Methods
A convenience sample of patients ≤25 years old undergoing cancer treatment at the University of Chicago were approached. The University of Chicago is an urban, quaternary medical center, which serves racial/ethnically- and socioeconomically-diverse patients.9 Participants >18 years old provided informed consent, and participants < 17 years old completed the study with a parent or primary caregiver. All questionnaires were completed electronically using a tablet during clinic appointments.
Demographic, biologic, and behavioral variables were collected through self-report questionnaires. This included endorsement/denial of chronic health conditions, mental health issues, and substance misuse. We used age-stratified measures to assess participant ACEs.4,10 Participants answered ten dichotomous items indicating presence/absence of each ACE that potentially occurred prior to the age of 18, and endorsements were summed to create a final ACE score. Resilience was assessed using age-stratified measures from the Resilience Research Centre.11 These measures provide a categorization of social-ecological resilience based on a summed score: “Low” (≤62), “Moderate” (63-70), “High” (71-76), or “Exceptional” (≥77). Lastly, participants completed questionnaires for study feasibility/acceptability. These assessed their comfort during the study, sense of privacy, understanding and the clarity of the instruments, and interest in the topics of ACEs and resilience. It also asked if they experienced workflow or technical difficulties.
Descriptive statistics characterized demographic, biologic, behavioral and study feasibility/acceptability data. Two-sample t -tests and chi-squared tests evaluated differences in demographics, health behaviors and outcomes, and resilience based on ACEs exposure.