The development of a technology-based information support intervention (iSupport) among patients with differentiated thyroid cancer post radioactive iodine therapy

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Abstract Radioactive iodine (RAI) therapy is routinely used among patients diagnosed with differentiated thyroid cancer (DTC), with approximately 76% of patients receiving RAI. Patients with DTC post RAI treatment report extensive short-term and late effects of treatment, symptom burden, and unmet informational needs about treatment related side effects. However, thyroid cancer is frequently referred to as the “good cancer” and is an understudied cancer population for survivorship research and web-based interventions. One way to address these gaps is through digital technologies such as a web-based intervention, which can empower patients with direct access to educational and support tools to reduce symptom burden. I propose to develop and evaluate a web-based intervention, called iSupport (informational support among patients post RAI treatment), to reduce symptom burden among patients diagnosed with DTC post RAI. I propose the following aims: Aim 1 (K99). Develop iSupport, a web-based intervention, for patients with DTC post RAI therapy. Aim 2 (K99). Test the usability of the newly developed iSupport intervention among patients with DTC post RAI. Aim 3 (R00). Assess the feasibility and acceptability of the iSupport intervention. Aim 4 (R00). Test the preliminary efficacy of the iSupport intervention vs. treatment as usual (TAU) among patients with DTC on symptom burden. The K99 phase will involve: 1) conducting patient focus groups (N=32) and individual stakeholder interviews (N=12) to develop iSupport and 2) testing the usability of the iSupport intervention among patients with DTC post RAI therapy (N=8). The R00 phase will involve conducting a pilot randomized controlled trial (RCT; N=72) to: 1) assess the feasibility and acceptability of iSupport and 2) test the preliminary efficacy of iSupport compared to a (TAU) control group with DTC patients on RAI-related symptom burden, patient bioheath indicators (oral mucositis; oral health problems), knowledge of DTC and RAI, self-efficacy for coping with side effects, cancer- related distress, and health-related quality of life. The overall objective of the K99/R00 is to provide Dr. Carr with training and mentorship to become an independent cancer control investigator with expertise in digital technology evidenced-based interventions among cancer patients. The K99 training goals include: 1) increase knowledge of clinical concerns and symptoms among patients with DTC post RAI, 2) obtain advanced training in technology-based intervention design and development, 3) develop expertise in behavioral intervention clinical trials design and testing, and 4) refine grant writing and leadership skills for future independence. Dr. Carr’s mentorship team includes Drs. Kristi Graves (primary), Jacqueline Jonklaas (co-mentor), and Kristen Miller (co-mentor) who are committed to her career development. The proposed training plan will facilitate Dr. Carr’s transition to independence as a cancer control researcher with expertise in digital health interventions to reduce symptom burden and improve health-related quality of life in cancer patient outcomes after treatment.