2 - (SYM 85) Testing a Resilience-building Mobile App for Adolescents and Young Adults with Cancer

Background: Adolescents and young adults (AYAs) with cancer experience unique developmental and psychosocial needs, and are at risk of poor psychosocial outcomes including social isolation, distress, behavioral maladjustment, anxiety, and depression. With the rapid rise in digital technologies, skills-based psychosocial interventions are increasingly deployed via mobile health (mHealth) platforms. Such interventions show promising treatment effects, are cost-effective, and help overcome barriers to traditional in-person delivery models. However, mHealth interventions focused on improving quality of life and psychosocial outcomes have not yet been successfully evaluated or implemented among AYA cancer patients.

Method: We conducted a qualitative study with N=32 AYAs with cancer (ages 14-25) on psychosocial care models and delivery preferences. We coded interview transcripts using directed content analysis. I and my team then designed an mHealth psychosocial intervention which was adapted from an in-person evidence-based coping skills intervention (Promoting Resilience in Stress Management, PRISM). In an ongoing pilot study, 10 AYAs with cancer will use the PRISM app for 8 weeks, and complete well-established implementation measures of acceptability, appropriateness, and feasibility. They will then complete exit-interviews to describe their experiences and engagement with the app.

Results: In the qualitative study, AYAs found a smartphone app-based delivery format to be universally appealing and appropriate, and were accustomed to the use of smartphone apps. AYAs expressed reluctance sharing personal problems with psychosocial clinicians, and appreciated the opportunities an app would provide to confidentially seek help. Several features of digital tools were described as helpful, including skills reminders, real-time practice opportunities, and guided audiovisual exercises. All of these components were incorporated into the PRISM app. Data collection for the ongoing pilot study will be complete by July 2023. We anticipate that the PRISM app will be feasible and acceptable (implementation measure scores ≥4/5), and that a qualitative content analysis of exit-interviews will inform strategies to optimize stakeholder engagement and enhance uptake.

Conclusions: mHealth interventions are appealing to AYAs with cancer, low-cost, scalable, and maximize public health impact. The PRISM app has the potential to improve the health-related quality of life and psychosocial outcomes of AYAs with cancer.