Tailoring a fun and engaging tech-assisted cognitive behavioral therapy program for adolescents and young adults with hematological malignancies: A planning grant

Project Summary/Abstract Adolescents and young adults (AYA) with cancer face unique psychosocial challenges during their cancer journey, especially individuals diagnosed with a hematologic malignancy (HM), often resulting in clinically significant depression. While evidence-based depression treatments are available for AYAs without cancer, AYAs with cancer, in general, and AYAs diagnosed with HM, in particular, encounter mental health disparities in regard to evidence-based mental health treatment. Technology-assisted cognitive behavioral therapy (tCBT) has the potential to reduce these disparities, but existing tCBTs have major weaknesses, such as being text- heavy, academically oriented, and not engaging enough. Our team has developed and pilot-tested a fun and engaging tCBT intervention among AYA cancer survivors. While promising, the platform’s core components were not designed for the AYA cancer population. In this R34 application, we will first tailor the engaging tCBT program, MYTH, for the unique and specific needs of the AYA HM population to create MYTH-C (study Aim 1). Specifically, we will collaborate with an advisory panel composed of AYA cancer survivors, many diagnosed with HM, and stakeholders, i.e., oncologists, oncology nurses, and other allied oncological providers. The advisory panel will closely guide our refinement/tailoring of MYTH for AYA HM patients, i.e., MYTH-C. Concurrently, in Aim 2, we will collect essential data to design and plan the next level multicenter randomized controlled trial (RCT) across the three collaborating study sites: University of Michigan Health, University of Chicago Medicine, and MD Anderson Cancer Center. We will work with each study site’s staff to obtain essential clinical trial-related data, including but not limited to screening-to-enrollment data, anticipated site- specific patient volume, and how MYTH-C may interact with each study site’s clinicians’ day-to-day workflow. Finally, in Aim 3, we will conduct a pilot RCT to evaluate the feasibility and acceptability of delivering MYTH-C at the University of Chicago Medicine site. Patients will be randomly assigned to MYTH-C or treatment-as- usual (TAU) using the University of Chicago Medicine standard psychosocial care for AYA HM patients and post-treatment survivors. Participants will be evaluated at baseline, throughout the session, immediately post- intervention, 4 weeks post-intervention, and 3 months post-intervention using a set of process and clinical measures outlined in the application.