An mHealth Positive Psychology Intervention to Reduce Cancer Burden in Young Adult Cancer Survivors

项目概要/摘要 青年期（YA）是塑造与教育、财务和家庭有关的人生轨迹的关键时期 目标等。不幸的是，癌症诊断/治疗及其心理社会后遗症破坏了这一点。 关键时期的一些青年。这种生活目标障碍与较差的心理结果有关，特别是 然而，目标修正和重新确定优先级会导致更积极的心理结果。因此，在本发明中， 目标协商是生存的关键部分。理解积极的社会心理决定因素 心理和行为结果对于制定有效的行为干预措施至关重要。内 在丰富的积极心理学文献中，希望的构建是与YA癌症特别相关的因素之一 幸存者;希望被定义为一种基于成功目标导向感的积极认知状态 决心和计划来实现这些目标。在一般人群和癌症幸存者中，希望是 与更好的生活质量（QOL），心理健康，健康行为和应对疾病/癌症有关。我们的团队 开创了移动健康干预（即，基于应用程序和基于电话的咨询）称为实现健康 在早期生活中的坎瑟（觉醒）旨在增加YA幸存者的希望，从而重新让他们参与 跨领域的长期生活目标（例如，职业，家庭），并最终提高生活质量。在为期8周的 从2个癌症中心招募的56名YA的试点RCT，AWAKE证明了可行性（95%保留）， 可接受性（例如，高满意度），以及希望、QOL、抑郁症状 和健康行为（例如，在幸存者中使用药物。该提案建立在我们之前的工作基础上， 清醒（例如，其技术），扩大其影响范围，并提高我们检查其影响的能力。我们的具体 目的是：1）进行形成性研究，检查YA癌症幸存者对基于电话的偏好 咨询与应用程序的支持，以提高清醒;和2）测试的可行性，可接受性，和初步 通过对150名YA癌症幸存者进行为期8周的RCT，评估清醒与注意力控制（AC）的疗效。拟议 研究创新地使用了一种新的干预目标-希望-作为解决目标的机制， YA幸存者的中断和QOL，以及其使用新的mHealth组件和基于人群的 招募策略（通过社交媒体），特别是与YA幸存者和那些有可能 有限的医疗保健。本提案响应RFA-CA-20-028，具有潜在的高影响力 由于与AWAKE相关的YA癌症幸存者的数量，AWAKE在以下方面的潜在效用 降低癌症相关的发病率和生活目标的中断，以及其覆盖范围/可扩展性。我们的团队是独一无二的- 有资格进行这项研究，基于我们的互补技能和专业知识以及我们的合作 历史研究结果将为未来研究AWAKE的有效性，普遍性， 和可扩展性，并将促进研究，以解决通过mHealth癌症生存护理的局限性。

PROJECT SUMMARY/ABSTRACT Young adulthood (YA) is a critical time in shaping life trajectories related to educational, financial, and family goals, among others. Unfortunately, cancer diagnosis/treatment and its psychosocial sequelae disrupt this critical period for some YAs. This life goal disturbance is related to poorer psychological outcomes, particularly among YAs; however, goal revision and reprioritization lead to more positive psychological outcomes. Thus, goal negotiation is a critical part of survivorship. Understanding psychosocial determinants of positive psychological and behavioral outcomes is critical for developing effective behavioral interventions. Within the rich positive psychology literature, the construct of hope is one particularly relevant factor for YA cancer survivors; hope has been defined as a positive cognitive state based on a sense of successful goal-directed determination and planning to meet these goals. In the general population and in cancer survivors, hope is related to better quality of life (QOL), mental health, health behaviors, and coping with illness/cancer. Our team pioneered an mHealth intervention (i.e., app-based with phone-based counseling) called Achieving Wellness After Kancer in Early life (AWAKE) aimed at increasing hope among YA survivors, thereby re-engaging them in long-term life goals across domains (e.g., vocational, familial) and ultimately increasing QOL. In an 8-week pilot RCT of 56 YAs recruited from 2 cancer centers, AWAKE demonstrated feasibility (95% retention), acceptability (e.g., high satisfaction), and promising trends in changes in hope, QOL, depressive symptoms, and health behaviors (e.g., substance use) in YA survivors. This proposal builds on our prior work to update AWAKE (e.g., its technology), enhance its reach, and increase our ability to examine its effects. Our specific aims are to: 1) conduct formative research examining YA cancer survivor preferences on phone-based counseling with app support to enhance AWAKE; and 2) test the feasibility, acceptability, and preliminary efficacy of AWAKE vs. attention control (AC) via an 8-week RCT of 150 YA cancer survivors. The proposed research is innovative in its use of a novel intervention target – hope – as a mechanism for addressing goal- disruption and QOL among YA survivors, and its use of novel mHealth components and population-based recruitment strategy (via social media) that are particularly relevant to YA survivors and those with potentially limited access to healthcare. This proposal is responsive to RFA-CA-20-028 and has potential high impact due to the number of YA cancer survivors for whom AWAKE may be relevant, AWAKE’s potential utility in reducing cancer-related morbidity and disrupted life goals, and its reach/scalability. Our team is uniquely- qualified to conduct this research, based on our complementary skills and expertise and our collaborative history. Findings will provide the foundation for future research examining AWAKE’s efficacy, generalizability, and scalability, and will also catalyze research to address limitations in cancer survivorship care via mHealth.