iManageAYA: Preparation and Optimization of a mHealth Intervention for Managing Depressive Symptoms in Adolescent and Young Adult Cancer Survivors.

Adolescent and young adult cancer survivors (AYACS) experience significant disruptions to achieving normative developmental milestones, which often results in elevated rates of depressive symptoms. Among cancer survivors, depressive symptoms are associated with poorer quality of life, increased healthcare utilization/costs, and elevated mortality risk. However, interventions to improve depressive symptoms among cancer survivors have typically been provided in-person during business hours, resulting in limited access for AYACS who often have competing commitments (e.g., school, work, child rearing). Our team has engaged in an iterative user-centered design process to adapt existing evidence-based interventions for depression for remote, on-demand delivery via a digital tool that has been tailored to the preferences of AYACS called ASCENT (AYA Survivors Coping and Emotional Needs Toolkit). The objective of this proposal is to optimize ASCENT to promote self-management of depressive symptoms among AYACS using a full factorial experiment. We will test the impact of four evidence-based components (behavioral activation, cognitive restructuring, mindfulness training, and positive psychology) on depressive symptoms. This will allow us to determine which components can be reduced, eliminated, or replaced to improve efficiency, resulting in an optimized intervention that only includes active components. Future studies will test the efficacy of this optimized intervention.

Scholars @ ECU