REDEFINE AYAO - Reducing Emotional Distress, Enhancing Function, and Improving Network Engagement in Adolescent and Young Adult Oncology

BACKGROUND: Over the past two decades, adolescent and young adult (AYA) cancer survivors have experienced disparities in 5-year survival rates compared to pediatric and older adult cancer survivors, which has been attributed to inadequate access to health care and insurance, insufficient long-term care, delayed diagnosis, limited clinical trial participation, and unmet psychosocial and supportive care needs. Emotional distress, inadequately managed treatment-related side effects and social isolation are contributing factors to AYA maladjustment. Mind-body medicine practices such as meditation and yoga have seen a steady increase over the past decade, especially among younger adults. A well-established mind-body stress management intervention (Mindfulness-Based Stress Reduction, or MBSR) has been implemented across numerous older adult cancer patient populations and has demonstrated significant participant improvement in quality of life and decreases in emotional distress. MBSR has never been examined specifically with an AYA cancer survivor cohort. OBJECTIVE: The primary objective of this proposal is to investigate the feasibility and preliminary efficacy of MBSR on outcomes of health related quality of life in a sample of AYA cancer survivors in order to begin to address the unmet psychosocial needs that contribute to cancer disparities in this population. SPECIFIC AIMS: AIM I: Examine the Feasibility and Acceptability of MBSR with AYA Cancer Survivors. We hypothesize that MBSR will be feasible and acceptable with this patient population, which will be assessed through a semi-structured debriefing survey at the end of the study as well as examination of response rate and study attrition. AIM II: Evaluate the Effects of MBSR on Outcomes of Health Related Quality of Life, Emotional Distress, Disease/Treatment Related Symptoms and Psychosocial Wellbeing in a sample of AYA Cancer Survivors. We hypothesize that compared to control group participants; MBSR group participants will experience significantly less symptoms of emotional distress (e.g., perceived stress, anxiety, uncertainty, fear of recurrence), significantly less disease and treatment related symptoms (e.g., pain, fatigue, sleep disturbance, disease specific symptoms) and significantly higher psychosocial wellbeing (e.g., positive affect, life satisfaction, meaning & purpose and social connectedness). These outcomes will be assessed using validated patient reported outcomes measures, several of which PI Victorson has helped develop through NIH efforts. STUDY DESIGN: This study will use a randomized waitlist controlled study design. CANCER RELEVANCE: Emphasizing standardized and age-appropriate integrative supportive care opportunities for AYA cancer survivors can advance the knowledge, acceptance and application of novel integrative therapies such as MBSR with this often under-studied patient population that will provide indispensable pilot data for future NIH proposals.