A Hope-Based Intervention to Address Disrupted Goal Pursuits and Quality of Life in Young Adult Cancer Survivors

Abstract

Abstract In this pilot study, we assessed feasibility and acceptability, and obtained efficacy parameters of an app based 8-week program focusing on a hope- based intervention to address the disruption of goal pursuits among young adult cancer survivors in order to ultimately increase quality of life. Methods: This 8-week app-based intervention program, known as AWAKE (Achieving Wellness After Kancer in Early Life), consists of educational videos, mood/activity tracking, and telephone-based coaching to promote goal-oriented thinking and quality of life (QOL) in young adult cancer survivors (YACSs). Fifty-seven YACSs (18–40 years old), two years post treatment were recruited from two NCI-designated cancer centers and randomly assigned to AWAKE (n = 38) or an attention control (n = 19). Both AWAKE and attention control group received weekly coaching calls. The app content for the AWAKE intervention group included 8 weekly modules specifically targeting the needs of young adult cancer survivors; the content delivered via text for those in attention control focused on personal finances. At weeks 0, 8, and 24, we assessed hope (via the Trait Hope Scale) and QOL (via the 36-Item Short Form Health Survey and Functional Assessment of Cancer Therapy-General). Results: The mean age was 32.2 years old, and 75.0% were female, 77.6% non- Hispanic White, 61.2% employed, and 67.3% married/stable union. Diagnoses included breast cancer (28.6%), hematologic malignancies (12.2%), and melanoma (12.2%). Weekly adherence to AWAKE averaged 86.1% (range: 100.0% at week 1 to 75.7% at week 8). Retention at end-of-treatment was 90.7%. Among AWAKE participants, 90.9% were satisfied with AWAKE and would recommend AWAKE to friends with cancer; >84.8% reported that AWAKE components were helpful. Despite being underpowered to detect efficacy, changes in hope and QOL outcomes trended in the hypothesized directions. Conclusion: AWAKE was a feasible and acceptable approach; changes in hope and some measures of QOL trended in the hypothesized direction. AWAKE has the potential to address disrupted goal pursuits and enhance QOL among YACSs. Future research is needed to examine AWAKE's efficacy in a larger RCT. Future research is needed to examine AWAKE's efficacy in a larger RCT.