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Properties of the Shift and Persist Questionnaire in adolescent and young adult cancer patients and survivors: Validity, consistency, and interpretability

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Abstract

Purpose

The Shift and Persist model provides an informative framework to understand how adolescent and young adult (AYA) cancer patients and survivors (ages 15–39) may withstand stress and thrive despite adversity. The goal of the present study was to examine the psychometric properties of the Shift and Persist Questionnaire (SPQ) in this population and provide guidelines for interpretation.

Methods

AYA cancer patients and survivors were recruited via an online research panel. Participants reported demographics and health history and completed the SPQ and Patient-Reported Outcome Measurement Information System 29-item profile (PROMIS®-29). We evaluated the structural validity, internal consistency, and construct validity of the SPQ. Minimally important differences (MIDs) were estimated to inform SPQ score interpretation.

Results

572 eligible individuals completed the survey. On average, participants were aged 24 (SD = 7) at evaluation. Of the participants, 43.5% were female, 77.1% were white, and 17.5% were Hispanic (across races). The two-factor structure of the SPQ demonstrated very good structural validity (CFI > 0.95, SRMR < 0.08), and construct validity with PROMIS-29® domains (convergent Rs = 0.17 to 0.43, divergent Rs = − 0.11 to − 0.51). Internal consistency was adequate (ω = 0.76–0.83). Recommended MIDs were 1 point for the Shift subscale, 1–2 point(s) for the Persist subscale, and 2–3 points for the total SPQ score.

Conclusion

The SPQ is a psychometrically sound measure of skills that contribute to resilience in AYA cancer patients and survivors. MID recommendations enhance the interpretability of the SPQ in this population. Future studies examining shifting and persisting in this population may benefit from administering the SPQ.

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Funding

Research reported in this publication was supported by pilot funding from the Department of Medical Social Sciences at the Northwestern University Feinberg School of Medicine. During the preparation of this manuscript, Drs. Murphy, Chen, Rosenberg, and Salsman have been supported, in part, by unrelated Grants from the National Institutes of Health (Murphy T32CA122061, K99CA248701; Chen: R01HL136676; Rosenberg: R01CA222486, R01CA225629; Salsman: R01CA242849). The opinions herein represent those of the authors and not necessarily their funders.

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Authors and Affiliations

  1. Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest Baptist Comprehensive Cancer Center, Winston-Salem, NC, USA

    Karly M. Murphy & John M. Salsman

  2. Department of Psychology, Weinberg College of Arts & Sciences, Northwestern University, Evanston, IL, USA

    Edith Chen

  3. Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA

    Edward H. Ip

  4. Palliative Care and Resilience Program, Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, WA, USA

    Abby R. Rosenberg

  5. Department of Pediatrics, Division of Hematology/Oncology, University of Washington School of Medicine, Seattle, WA, USA

    Abby R. Rosenberg

  6. Office of Research and National Laboratories, The University of Chicago, Chicago, IL, USA

    Mallory A. Snyder

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Contributions

JS, EC, and KMM contributed to conceptualization. JS contributed to data curation, funding acquisition, resources, and supervision. KMM contributed to formal analysis. JS and MAS contributed to investigation. JS and KMM contributed to methodology. MAS contributed to project administration and software. KMM and EI contributed to validation. KMM contributed to visualization and writing—original draft. JS, EC, AR, EI, and MAS contributed to writing—review & editing.

Corresponding author

Correspondence to Karly M. Murphy.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Consent to participate

Op4G obtained consent from all adult participants and assent from all adolescent participants included in the study. For adolescent participants (< 18 years), Op4G obtained permission from a parent/guardian for their participation in the panel.

Ethical approval

This study was approved by the Northwestern University Institutional Review Board and was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

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Murphy, K.M., Chen, E., Ip, E.H. et al. Properties of the Shift and Persist Questionnaire in adolescent and young adult cancer patients and survivors: Validity, consistency, and interpretability. Qual Life Res 32, 273–283 (2023). https://doi.org/10.1007/s11136-022-03219-7

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