TOPIC 424 - MYH 2.0: A DIGITAL EXPERIENCE TO IMPROVE SURVIVORSHIP AMONG AYA CANCER SURVIVORS

青少年和青年癌症幸存者在成年后预计将承担其医疗保健的主要责任。然而，只有少数（<18%）的成年儿童癌症幸存者获得基于风险的随访护理。过渡准备是成人护理自我管理的关键前兆，成人自我管理可改善健康状况并减少医疗保健利用。在其他人群中开展的越来越多的研究普遍表明，做好过渡准备与坚持接受成人护理和获得更好的健康结果之间存在积极关联。虽然有强有力的证据表明，向以成人为导向的医疗保健过渡是至关重要的，但很少有正式的过渡方案可用，也没有理论上驱动的以幸存者为中心的干预措施。在这个项目中，我们将调整和扩展一个原型数字健康干预，管理你的健康（MYH），其特点是有指导的同伴导师互动，量身定制的专家内容，解决与幸存者相关的过渡准备障碍，包括癌症治疗知识不足和后期影响风险，缺乏自我管理技能，管理护理的自我效能低，关注与成人提供者的非个人关系，与父母和服务提供者缺乏沟通，与竞争性的发展追求相比，健康的优先级较低。在一群关键利益相关者和有代表性的用户的指导下，我们将开发下一代MYH干预措施，并在儿童癌症幸存者样本中评估其可用性和可行性。

Adolescent and Young Adult (AYA) cancer survivors are expected to assume primary responsibility for their healthcare when they reach adulthood. However, only a minority (<18%) of adult childhood cancer survivors obtain risk-based follow-up care. Transition readiness is a critical precursor to adult self-management of care, and adult self-management improves health status and reduces healthcare utilization. A growing body of research in other populations has generally shown positive associations between transition readiness and adherence to adult care and better health outcomes. While there is strong evidence demonstrating that the transition to adult-oriented healthcare is critical, there are few formal transition programs available, and no theoretically driven survivor-focused interventions. In this project, we will adapt and extend a prototype digital health intervention, Managing Your Health (MYH), that features guided peer mentor interaction with tailored expert content that addresses survivor-related barriers to transition readiness including inadequate knowledge of cancer treatment and late effect risks, lack of self-management skills, low self-efficacy for managing care, concern about impersonal relationships with adult providers, poor communication with parents and providers, and lower perceived priority of health compared with competing developmental pursuits. Informed by a cohort of key stakeholders and representative users, we will develop the next generation of the intervention of MYH and evaluate it for usability and feasibility among a sample of pediatric cancer survivors.