{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T16:31:55Z","timestamp":1765297915906,"version":"3.46.0"},"reference-count":72,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Synergy Award from Emory University","award":["K01MD018637"],"award-info":[{"award-number":["K01MD018637"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Childhood cancer survivors face long-term psychological challenges, including depression, trauma\/stress, and anxiety. However, objective assessments of mental health service utilization among child and young adult (YA) survivors of childhood cancer remain limited. We examined mental health care utilization among publicly insured childhood cancer survivors and disparities by sociodemographic and neighborhood-level factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using multistate public insurance claims data, we identified 5946 survivors (diagnosed \u226421\u2009years) who completed cancer therapy; initiated treatment episode(s) for depression, trauma\/stress, or anxiety post cancer therapy; and maintained continuous coverage. Logistic regressions examined factors associated with having any mental health visit and \u22654 visits within 12\u2009weeks of treatment episode initiation in children (ages 3-17) and YAs (ages 18-39).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 4052 child treatment episodes, 54.6% were in female survivors, 41.5% non-Hispanic White survivors, and 27.4% Hispanic survivors; demographics were similar across 3871 YA episodes. Utilization was highest among survivors aged 3\u201311 years (any visit: 73.4%; \u22654 visits: 39.8%), followed by those aged 12\u201317 years (67.8%; 33.2%), 18\u201326 years (51.9%; 20.2%), and 27\u201339 years (43.3%; 16.4%). Hispanic children were less likely than non-Hispanic White peers to have \u22654 mental health visits (marginal effect = \u20138.73 percentage points; 95% CI = \u201312.78 to \u20134.68), as were children in most (vs least) deprived neighborhoods (marginal effect = \u20138.80 percentage points; 95% CI = \u201314.07 to \u20133.53). Similar disparities were observed for any mental health visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Mental health service utilization was low among publicly insured childhood cancer survivors after mental health diagnosis, with notable disparities by age, ethnicity, and geographic location, underscoring the need for interventions to improve psychological support in this underserved population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jncics\/pkaf099","type":"journal-article","created":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:27:45Z","timestamp":1760362065000},"source":"Crossref","is-referenced-by-count":0,"title":["Mental health service utilization in publicly insured survivors of childhood cancer: a claims-based analysis"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3025-3984","authenticated-orcid":false,"given":"Xu","family":"Ji","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, GA,","place":["United States"]},{"name":"Aflac Cancer and Blood Disorders Center, Children\u2019s Healthcare of Atlanta , Atlanta, GA,","place":["United States"]},{"name":"Department of Health Policy and Management, Emory University Rollins School of Public Health , Atlanta, GA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1097-3300","authenticated-orcid":false,"given":"Xin","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Emory University Rollins School of Public Health , Atlanta, GA,","place":["United States"]},{"name":"Department of Radiation Oncology, Emory University School of Medicine , Atlanta, GA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3664-5815","authenticated-orcid":false,"given":"Ilana","family":"Graetz","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Emory University Rollins School of Public Health , Atlanta, GA,","place":["United States"]},{"name":"Department of Radiation Oncology, Emory University School of Medicine , Atlanta, GA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9111-9191","authenticated-orcid":false,"given":"Karen E","family":"Effinger","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, GA,","place":["United States"]},{"name":"Aflac Cancer and Blood Disorders Center, Children\u2019s Healthcare of Atlanta , Atlanta, GA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8747-7375","authenticated-orcid":false,"given":"Jordan Gilleland","family":"Marchak","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Emory University School of Medicine , Atlanta, GA,","place":["United States"]},{"name":"Aflac Cancer and Blood Disorders Center, Children\u2019s Healthcare of Atlanta , Atlanta, GA,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3845-7853","authenticated-orcid":false,"given":"Janet R","family":"Cummings","sequence":"additional","affiliation":[{"name":"Department of Health Policy and Management, Emory University Rollins School of Public Health , Atlanta, GA,","place":["United 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