Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta, GA, 30322, USA.
Markey Cancer Center, University of Kentucky, 2365 Harrodsburg Road, Suite A230, Lexington, KY, 40504, USA.
J Cancer Educ. 2020 Dec;35(6):1158-1169. doi: 10.1007/s13187-019-01574-7.
Over 70,000 US young adults are diagnosed with cancer annually, disrupting important life transitions and goal pursuits. Hope is a positive psychology construct associated with better quality of life (QOL) that focuses on goal-oriented thinking. We developed and tested Achieving Wellness After Kancer in Early life (AWAKE), a scalable 8-week app-based program consisting of educational videos, mood/activity tracking, and telephone-based coaching to promote hope and QOL in young adult cancer survivors (YACS, 18-40 years old). A two-arm RCT was used to examine the feasibility, acceptability, and potential efficacy of AWAKE (n = 38) versus attention control (AC; n = 18) among YACS within 2 years of completing treatment and recruited from two NCI-designated cancer centers. Outcomes including hope (Trait Hope Scale), QOL (36-Item Short Form Health Survey; Functional Assessment of Cancer Therapy-General), depressive symptoms (Patient Health Questionnaire-9), and substance use were assessed at baseline, 8 weeks, and 6 months. Participants were an average of 32.55 (SD = 5.45) years old; 75.0% were female, and 80.4% White. The most common cancers were breast cancer (28.6%), melanoma (16.1%), and leukemia/lymphoma (12.5%). High retention, engagement, and satisfaction rates were documented in both conditions; AWAKE versus AC participants rated video content as more relevant (p = 0.007) and reported greater likelihood of talking positively about the program (p = 0.005). Many efficacy change scores showed positive trends in AWAKE versus AC. Reorienting to one's goal pursuits after cancer diagnosis and treatment is critical and may be supported through hope-based interventions. Findings suggest that the AWAKE warrants subsequent research testing its efficacy, effectiveness, and scalability.
每年有超过 70,000 名美国年轻人被诊断出患有癌症，这扰乱了他们重要的人生过渡和目标追求。希望是一种与更高生活质量（QOL）相关的积极心理学构建，它侧重于目标导向思维。我们开发并测试了“在生命早期癌症后获得健康（AWAKE）”，这是一个可扩展的 8 周基于应用程序的计划，包括教育视频、情绪/活动跟踪和基于电话的辅导，以促进年轻癌症幸存者（YACS，18-40 岁）的希望和 QOL。一项两臂 RCT 用于检查 AWAKE（n=38）与注意对照组（AC；n=18）在治疗后 2 年内从两个 NCI 指定的癌症中心招募的 YACS 的可行性、可接受性和潜在疗效。在基线、8 周和 6 个月时评估了希望（特质希望量表）、QOL（36 项简短健康调查；癌症治疗一般功能评估）、抑郁症状（患者健康问卷-9）和物质使用情况。参与者的平均年龄为 32.55 岁（SD=5.45）；75.0%为女性，80.4%为白人。最常见的癌症是乳腺癌（28.6%）、黑色素瘤（16.1%）和白血病/淋巴瘤（12.5%）。在两种情况下都记录了较高的保留率、参与率和满意度；与 AC 相比，AWAKE 参与者认为视频内容更相关（p=0.007），并且更有可能积极谈论该计划（p=0.005）。许多疗效变化评分在 AWAKE 与 AC 相比表现出积极趋势。在癌症诊断和治疗后重新定向到一个人的目标追求至关重要，这可能通过基于希望的干预来支持。研究结果表明，AWAKE 值得进一步研究，以测试其疗效、有效性和可扩展性。
