Addressing Social Needs of Adolescents and Young Adults (AYAs) with Cancer

项目总结 患有癌症的青少年和年轻人(AYA)是心理社会和生活质量不佳的高危人群。 癌症可能带来风险的一种方式是通过妥协的社会支持，这是心理社会健康的有力预测因素。 AYAS非常重视来自家人、朋友和其他AYA患者的支持。然而，许多患有癌症的AYA认为 与世隔绝，并报告在治疗期间他们的关系紧张，导致长期的社会支持 不足之处。尽管有既定的需求，但针对Aya社会支持需求的项目很少。那些这样做的人 缺乏理论基础或发展量身定做。目前的研究使用了一种新的方法来解决这些问题 通过调整以循证为基础的多成分支持性护理计划来针对社会关系来满足需求 应对效能(SRCE)。被定义为一个人保持或加强在 疾病背景，SRCE是一个新的结构，具有强大的理论基础，与AYAS的很好地一致 发展需要。支持SRCE将使AYA能够管理与癌症相关的挑战，并 寻求并维持支持性的关系，从而缓冲癌症对感知的负面影响 支持。此外，在促进压力管理复原力(PRISM)方案中，以SRCE为目标， 基于技能的Aya弹性干预，具有成功的适应历史，将使这一成功 工作和以后传播的潜力。基于初步数据并跟踪与肥胖相关的 本研究的第一阶段，行为干预发展的行为干预试验(Orbit)模型 (K99，2年)旨在完善PRISM SRCE适应。具体地说，这一阶段的目标是(1) 使用AYA(n≥12)利益相关者反馈反复改进SRCE组件内容；(2)改进实际方面 综合PRISM SRCE计划，包括使用AYA进行交付、培训和保真度监测(n=15) 和PRISM干预者(n=3)利益攸关方反馈；以及(3)制定最终干预手册和交付 协议。此外，K99活动将提供适用的机会，以补充 有前途的早期职业行为科学家，包括在定性研究方法和 临床试验设计和实施的概念和实践方面的培训。第二个独立阶段 这项研究(R00，3年)的目的是建立这种适应的概念验证。通过两个地点的随机试验- N=100名新诊断为癌症的AYA的对照试验，这一阶段的目标是：(1)建立可行性 PRISM SRCE计划的可接受性；以及，(2)探索PRISM SRCE是否能改善心理社会 结果与通常的护理相比。这项研究的结果将为后续的(R01资助) 这一适应的第三阶段疗效试验。该项目实现了RFA-CA-20-057在癌症中的目标 控制科学领域，旨在加强应用行为干预，以提高阿雅的生活质量。如果 如果成功，这一适应既将改善社会成果，又将增强棱镜的整体影响 方案，从而为全面解决阿亚的心理社会需求创造了一个很有前途的范例。

PROJECT SUMMARY Adolescents and young adults (AYAs) with cancer are at high risk for poor psychosocial and quality of life outcomes. One way cancer may confer risk is through compromising social support, a robust predictor of psychosocial wellbeing. AYAs highly value support from family, friends, and other AYA patients. However, many AYAs with cancer feel isolated and report that their relationships are strained during their treatment, resulting in long term social support deficiencies. Despite established demand, few programs targeting AYA social support needs exist. Those that do lack theoretical bases or developmental tailoring. The current study uses a novel approach to address these needs by adapting an evidence-based, multicomponent supportive care program to target social relationship coping efficacy (SRCE). Defined as one’s perceived ability to maintain or enhance close relationships in the context of illness, SRCE is a new construct with a strong theoretical basis that is well aligned with AYAs’ developmental needs. Bolstering SRCE will enable AYAs to manage cancer-related relational challenges and seek and maintain supportive relationships, thereby buffering the negative impact of cancer on perceived support. Moreover, targeting SRCE within the Promoting Resilience in Stress Management (PRISM) program, a skill based AYA resilience intervention with a history of successful adaptation, will enable the success of this work and potential for later dissemination. Building on preliminary data and following the Obesity-Related Behavioral Intervention Trials (ORBIT) model for behavioral intervention development, the first phase of this study (K99, 2 years) aims to refine the PRISM+SRCE adaptation. Specifically, the goals of this phase are to (1) iteratively refine SRCE component content using AYA (n≥12) stakeholder feedback; (2) refine practical aspects of the combined PRISM+SRCE program including delivery, training, and fidelity monitoring using AYA (n=15) and PRISM interventionist (n=3) stakeholder feedback; and (3) develop a final intervention manual and delivery protocol. Additionally, K99 activities will provide applied opportunities to complement the learning goals of a promising early career behavioral scientist, including developing expertise in qualitative research methods and training in conceptual and practical aspects of clinical trial design and conduct. The second, independent phase of this study (R00, 3 years) aims to establish proof-of-concept of this adaptation. Through a two-site randomized- controlled trial of N=100 AYAs newly diagnosed with cancer, the goals of this phase are to (1) establish feasibility and acceptability of the PRISM+SRCE program; and, (2) explore whether PRISM+SRCE improves psychosocial outcomes compared to usual care. Findings from this study will critically inform a subsequent (R01-funded) Phase III efficacy trial of this adaptation. This project fulfills the objectives of RFA-CA-20-057 in the Cancer Control Science area by aiming to enhance an applied behavioral intervention to improve AYA quality of life. If successful, this adaptation will both improve AYA social outcomes and bolster the overall impact of the PRISM program, thus creating a promising paradigm for comprehensively addressing AYA psychosocial needs.