Outcomes of a Randomized Controlled Trial Testing the Feasibility, Acceptability and Preliminary Efficacy of a Digital, Coach-Assisted Intervention to Enhance Hope and Quality of Life Among Young Adult Cancer Survivors

Objective: The increasing number of young adult (YA) cancer survivors underscores the need for psychosocial interventions, which have been limited in scalability and their focus on mental health symptoms. We tested “Achieving Wellness After Reaching the End-of-treatment” (AWARE), an 8-week digital, coach-assisted intervention to promote hope and quality of life (QOL) in YA survivors. Methods: A 2-arm RCT compared AWARE versus attention control (AC) among 155 YA survivors (ages 18–39; M_age = 32.89, 87.7% female, 8.4% Hispanic, 22.6% racial minority) within 3 years post-treatment, all recruited online. We assessed feasibility, acceptability, and preliminary efficacy on hope and QOL at baseline, end-of-treatment (EOT), and 16-week follow-up (FU). Results: Both conditions showed high retention at EOT (94.2%; AWARE: 94.9% vs. AC: 93.5%) and FU (94.8%; AWARE: 96.2% vs. AC: 93.5%) and session completion (≥ 75%). AWARE (vs. AC) participants reported greater program recommendation (90.5% vs. 83.3%), satisfaction (M = 4.16 vs. M = 3.68), and helpfulness of the educational recordings/transcripts (M = 4.07 vs. M = 3.69), reflections (M = 4.18 vs. M = 3.39), and coaching (M = 4.15 vs. M = 3.46, p's < 0.05). AWARE participants provided positive comments about program concepts/components and suggested more application opportunities including on key issues (e.g., guilt, anger, communication). Multivariable regression showed no associations between condition and hope or QOL; however, AWARE (vs. AC) showed greater effects on those with lower baseline hope, and bivariates showed AWARE's unique effects on hope's pathways and certain QOL dimensions at FU. Conclusions: Feedback on AWARE was positive; yet, intervention revisions or greater focus on those with lower hope may enhance AWARE's utility in promoting hope or QOL. Trial registration: NCT05905250.