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

项目摘要/摘要 青年时期是形成与教育、经济和家庭相关的生活轨迹的关键时期 目标，还有其他。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。 对一些亚斯来说是关键时期。这种生活目标障碍与较差的心理结果有关，尤其是 然而，修改目标和重新确定优先顺序会带来更积极的心理结果。因此， 目标协商是生存的关键部分。理解积极情绪的心理社会决定因素 心理和行为结果对于制定有效的行为干预措施至关重要。在 丰富的积极心理学文献，希望的建构是YA癌的一个特别相关的因素 幸存者；希望被定义为一种积极的认知状态，基于一种以成功为目标的感觉 实现这些目标的决心和计划。在普通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 开创了一种名为实现健康的移动健康干预(即基于应用程序和基于电话的咨询) 在坎瑟的早期生活(清醒)之后，旨在增加YA幸存者的希望，从而使他们重新参与到 跨领域(例如，职业、家庭)的长期生活目标，并最终提高生活质量。在8周内 从两个癌症中心招募的56名YA的试点随机对照试验，WAKE证明了可行性(95%保留)， 可接受性(例如，高满意度)，以及希望、生活质量、抑郁症状、 以及YA幸存者的健康行为(例如，使用药物)。本提案建立在我们要更新的先前工作的基础上 觉醒(例如，它的技术)，增强它的影响范围，并提高我们检查其影响的能力。我们的特定 目的是：1)进行形成性研究，考察YA癌症幸存者在手机上的偏好 通过应用程序支持进行咨询以增强清醒；以及2)测试可行性、可接受性和初步 通过对150名YA癌症幸存者进行为期8周的随机对照试验，观察清醒与注意控制(AC)的疗效。建议数 研究创新地使用了一种新的干预目标--希望--作为一种解决目标的机制。 YA幸存者的中断和生活质量，以及对新的mHealth组件和基于人群的使用 招聘战略(通过社交媒体)，尤其与YA幸存者和潜在 获得医疗保健的机会有限。该提案响应RFA-CA-20-028并具有潜在的高影响 由于觉醒可能与YA癌症幸存者的数量有关，因此Acreen在以下方面的潜在用途 减少与癌症相关的发病率和扰乱的生活目标，及其覆盖范围/可伸缩性。我们的团队是独一无二的- 有资格进行这项研究，基于我们互补的技能和专业知识以及我们的合作 历史。这些发现将为未来检验Awag的有效性、普适性、 和可伸缩性，并将催化研究，以解决通过mHealth在癌症生存护理方面的局限性。

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.