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and may importantly bias the conclusions of a study, the importance of sending follow-
up reminders to improve response rates has been demonstrated (Kaplowitz et al., 2004).
In conclusion, factors such as follow up, the age of the respondent and the
effective use of incentives are all associated with higher response rates. It appears there
are many benefits to using internet surveys within certain age populations, specifically
adolescents, as they are quick to administer, inexpensive and flexible compared to mail
and telephone surveys. However, issues such as internet accessibility and privacy
concerns need to be taken into account.
2.7 Summary
In the context of New Zealand childhood cancer survivorship, there has been no
research into the psychosocial impact on these young people, so the implementation of
a long term follow up programme is based on anticipated needs identified in overseas
studies. The review of the literature confirms that late effects of childhood cancer
therapy can include disruption to normal growth and development especially during
adolescence. Adverse effects on quality of life, risk taking behaviours, post-traumatic
stress and social interactions of survivors are all identified by various authors. However,
there is no clear consensus on the impact of these psychosocial issues for child cancer
survivors (Zebrack & Chesler, 2001; Zebrack & Chesler, 2002; Zeltzer et al., 2009).
It is clear from the review of existing literature that there are a significant
number of validated, peer reviewed studies providing valuable insight into not only the
medical consequences of treatment to effect a cure, but also the psychosocial impact on
the rapidly growing numbers of survivors world wide. While much of the findings of
these studies extrapolate across to the New Zealand childhood cancer survivor
experience, the opportunity to repeat the Youth’07 survey and compare findings with a
cohort of peers provides a unique opportunity to capture information on the
psychosocial wellbeing of young people who have survived childhood cancer in
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