telecounseling and cessation pharmacotherapies) or the experimental QuitIT study arm (SC and QuitIT game). Gameplay parameters were captured in-game; satisfaction with the game was assessed at 1-month follow-up. We report study screening, exclusion, and refusal reasons; compare refusal and attrition by key demographic and clinical variables; and report tobacco-related outcomes. Follow-up data were collected from 65% (13/20) patients in the QuitIT and 61% (11/18) in SC arms. Study enrollees were 71% (27/38) females, 92% (35/38) white people, and 95% (36/38) non-Hispanic people. Most had either lung (12/38, 32%) or gastrointestinal (9/38, 24%) cancer. Those dropping out were less likely than completers to have used a tablet (P<.01) and have played the game at all (P=.02) and more likely to be older (P=.05). Of 20 patients in the QuitIT arm, 40% (8/20) played the game (system data). There were no differences between those who played and did not play by demographic, clinical, technology use, and tobacco-related variables. Users completed an average of 2.5 (SD 4.0) episodes out of 10. A nonsignificant trend was found for increased confidence to quit in the QuitIT arm (d=0.25, 95% CI −0.56 to 1.06), and more participants were abstinent in the QuitIT group than in the SC arm (4/13, 30%, vs 2/11, 18%). Satisfaction with gameplay was largely positive, with most respondents enjoying use, relating to the characters, and endorsing that gameplay helped them cope with actual smoking urges. Recruitment and retention difficulties suggest that the perihospitalization period may be a less than ideal time for delivering a smoking cessation app intervention. Framing of the app as a “game” may have decreased receptivity as participants may have been preoccupied with hospitalization demands and illness concerns. Less tablet experience and older age were associated with participant dropout. Although satisfaction with the gameplay was high, 60% (12/20) of QuitIT participants did not play the game. Paying more attention to patient engagement, changing the intervention delivery period, providing additional reward and support for use, and improving cessation app training may bolster feasibility for a larger trial. ClinicalTrials.gov NCT01915836; https://clinicaltrials.gov/ct2/show/NCT01915836 (Archived by WebCite at http://www.webcitation.org/73vGsjG0Y)

The Anal Cancer HSIL Outcomes Research (ANCHOR) trial aims to determine whether treating precancerous anal high-grade squamous intraepithelial lesions (HSIL), versus active surveillance, is effective in reducing anal cancer incidence in HIV-infected individuals. We evaluated the reliability (i.e., internal consistency, test–retest) and between-group stability of a 25-item ANCHOR Health-Related Symptom Index (A-HRSI). ANCHOR participants at least 1-month post-randomization to treatment or active surveillance completed the A-HRSI via telephone. Participants were contacted 7–10 days later to complete the A-HRSI and a participant global impression of change (PGIC) item. Participants (n = 100) were enrolled (mean age = 51.4, 79% cisgender-male, 73% African American, 9% Hispanic) from five ANCHOR sites. Cronbach’s α was good for the physical symptoms (0.82) domain and fair for the physical impacts (0.79) and psychological symptoms (0.73) domains. Intraclass correlation coefficients were good for each of respective domains (i.e., 0.80, 0.85, and 0.82). There were no significant differences in PGIC between the treatment (n = 56) and active surveillance (n = 44) groups (F(1,98) = 2.03, p = 0.16). The A-HRSI is able to reliably assess participant-reported symptoms and impacts of anal HSIL across a 7–10 days of timeframe. Future work will involve the establishment of construct and discriminant validity prior to inclusion in the full ANCHOR trial.

OBJECTIVE:We developed an interactive voice response system (IVRS), an automated telephone survey technology, to assess real-time decision making about sun protection. We examined the feasibility and acceptability of IVRS in this electronic health (eHealth) context.METHODS:Melanoma patients who underwent surgery referred their first-degree relatives (FDRs) for participation. Eligible FDRs were contacted twice daily (12:30 pm; 5:00 pm) over 14 consecutive days via IVRS to complete a survey about their sun protection behaviors and decisions about those behaviors.RESULTS:Of the 81 eligible FDRs, 69 (85%) consented to the study, and 53 (77%) completed the study. We assessed adherence with the IVRS via the number and pattern of missing survey items across all answered IVRS calls. About 80% of scheduled IVRS calls were answered (1316/1652). Most surveys (93%) of the IVRS-answered calls were completed. To examine acceptability, we analyzed the program satisfaction survey data collected at the end of the study. Most participants viewed the IVRS to be highly acceptable and easy to use.CONCLUSIONS:These findings illustrate that use of real-time IVRS data collection regarding sun protection decision making is feasible and acceptable to higher-risk research participants and could thus be used with time and location-sensitive eHealth support to enhance sun protection decision making.

Background: Anal cancer, caused by oncogenic types of human papillomavirus, is a growing problem in the United States. A key focus of anal cancer prevention has been screening for and treating precancerous high-grade squamous intraepithelial anal lesions (HSILs). Objectives: To develop a health-related symptom index for HSIL using qualitative techniques because anal HSIL and its treatment may have a negative impact on health-related quality of life (HRQOL), and no HRQOL measure specific to this condition and treatment currently exists. Methods: Expert consultation was used to guide one-on-one concept elicitation interviews with participants to identify HRQOL aspects they attribute to their anal HSIL and its treatment. This resulted in a draft instrument, which was administered to an independent participant sample, where cognitive interview techniques assessed comprehension. Results: Eighteen anal HSIL-related concepts were identified by the expert panel. Across the 41 concept elicitation interviews, 23 items representing physical symptoms, physical impacts, and psychological symptoms were identified to comprise the initial measure, which was then evaluated during three rounds of cognitive interviews (n = 45). Several questionnaire aspects were refined on the basis of participant input, with three additional items added per expert/participant recommendation. One item was removed because of poor comprehension, resulting in a 25-item measure. Conclusions: Using state-of-the-art qualitative methodology, we have established the content validity of this new instrument, the ANCHOR Anal HSIL Health-Related Symptom Index. Quantitative validation efforts are currently underway. The participant-driven process of developing this tool will facilitate a participant-centered evaluation of the impact on morbidity for treatment of anal HSIL or observation without treatment.

Background: Precancerous anal high-grade squamous intraepithelial lesions (HSIL) and its associated treatments have the potential to reduce health-related quality of life (HRQoL) in impacted individuals. The ANCHOR (ANal Cancer HSIL Outcomes Research) trial aims to determine whether treating anal HSIL, versus active monitoring, is effective in reducing incidence of anal cancer in HIV-infected individuals. The present study sought to establish preliminary psychometric evidence of the 25-item ANCHOR Health-Related Symptom Inventory (A-HRSI). Methods: Eligible ANCHOR participants recruited within two-weeks post-treatment or randomization to active surveillance completed the A-HRSI and well-established legacy HRQoL measures (i.e., Functional Assessment of Cancer Therapy – General [FACT-G] and MD Anderson Symptom Inventory [MDASI]) via telephone. Construct validity was assessed using an exploratory factor analysis (EFA). Pearson correlations were then calculated between summed items within the resulting A-HRSI latent factors and legacy measure outcome subscales to establish convergent and divergent validity. Results: 200 participants were enrolled. EFA provided initial confirmation that the A-HRSI items are best represented by the proposed broad three-factor structure (e.g., physical symptoms, physical impacts, psychological symptoms). These three factors had fair to moderate Pearson correlations with FACT-G Total and MDASI Symptom Severity and Interference subscales. Conclusions: Preliminary psychometric evidence exists to support the construct validity of the A-HRSI, indicating this measure can capture disease- and treatment-related physical and psychological symptoms and physical impacts. Clinical responsiveness and Spanish-translation of this measure will be completed prior to ultimately deploying this measure in the ANCHOR trial to facilitate participant reporting of their HRQoL to inform clinical decision-making.

The period of recovery following a lung-cancer surgery presents unique challenges and psychological demands. The study utilized ecological momentary assessments (EMA) to repeatedly sample mindfulness states in a sample of mindfulness-untrained individuals following hospital discharge. Intra- and inter- individual variability was assessed to examine cancer patients’ natural capacity to exhibit mindfulness states during two weeks of recovery. Fifty nine stage I lung cancer patients (61% women, mean age = 66.1, SD = 7.9) completed EMA twice a day for two weeks. Mean level of mindfulness in the sample was low and equaled .49 (SD = .51) on the 5 point scale, with older participants being less likely to endorse mindful states. Net variability in mindfulness, defined as the person-based standard deviation in momentary scores, equaled .42 (SD = .26), ranging for 0 to 1.3 and indicating very modest variability for most participants. Results of the multi-level variance partitioning model revealed 41.4% of variance in mindfulness scores at the inter-individual, 2.4% on the temporal (i.e., .2% weekly and 2.2% daily), and 56.2% on the momentary levels. Findings indicate that, for cancer patients recovering from surgery, the innate ability to exhibit mindfulness is limited. From the methodological standpoint, consideration of intra-individual variability has implications for conceptualization and design of EMA studies.

Background: Overall, people living with HIV/AIDS (PLWHA) are living longer, but compared with the general population, they are at elevated risk for numerous AIDS-defining and non-AIDS-defining cancers. The AIDS Malignancy Consortium (AMC) is dedicated to conducting clinical trials aimed at prevention and treatment of cancers among PLWHA. Objective: To examine patient-level characteristics and perceptions that influence decision-making regarding AMC treatment trial participation. Methods: PLWHA diagnosed with cancer or anal high-grade intraepithelial neoplasia who were >= 18 years old and offered participation on a therapeutic AMC clinical trial were eligible. Participants completed a 17-item survey assessing sociodemographic and other factors potentially influencing decision-making regarding trial participation. Results: The sample of 67 participants was mainly male (n = 62, 92.5%), non-Hispanic (89.5%) and white (67.2%), with a mean age of 48.3 years. About half of participants were screened for lymphoma studies. Nearly all (98.5%) of the participants learned about AMC clinical trials from a medical provider, most (73.1%) knew little about clinical trials in general, and half decided on trial participation on their own. Altruism was the most frequently cited reason for trial participation. Participant recommendations for improving AMC trial accrual included systems changes to speed access to clinical trials and reduce participant burden. Conclusions: This formative study highlights the perceived benefits to others, i.e. altruism, as an important factor in trial decision-making, little knowledge about clinical trials in general, and the role of physicians in informing participants about clinical trials. Future research should address knowledge barriers and explore systems- and provider-level factors affecting accrual to AMC trials.

Investigators have proposed a transdiagnostic vulnerability framework that examines the relationship between smoking and broader emotional factors, including anhedonia, anxiety sensitivity, and distress tolerance. Because smoking and depression are more common in persons living with HIV and AIDS (PLWHA) than in the general population, understanding the relationship between smoking and mental health is critical. The following study aims to characterize levels of clinically significant depressive symptoms and these broader emotional factors as well as the relationship between these factors and smoking-related variables in a sample of PLWHA. This cross-sectional study employed convenience sampling to survey adult clients who attended one of three AIDS service organizations in New York City. The questionnaires assessed sociodemographic and HIV health care variables, tobacco use, and anxiety - and depression-related constructs. 150 PLWHA completed surveys. Among the 118 smokers, the prevalence of clinically depressive symptoms was 53%. Participants with clinically significant depressive symptoms had significantly higher mean anhedonia scores and anxiety sensitivity scores and lower mean distress tolerance total scores compared to participants without clinically significant depressive symptoms (p<0.001). Smoking cessation treatment for persons with co-morbid psychiatric disorders has been suboptimal and treatment for co-morbid mental health conditions tends to align with disorder-specific treatment. Given that PLWHA are a priority population, further research should address how to best tailor interventions to a group with multiple obstacles to successful tobacco cessation.

Psycho-OncologyVolume 26, Issue 3 p. 408-411 CLINICAL CORRESPONDENCE Assessing real-time sun protection decisions using audio diaries: feasibility and outcomes Laura Fitzpatrick, Corresponding Author Laura Fitzpatrick ljf2004@med.cornell.edu Memorial Sloan Kettering Cancer Center, New York, NY, USACorrespondence to: Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th floor New York, NY 10022 USA. E-mail: ljf2004@med.cornell.eduSearch for more papers by this authorJoshua Pulinat, Joshua Pulinat Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this authorElyse Shuk, Elyse Shuk Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this authorSusan Holland, Susan Holland Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this authorJack Burkhalter, Jack Burkhalter Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this authorJennifer L. Hay, Jennifer L. Hay Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this author Laura Fitzpatrick, Corresponding Author Laura Fitzpatrick ljf2004@med.cornell.edu Memorial Sloan Kettering Cancer Center, New York, NY, USACorrespondence to: Department of Psychiatry & Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, 641 Lexington Avenue, 7th floor New York, NY 10022 USA. E-mail: ljf2004@med.cornell.eduSearch for more papers by this authorJoshua Pulinat, Joshua Pulinat Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this authorElyse Shuk, Elyse Shuk Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this authorSusan Holland, Susan Holland Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this authorJack Burkhalter, Jack Burkhalter Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this authorJennifer L. Hay, Jennifer L. Hay Memorial Sloan Kettering Cancer Center, New York, NY, USASearch for more papers by this author First published: 08 February 2016 https://doi.org/10.1002/pon.4080Citations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat Citing Literature Volume26, Issue3March 2017Pages 408-411 RelatedInformation

Objective: Melanoma is the most serious skin cancer, and consistent use of sun protection is recommended to reduce risk. Yet sun protection use is generally inconsistent. Understanding the decisional factors driving sun protection choices could aid in intervention development to promote sun protection maintenance. Method: In 59 first-degree relatives of melanoma patients, an interactive voice response system (IVRS) on participants' cell phones was used to assess twice daily (morning, afternoon) real-time sun protection usage (sunscreen, shade, hats, protective clothing) and decision factors (weather, type of activity, convenience, social support) over a 14-day summer interval where morning and afternoon outdoor exposures were anticipated. Generalized estimating equations and hierarchical linear models were used to examine the effect of demographics and decisional factors on sun protection choices over time. Results: Sun protection use was inconsistent (e.g., 61% used sunscreen inconsistently). Most strategies were used independently, with the exception of moderate overlap of sunscreen and hat usage. Decision factors were highly relevant for sun protection. For instance, sunscreen use was related to the perception of having adequate time to apply it, whereas shade and hat usage were each related to convenience. Few findings emerged by gender, age, time of day, or year. Significant within-subject variation remained, however. Conclusions: The findings support continued examination of decision factors in understanding sun protection consistency in real time. Interventions where cues to action and environmental supports work together in varied settings can be developed to improve sun protection maintenance in populations at risk for this common disease.

Despite growing social acceptance of lesbians, gay men, bisexuals, and transgender (LGBT) persons and the extension of marriage rights for same-sex couples, LGBT persons experience stigma and discrimination, including within the healthcare system. Each population within the LGBT umbrella term is likely at elevated risk for cancer due to prevalent, significant cancer risk factors, such as tobacco use and human immunodeficiency virus infection; however, cancer incidence and mortality data among LGBT persons are lacking. This absence of cancer incidence data impedes research and policy development, LGBT communities' awareness and activation, and interventions to address cancer disparities. In this context, in 2014, a 2-day National Summit on Cancer in the LGBT Communities was convened by a planning committee for the purpose of accelerating progress in identifying and addressing the LGBT communities' concerns and needs in the spheres of cancer research, clinical cancer care, healthcare policy, and advocacy for cancer survivorship and LGBT health equity. Summit participants were 56 invited persons from the United States, United Kingdom, and Canada, representatives of diverse identities, experiences, and knowledge about LGBT communities and cancer. Participants shared lessons learned and identified gaps and remedies regarding LGBT cancer concerns across the cancer care continuum from prevention to survivorship. This white paper presents background on each of the Summit themes and 16 recommendations covering the following: sexual orientation and gender identity data collection in national and state health surveys and research on LGBT communities and cancer, the clinical care of LGBT persons, and the education and training of healthcare providers.

e17724 Background: We sought to describe and compare longitudinal treatment-related symptom frequency (Sym-F) and distress (Sym-D) after open esophagectomy (OE) or minimally invasive esophagectomy (MIE). Methods: Sequential patients undergoing OE or MIE for esophageal cancer were enrolled in a prospective, 2-arm, nonrandomized clinical trial. Treatment-related Sym-F and Sym-D were assessed using the 27-item patient self-reported Memorial Symptom Assessment Scale-Short Form (MSAS-SF) at before surgery (BL), at the first postop visit (POV), and at 4, 8, and 12 mo postop. Total Sym-F count (0–27) and total Sym-D score (0–108) were recorded at each time point and compared between and within cohorts across time. Results: Between 2012 and 2014, 138 patients (83 OE, 55 MIE) were enrolled, with no significant differences between groups at BL. For both groups, total Sym-F and Sym-D increased between BL and POV (p≤0.001) but recovered to BL levels within 4 mo for MIE and 8 mo for OE. Compared with the OE group, the MIE group had significantly lower Sym-F and Sym-D at POV, with no differences later (Table). The MIE group had fewer symptoms of reflux (p=0.024) and lack of appetite (p=0.033) at POV and decreased fullness at 8 mo (p=0.007). Internal consistency of MSAS was 0.80-0.91 (standardized Cronbach’s Alpha) for each of the 5 time points. Conclusions: Patient self-reported global symptom frequency and distress are improved in the short-term with MIE, compared with OE, with improvements persisting to 8 mo after surgery. Clinical trial information: NCT01558648.Symptom frequency and distress score following OE or MIE. OE MIE P N Median (IQR) N Median (IQR) Symptoms reported (range, 0–27) BL 83 5.0 (1.0-10.0) 55 4.0 (2.0-8.0) 0.76 Postop 78 10.0 (7.0-13.0) 53 8.0 (4.0-10.0) 0.004 4 mo 62 7.5 (4.0-12.0) 45 4.0 (2.0-11.0) 0.60 8 mo 40 6.5 (3.0-11.5) 29 5.0 (3.0-7.0) 0.072 12 mo 27 7 (2.0-13.0) 23 3.0 (2.0-9.0) 0.16 Total distress score (range, 0–108) BL 70 6.4 (3.2-12.0) 46 4.8 (3.2-10.4) 0.40 Postop 77 13.6 (8.0-21.6) 52 9.6 (5.6-16.0) 0.005 4 mo 60 10.4 (5.2-16.8) 37 8.8 (4.0-13.6) 0.44 8 mo 37 10.4 (3.2-15.2) 25 6.4 (4.0-8.8) 0.063 12 mo 30 8 (3.2-13.6) 24 4.8 (1.6-12.8) 0.293

BACKGROUND Given that continued smoking after a cancer diagnosis increases the risk of adverse health outcomes, patients with cancer are strongly advised to quit. Despite a current lack of evidence regarding their safety and effectiveness as a cessation tool, electronic cigarettes (E‐cigarettes) are becoming increasingly popular. To guide oncologists' communication with their patients about E‐cigarette use, this article provides what to the authors' knowledge is the first published clinical data regarding E‐cigarette use and cessation outcomes among patients with cancer. METHODS A total of 1074 participants included smokers (patients with cancer) who recently enrolled in a tobacco treatment program at a comprehensive cancer center. Standard demographic, tobacco use history, and follow‐up cessation outcomes were assessed. RESULTS A 3‐fold increase in E‐cigarette use was observed from 2012 to 2013 (10.6% vs 38.5%). E‐cigarette users were more nicotine dependent than nonusers, had more prior quit attempts, and were more likely to be diagnosed with thoracic and head or neck cancers. Using a complete case analysis, E‐cigarette users were as likely to be smoking at the time of follow‐up as nonusers (odds ratio, 1.0; 95% confidence interval, 0.5‐1.7). Using an intention‐to‐treat analysis, E‐cigarette users were twice as likely to be smoking at the time of follow‐up as nonusers (odds ratio, 2.0; 95% confidence interval, 1.2‐3.3). CONCLUSIONS The high rate of E‐cigarette use observed is consistent with recent articles highlighting increased E‐cigarette use in the general population. The current longitudinal findings raise doubts concerning the usefulness of E‐cigarettes for facilitating smoking cessation among patients with cancer. Further research is needed to evaluate the safety and efficacy of E‐cigarettes as a cessation treatment for patients with cancer. Cancer 2014;120:3527–3535. © 2014 American Cancer Society .

BACKGROUND:Minimally invasive lung lobectomy and segmentectomy by video-assisted thoracic surgery (VATS) are assumed to result in better quality of life and less postoperative pain compared with standard open approaches. To date, few prospective studies have compared the two approaches. We performed a prospective cohort study to compare quality of life and pain scores during the first 12 months after VATS or open anatomic resection. METHODS:Patients were prospectively enrolled from May 2009 to April 2012. Patients with clinical stage I lung cancer who were scheduled to undergo anatomic lung resection were eligible. The Brief Pain Index and Medical Outcomes Study 36-Item Short Form Health Survey were conducted perioperatively and at four assessments during the first 12 months after the operation. Intent-to-treat analyses using mixed-effects models were used to longitudinally assess the effect of treatment on quality of life components (physical component summary and mental component summary) and pain. RESULTS:In total, 74 patients underwent thoracotomy, and 132 underwent VATS (including 19 patients who were converted to thoracotomy); 40 and 80 patients, respectively, completed the 12-month surveys. Baseline characteristics were similar between the two groups. Physical component summary and Brief Pain Index scores were similar between the two groups throughout the 12 months of follow-up. The mental component summary score, however, was consistently worse in the VATS group. CONCLUSIONS:Patient-reported physical component summary and pain scores after VATS and thoracotomy were similar during the first 12 months after surgical resection.

Community-based organizations (CBOs) serving persons living with HIV or AIDS face the challenge of an aging population with more chronic diseases. This study assessed cancer programming needs of AIDS service organizations (ASOs) in New York, New Jersey, and Connecticut by conducting a community needs assessment. Sixty (58%) of 103 organizations completed the survey. ASOs conduct activities most related to early steps along the cancer care continuum, but they also express great interest in expanding cancer-focused programming into new areas. ASOs have resources or capacities in assisting HIV+ clients with mental health or substance abuse problems, but there exists a need for funding in undertaking or expanding cancer-focused programs. ASOs are receptive to collaborating with researchers on disseminating cancer prevention and control knowledge in their settings. Community-academic research partnerships enable resonant training and technical assistance methods to be explored that will enhance the abilities of ASOs to bring cancer-related programming to their clients.