[R01] Testing Scalable Strategies to Identify, Reach, and Re-Engage Adolescent and Young Adult Cancer Survivors of Childhood Cancer in Risk-Based Care

Ente: National Cancer Institute

Scadenza: 2030-08-31

Importo max: $2,188,735

Paese: US

Descrizione

PROJECT SUMMARY/ABSTRACT After surviving childhood cancer, adolescents and young adults (AYAs) face the critical transition from pediatric oncology to adult-based follow-up care. Up to 80% discontinue recommended annual follow-up care during the AYA years, leaving a large proportion at risk for undetected and untreated late effects, including secondary cancers and cardiovascular disease. Current models for transitioning survivors to adult care are resource- intensive, clinic-based, and often limited to AYAs already engaged in care, excluding the most vulnerable who are disconnected from the healthcare system. To protect the investment in childhood cancer survival and maximize survivors’ long-term outcomes, effective and pragmatic approaches are needed to reach disengaged AYAs and re-establish their connection to follow-up. Aligned with RFA-CA-25-019, the overall objective of this project is to identify, connect with, and re-engage AYA childhood cancer survivors (ages 18-39) who are overdue for care. To accomplish this goal, we will leverage the nationwide Children’s Oncology Group Childhood Cancer Research Network and Project: EveryChild registries, which together include approximately 50,000 childhood cancer survivors in the AYA age range. In Aim 1, survivors will be contacted using varied message formats and messengers to identify optimal outreach approaches and determine the proportion who are disengaged from medical care. In Aim 2, 280 survivors who are ≥18 months overdue for care will be randomized in a factorial trial to receive a social media campaign, a single-session telehealth navigation program, both combined, or static information control. Building on pilot data demonstrating the acceptability of each intervention component, and AYAs’ preference for social media-enabled and peer-delivered approaches, we focus on intervention delivery methods most likely to reach and engage this vulnerable group. The primary outcome is re-engagement in annual care within 12 months, with mediators (e.g., knowledge) and moderators (e.g., age) examined to identify mechanisms and responsive subgroups. In Aim 3, a mixed methods evaluation will assess potential reach, adoption, and implementation determinants with survivors, clinicians, and community partners. This project is innovative in leveraging national registries for scalable, population-based outreach and applying digital health and community-partnered strategies to a hard-to-reach group. By establishing the effectiveness of a low-burden intervention, this study will provide a foundation for sustainable, registry-based survivorship support that re- engages AYAs in care and improves their long-term health outcomes. Istituzione: COLUMBIA UNIVERSITY HEALTH SCIENCES PI: Melissa Parsons Beauchemin, Alexandra Psihogios Progetto: 1R01CA315247-01

Settori: National Cancer Institute

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