# Supporting Employment After Cancer: A Mixed-Methods Evaluation of a Vocational Integration Programme for Childhood, Adolescent, and Young Adult Cancer Survivors

## TL;DR

A vocational program helps young cancer survivors return to work by combining career guidance, training, and internships.

## Contribution

A novel vocational integration program for CAYAC survivors was evaluated using mixed methods.

## Key findings

- Participants reported high satisfaction and improved self-confidence and career prospects.
- Health-related quality of life showed significant psychological impact but moderate physical effects.
- Social support and individualized pacing were key to program success.

## Abstract

Childhood, adolescent, and young adult cancer (CAYAC) survivors often face difficulties entering the workforce, and this transition is frequently complicated by the long-term effects of illness and treatment. Although guidelines emphasise the importance of vocational support, few structured interventions have been developed and systematically evaluated for this population. This study explored a vocational integration programme specifically designed for CAYAC survivors in a tertiary cancer centre in Italy. The programme combined individualised career guidance, soft skills training, and a paid internship, delivered by a multidisciplinary team. A mixed-method approach was used to examine both feasibility and impact, providing a comprehensive understanding of how such interventions may respond to the complex needs of young cancer survivors. The study highlights the significance of tailored, socially supportive vocational programmes and offers insights that may inform future research, clinical practice, and policy development in the field of survivorship care.

Childhood, adolescent, and young adult cancer (CAYAC) survivors often face challenges entering the workforce due to long-term physical, cognitive, and psychological late effects, defined as chronic health conditions resulting from cancer and its treatments. This study evaluated a vocational integration programme that addresses these barriers and promotes psychosocial well-being. The multidisciplinary intervention combined career guidance, soft-skills training, and a paid internship. Using a mixed-method design with questionnaires and semi-structured interviews, we assessed feasibility, satisfaction, and psychosocial outcomes. Thirteen participants (mean-age-at-diagnosis: 12.9 years, SD 5.2; mean-age-at-interview: 27.2 years, SD 5.3) reported over 40 late effects, mostly of moderate severity. Health-Related Quality of Life (HRQoL), measured by the SF-12, showed a Physical Component Score mean of 45.2 (SD 9.1) and a Mental Component Score mean of 43.5 (SD 11.2), indicating greater psychological impact. The programme received high satisfaction ratings (mean 8.3/10) and was described as motivating and valuable, enhancing self-confidence and career prospects. Social support emerged as a key facilitator, while participants noted the need for flexibility and individualised pacing. Despite a limited sample size and potential recruitment bias, this study provides preliminary insights into the feasibility and perceived value of tailored vocational programmes, emphasising the importance of adaptable, socially supportive interventions for CAYAC survivors.