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Cited by 8Cancer survivorship and careChildhood Cancer Survivors' Quality of LifeDigital Mental Health Interventions

A digital, coach-assisted intervention to address the psychosocial needs of young adult cancer survivors: Randomized controlled trial protocol and intervention adaptation process

Open access
McCready, Darcey M., Arem, Hannah, Duarte, Danielle A., Dennis, Kyla, Ball, Nathan, Cafferty, Lauren A., Hinds, Pamela S., Howlader, Afrah +1 more·2024·Contemporary Clinical Trials
DOI 10.1016/j.cct.2024.107545PMC PMC11365041
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Abstract

Background: Given the increasing number of young adult cancer survivors and the impacts of cancer on various life domains, interventions addressing the psychosocial needs of young adult survivors are crucial. However, such intervention research is limited, and the existing literature has often: 1) overlooked young adult survivors' psychosocial needs; 2) targeted depression, anxiety, or fear of recurrence – rather than positive outcomes like well-being; and 3) failed to consider scalable approaches, like digital health. Methods: This paper documents the development and refinement of an 8-week digital, coach-assisted intervention targeting hope among young adult cancer survivors (ages 18–39, within 3 years of treatment completion) and presents the protocol of the 2-arm RCT (comparing intervention vs. attention control). The intervention builds upon a 2017–2018 pilot trial (n = 56); intervention refinements were based on subsequent semi-structured interviews among young adult survivors (n = 23). Results: The pending trial design involves an increased sample size (n = 150) to increase power and diversified recruitment efforts (i.e., clinic-based, social media, community-based organizations, etc.) to facilitate intervention reach, accessibility, and scalability. The intervention was enhanced by integrating highly relevant theoretical and therapeutic frameworks, specifically the concept of hope and Acceptance and Commitment Therapy, as well as updating intervention delivery technology. Intervention outcomes include feasibility and acceptability at end-of-treatment and preliminary efficacy on hope (primary outcome) and quality of life measures (secondary outcomes) at end-of-treatment and 16-week follow-up. Conclusions: This paper may facilitate discussion regarding approaches for addressing the significant psychosocial challenges faced by young adult survivors and catalyze dissemination of trial results. Trial Registration: NCT05905250 © 2024 Elsevier Inc.

Integrity signals

Registry

Crossref · 10.1016/j.cct.2024.107545

Cites

60 of 60 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

64 of 101 cited sources checked · 23 supported · 3 flagged · accuracy not yet measured

  • Premisecitation

    Research on psychosocial interventions for cancer survivors has often targeted depression, anxiety, emotional distress, negative affect, or fear of cancer recurrence rather than positive outcomes such as well-being.

    “research on psychosocial interventions for cancer survivors has often targeted depression, anxiety, emotional distress, negative affect, or fear of cancer recurrence as outcomes – rather than positive outcomes, such as well-being [11, 12].”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [11] source

      The Results (Study characteristics; page not provided) report depression, anxiety, and distress far more often than well-being as outcomes, supporting the general contrast. The Introduction also describes ACT intervention reviews assessing anxiety, depression, and emotional distress. But this paper primarily reviews associations between ACT processes and distress, not outcomes of psychosocial interventions, and the cited passages do not establish fear of cancer recurrence as an intervention outcome. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [12] source

      The Discussion (page unavailable) says most studies in the psychological-intervention group focused on promoting healthy behaviours, and only two recruited patients with clinically significant distress for psychological support. The Psychological interventions section does report anxiety and depression outcomes in some studies, but the review does not support the claimed emphasis on negative outcomes rather than well-being or other positive outcomes. (LLM, conf=0.84)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Premisecitation

    Hope is associated with enhanced mental health and quality of life in cancer survivors.

    “and in cancer survivors [3, 16, 21-27]”
    Quote in the paperSubstantial claim4 of 9 sources checked
    • cites [3] source

      The Results and Conclusions discuss associations between life-goal pursuit and psychological outcomes in cancer patients, while the Background mentions quality of life in relation to treatment disruption. Searches for hope and quality of life found no passage linking hope to either mental health or quality of life in cancer survivors. Page numbers were not available in our copy. (LLM, conf=0.75)

      Experimental — accuracy not yet measured
    • cites [16] source
    • cites [21] source
    • cites [22] source
    • cites [23] source
    • cites [24] source

      The Discussion (page not provided) says hope can help patients cope with the psychological pressures of chronic disease, and the Abstract proposes hope-based therapies to improve patients’ mental well-being. The paper does not establish an association between hope and quality of life in cancer survivors; its study compared hope scores between breast cancer survivors and healthy women, without measuring quality of life. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [25] source

      The Introduction (page not available) links hope with cancer patients’ well-being and quality of life, and the Results (page not available) report that higher hope was associated with less depression and anxiety. The study enrolled oncology outpatients, not a defined population of cancer survivors, and did not measure quality of life as an outcome. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites [26] source

      The Discussion (page unavailable) reports that trait hope and expectations of chemotherapy benefit were independent of aspects of psychological well-being and quality of life in women receiving palliative chemotherapy for recurrent ovarian cancer. It instead links unfulfilled expectations of symptom benefit with scores indicative of depression, not hope with enhanced mental health and quality of life. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites [27] source
  • Premisecitation

    Existing interventions largely target depression, anxiety, or fear of cancer recurrence as outcomes rather than well-being or other positive outcomes.

    “existing interventions largely targeting depression, anxiety, or fear of cancer recurrence as outcomes – rather than well-being or other positive outcomes [11, 12]”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [11] source

      The Results (Study characteristics; page unavailable) report depression as an outcome in 71 of 110 studies and anxiety in 54, versus emotional or psychological well-being in 13. This supports an emphasis on negative outcomes in the reviewed studies, but the paper does not establish that interventions generally target fear of cancer recurrence, or that all the studies counted were intervention trials. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [12] source

      The Discussion (page not available) says that most studies in the psychological-intervention group focused on health behaviours for a healthy lifestyle; only two recruited patients with clinically significant distress for psychological support. The Target outcomes section lists anxiety and depression among several outcomes, but does not support the claim that interventions largely targeted those outcomes or fear of cancer recurrence rather than well-being or other positive outcomes. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
  • Premisecitation

    Of the 17 studies in the 2017 systematic review, 10 were randomized controlled trials.

    “Only 10 of these studies were randomized controlled trials (RCTs)”
    Quote in the paperSubstantial claim1 of 1 sources checked
  • Premisecitation

    Hope is associated with life meaning among cancer survivors.

    “life meaning among cancer survivors [28-30]”
    Quote in the paperNot a substantial claim3 of 3 sources checked
    • cites [28] source
    • cites [29] source

      The Methods (Study measures; page unavailable) describes measures of loneliness, depression, anxiety, and social support in young adults. Searches for hope, life meaning, and cancer survivors found no passage addressing an association between hope and life meaning among cancer survivors. (LLM, conf=0.76)

      Experimental — accuracy not yet measured
    • cites [30] source

      The Results section on COVID-19’s impact on psychological well-being reports anxiety, depression, isolation, and cancer-related worries among adolescents and young adults, but not an association between hope and meaning in life. Searches for “hope,” “meaning in life,” and the claimed association found no passage addressing it. Page numbers were not available in our copy. (LLM, conf=0.74)

      Experimental — accuracy not yet measured
  • Classified as probably not a substantial claim. 18
  • May combine two claims. 22

  • Classified as probably not a substantial claim.

    Premisecitation

    Acceptance and Commitment Therapy addresses goals, values, barriers, and cognition through acceptance, mindfulness, commitment, and behavior changes.

    “ACT addresses goals, values, barriers, and cognition through acceptance, mindfulness, commitment, and behavior changes [40-42].”
    Quote in the paperSubstantial claim3 of 3 sources checked
    • cites [40] source

      The Abstract identifies ACT as a third-wave approach and says third-wave methods emphasize acceptance, mindfulness, values, goals, and the relationship to thoughts and emotions. It does not specifically say that ACT addresses barriers or describe commitment and behavior change as the means by which ACT addresses all the listed areas. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [41] source
    • cites [42] source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    In the pilot trial, session topics included hope and relevance to cancer survivorship; effective goal-setting and goal re-evaluation; interactions between thoughts, emotions, and goal pursuits; effectively managing thoughts and emotions; and addressing barriers to goals.

    “In our pilot trial, session topics included: hope and relevance to cancer survivorship; effective goal-setting and goal re-evaluation; interactions between thoughts, emotions, and goal pursuits; effectively managing thoughts and emotions; and addressing barriers to goals (Table 1) [14].”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [14] source

      The Methods (Study Design; page unavailable) say AWAKE had eight weekly modules with aligned homework and coaching on hope-related skills and goal pursuits. The Discussion (page unavailable) also describes setting goals and maintaining motivation despite barriers. Our copy does not specify the claimed session topics on interactions among thoughts, emotions, and goals or on managing thoughts and emotions, so it does not verify the full list. (LLM, conf=0.80)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    The pilot results indicated areas for improvement, including overall satisfaction (M=3.14, SD=1.17), content relevance (M=3.14, SD=1.00), and engagement in homework activities (M=4.50, SD=2.31 of 8 completed).

    “results indicated areas for improvement, for example, to increase overall satisfaction (M=3.14, SD=1.17), content relevance (M=3.14, SD=1.00 of 0=not at all to 4=very satisfied/relevant), and engagement in homework activities (M=4.50, SD=2.31 of 8 completed) [14].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [14] source

      The Methods (Measures/Data Collection; page unavailable) say the study assessed satisfaction and use of intervention components, and the Results (Feasibility and Acceptability; page unavailable) discuss video relevance and homework engagement. The passages in our copy do not give the cited means, standard deviations, or rating scale, so those numerical details cannot be verified. The Discussion describes participants as highly satisfied rather than identifying satisfaction as an area needing improvement. (LLM, conf=0.82)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    The 2017-2018 pilot trial developed and tested an 8-week app-based intervention with interactive phone-based coaching versus an attention control focused on finances among young adult cancer survivors recruited from 2 cancer centers (n=56; ages 18-39, within 2 years of completing primary treatment).

    “In 2017-2018, our team developed and tested an 8-week app-based intervention with interactive phone-based coaching (vs. AC focused on finances) via an RCT among YA cancer survivors recruited from 2 cancer centers (n=56; ages 18-39, within 2 years of completing primary treatment; average age=32.55, SD=5.45; 75.0% female, 80.4% White, 28.6% breast cancer, 16.1% melanoma, 12.5% leukemia/lymphoma) [14”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [14] source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    The pilot intervention demonstrated high satisfaction (3.14 on 0-4 scale; 88.9% would recommend to peers).

    “high satisfaction (3.14 on 0-4 scale; 88.9% would recommend to peers)”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [14] source

      The Results (Feasibility and Acceptability; page not available) report that more than 88% of participants in both groups would recommend the program to friends who are cancer survivors. The Discussion says participants were highly satisfied on average. Our copy does not give the claimed 3.14 score, 0–4 scale, or exact 88.9% figure. (LLM, conf=0.84)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    The 2021 systematic review identified 29 reviews (including 139 primary studies), 23 of which included interventions with psychosocial outcomes.

    “this systematic review identified 29 reviews (including 139 primary studies), 23 of which included interventions with psychosocial outcomes.”
    Quote in the paperSubstantial claim1 of 1 sources checked

  • Classified as probably not a substantial claim.

    Premisecitation

    Health coaching incorporates evidence-based interventions and techniques from behavioral medicine literature to address health promotion, prevention, early intervention, treatment, and management of chronic conditions.

    “Health coaching incorporates evidence-based interventions and techniques from behavioral medicine literature (e.g., positive psychology, health psychology) to address health promotion, prevention, early intervention, treatment, and management of chronic conditions [48].”
    Quote in the paperSubstantial claim1 of 1 sources checked

  • May combine two claims.

    Findingcitation

    Formative interviews with 23 YA cancer survivors identified key opportunities for improvement: increased focus on navigating cancer's impacts on various life domains, particularly mental health and social relationships, including navigating new roles and seeking understanding/validation of cancer-related experiences and longer-term survivorship challenges.

    “key opportunities for improvement included increased focus on navigating cancer’s impacts on various life domains, particularly mental health and social relationships, for example, navigating new roles (e.g., accepting and/or asking for support) and effectively seeking understanding and validation of one’s cancer-related experiences and longer-term survivorship-related challenges [51].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • Rests on an assumption: The formative research sample of 23 YA cancer survivors is representative enough of the target population for the identified preferences and needs to guide intervention adaptations.

  • Classified as probably not a substantial claim.

    Premisecitation

    There is generally well-established evidence regarding nutrition and cancer.

    “we chose an AC focused on the generally well-established evidence regarding nutrition and cancer [56]”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [56] source

      The Recommendations and Summary of Evidence section says its general diet and activity recommendations for cancer survivors are supported by current scientific evidence. But the paper also describes limited or mixed evidence for several diet-related cancer outcomes, so it does not establish that evidence about nutrition and cancer is generally well established. (LLM, conf=0.83)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Study design and conductcitation

    The Adult Hope Scale is a psychometrically-sound measure including 4 agency items, 4 pathways items, and 4 distracter items, yielding scores from 8 to 64.

    “This psychometrically-sound measure includes 4 agency items (e.g., “I energetically pursue my goals”), 4 pathways items (e.g., “I can think of many ways to get out of a jam”), and 4 distracter items (assessed on a scale of 1=definitely false to 8=definitely true) [18], yielding scores ranging from 8 to 64 (4 to 32 for each subscale; higher scores indicate higher hope).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [18] source

      Section 2.5.1.2.5 (page unavailable) describes four agency items, four pathways items and four filler items, with an eight-point response scale and a total score of 8–64. Our copy does not provide psychometric evidence for calling the measure sound or reproduce the quoted example items. (LLM, conf=0.85)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In our prior study, Cronbach's alpha for the Adult Hope Scale total, agency, and pathways were .95, .91, and .89, respectively.

    “In our prior study, Cronbach’s alpha for the total scale, agency subscale, and pathways subscale were .95, .91, and .89, respectively [14].”
    Quote in the paperNot a substantial claim1 of 1 sources checked

  • May combine two claims.

    Study design and conductcitation

    With 15% attrition to follow-up, n=127 allows detection of an effect size of ~0.32, sufficient to detect the modest effects documented in the previous pilot study.

    “(With 15% attrition to FU, n=127 allows detection of an effect size of ~0.32, sufficient to detect the modest effects documented in the previous pilot study [14]).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [14] source

      The Results (Primary and Secondary Outcomes; page unavailable) report that few differences were significant, although several outcomes trended toward improvement in the intervention group. This supports using the pilot as evidence of promising effects, but the passages do not establish that those effects were of a particular modest magnitude. The 15% attrition, n=127, and detectable effect size of approximately 0.32 are the citing authors’ power calculation, not figures reported by this pilot. (LLM, conf=0.78)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    The 2021 systematic review indicated generally high retention rates (60%-95%), satisfaction (70%-85%), and adherence (70%-100%), although adherence was lower for longer interventions.

    “generally high retention rates (60%-95%), satisfaction (70%-85%), and adherence (70%-100%), although adherence was lower for longer interventions.”
    Quote in the paperSubstantial claim1 of 1 sources checked

  • May combine two claims.

    Premisecitation

    Intervention participants rated educational video content as more relevant and reported greater likelihood of talking positively about the program compared to control.

    “intervention (vs. control) participants rated educational video content as more relevant and reported greater likelihood of talking positively about the program [14].”
    Quote in the paperNot a substantial claim1 of 1 sources checked

  • May combine two claims.

    Premisecitation

    The ACT approach explicitly addresses concepts like meaning, values, purpose, challenges, acceptance, and being present, and aligns with hope theory.

    “which reflected the relevance of the ACT approach [40], which explicitly addresses these concepts and aligns with hope theory.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [40] source

      The Abstract identifies ACT as a third-wave approach and says third-wave methods emphasize mindfulness, acceptance, values, and goals. It does not specifically say ACT addresses meaning, purpose, or challenges, or that ACT aligns with hope theory. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • May combine two claims.

    Premisecitation

    In a 3-arm pilot randomized controlled trial addressing fear of cancer recurrence among breast cancer survivors, Acceptance and Commitment Therapy demonstrated greater acceptability and improvements in mental and physical quality of life, cognitive flexibility, and a reduction in avoidant coping skills, relative to survivorship education and enhanced usual care.

    “in a 3-arm pilot RCT addressing fear of cancer recurrence among breast cancer survivors, ACT demonstrated greater acceptability and improvements in mental and physical quality of life, cognitive flexibility, and a reduction in avoidant coping skills, relative to survivorship education and enhanced usual care [43].”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [43] source

      Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S2 (checkable).

    Premisereasoning

    There is a pressing need for interventions addressing YA survivors' psychosocial concerns to enhance quality of life across the lifespan.

    “Given the increasing number of YA survivors [1] and the impacts of cancer across various aspects of life, particularly among YAs [2-6, 8], there is a pressing need for interventions addressing YA survivors’ psychosocial concerns in order to enhance quality of life across the lifespan [7].”
    Quote in the paperNot a substantial claim3 of 8 sources checked
    • cites [1]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [2] source
    • cites [3] source

      The Conclusions (page unavailable) say cancer disrupts younger adults’ life goals more than older adults’ and propose research to inform interventions that could improve patients’ life goals and psychological outcomes. The paper does not specifically call for urgent psychosocial interventions for young adult survivors or establish that such interventions enhance quality of life across the lifespan. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [4] source
    • cites [5]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [6]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

    • cites [8] source

      The Discussion (page unavailable) says psychosocial interventions can increase positive affect and may help survivors manage long-term psychosocial effects of cancer. It does not establish a pressing need for interventions specifically addressing young adult survivors, or show that such interventions enhance quality of life across the lifespan. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
    • cites [7]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    This trial advances our prior pilot trial by using a more rigorous RCT with a larger sample, diversifying recruitment channels, updating the technological approach, and enhancing intervention content.

    “This trial advances our prior pilot trial [14] by using a more rigorous RCT with a larger sample, diversifying the recruitment channels to include digital media to increase reach and accessibility among YA survivors, updating the technological approach for intervention delivery and its components to facilitate usability and scalability, and enhancing the intervention content to be more responsive”
    Quote in the paperSubstantial claim1 of 1 sources checked

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    One of the most frequent suggestions for intervention enhancement was to provide a set of resources related to various life domains (e.g., mental health, social, reproductive) and positive psychology (e.g., meditation).

    “One of the most frequent suggestions for intervention enhancement was to provide a set of resources related to various life domains (e.g., mental health, social, reproductive) and positive psychology (e.g., meditation).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The formative research sample of 23 YA cancer survivors is representative enough of the target population for the identified preferences and needs to guide intervention adaptations.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Weekly coaching sessions were preferable to the participants (with others suggesting every 2 weeks).

    “weekly coaching sessions were preferable (others suggested every 2 weeks)”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The formative research sample of 23 YA cancer survivors is representative enough of the target population for the identified preferences and needs to guide intervention adaptations.

  • Classified as probably not a substantial claim.

    Premisecitation

    The field of positive psychology offers theories and constructs that may inform interventions for young adult survivors.

    “The field of positive psychology offers a range of theories and constructs that may inform interventions for YA survivors [13].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [13]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Premisenone given

    Historically, much cancer survivorship research has focused on physical needs and defined populations by cancer site.

    “historically much of the research has focused on the physical needs of cancer survivors and, perhaps relatedly, has defined the target populations by cancer site.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Participants are randomized to intervention or attention control using a pre-determined blocked random number sequence.

    “participants are randomized to intervention or AC (using a pre-determined blocked random number sequence).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisenone given

    The utility of Acceptance and Commitment Therapy for young adult survivors and for those further along in survivorship has yet to be explored.

    “its utility for YA survivors and for those who are further along in their survivorship journey has yet to be explored.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    A financial management intervention would, in essence, apply hope-related cognitive processes (e.g., goal-setting, planning) to that topic.

    “a financial management intervention would, in essence, apply hope-related cognitive processes (e.g., goal-setting, planning) to that topic.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    There was only 1 review of survivorship interventions for adolescent and young adult survivors, which included only 4 studies testing interventions addressing psychosocial outcomes (typically as secondary outcomes).

    “there was only 1 review of survivorship interventions for adolescent and YA survivors [47], which included only 4 studies testing interventions addressing psychosocial outcomes (typically as secondary outcomes) [47].”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [47] source

  • May combine two claims.

    Study design and conductreasoning

    The sample size allows detection of differences across conditions in key measures of feasibility and acceptability at end-of-treatment, as well as preliminary efficacy on hope and quality of life at follow-up.

    “which allows detection of differences across conditions in key measures of feasibility (i.e., retention, adherence) and acceptability (e.g., satisfaction) at end-of-treatment (EOT), as well as preliminary efficacy on hope and quality of life at FU.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Each participant is assigned a coach trained and supervised by a licensed clinical psychologist.

    “Each participant is assigned a coach trained and supervised by a licensed clinical psychologist (CJB).”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductnone given

    The study is approved by the George Washington University Institutional Review Board (NCR224269) and registered with clinicaltrials.gov (NCT05905250).

    “This study is approved by the George Washington University Institutional Review Board (NCR224269) and registered with clinicaltrials.gov (NCT05905250).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    The clinical trial follows CONSORT guidelines.

    “The clinical trial follows CONSORT guidelines.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    The target sample size is n=150, with representation of each sex ≥35% and racial/ethnic minorities ≥35%.

    “The target sample size is n=150 (with representation of each sex [≥35%] and racial/ethnic minorities [≥35%])”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    An attention control should not include active intervention elements.

    “To better align with the purpose of an AC (i.e., not to include active intervention elements [55])”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [55] source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Program usability is assessed using an adapted and abbreviated version of the System Usability Scale.

    “Program usability is assessed using an adapted and abbreviated version of the System Usability Scale [58].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [58] source

  • May combine two claims.

    Study design and conductcitation

    Recommended processes are used to ensure coaching protocol fidelity, including tracking logs, review of 25% of audio-recorded coaching calls using a fidelity checklist, and regularly occurring supervision.

    “Recommended processes are used to ensure coaching protocol fidelity (i.e., tracking logs, review of audio-recorded coaching calls [25%] using a fidelity checklist, regularly-occurring supervision) [52].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [52] source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    Participant randomization is stratified by biological sex and age (18-29, 30-39).

    “Participant randomization is stratified by biological sex (due to the different cancer types by biological sex, e.g., breast, testicular, and relatedly different treatment protocols and implications) and age (18-29, 30-39, given likely developmental differences in emerging versus later young adulthood).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    To examine preliminary efficacy on hope and quality of life, we will assess changes through ANCOVA using the intent-to-treat principle.

    “To examine preliminary efficacy on hope and quality of life, we will assess the respective changes through ANCOVA using the intent-to-treat principle.”
    Quote in the paperSubstantial claim
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  • The paper relies on this without support.

    The formative research sample of 23 YA cancer survivors is representative enough of the target population for the identified preferences and needs to guide intervention adaptations.

    “we conducted formative work involving semi-structured video interviews with YA cancer survivors (n=23) [51] to inform intervention refinements”

  • The paper relies on this without support.

    The target population of YA cancer survivors has sufficient access to mobile smart-devices or computers to use the digital program.

    “The interface for the 2 digital programs was designed to be accessible on a mobile smart-device or online via computer.”
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Authors
McCready, D. M., Arem, H., Duarte, D. A., Dennis, K., Ball, N., Cafferty, L. A., Hinds, P. S., Howlader, A., & Berg, C. J.
Affiliations
  • George Washington University (US)
  • Georgetown University (US)
  • Children's National (US)
Corresponding author
Berg, Carla J.
ORCID
Venue
Contemporary Clinical Trials
Publisher
Elsevier BV
Published
2024-06
Volume
141
Pages
107545
ISSN
1551-7144 (ISSN-L)
DOI
10.1016/j.cct.2024.107545
PMC
PMC11365041
OpenAlex
W4395013863
Cited by
8
References
61
Citations by year
2026: 3 · 2025: 5
FWCI
1.36
Type
journal article
Language
en
Open access
Licence
Locations
  • Contemporary Clinical Trials (acceptedVersion)
  • SSRN Electronic Journal (acceptedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institute on Drug Abuse (R01DA054751)
  • Agency for Healthcare Research and Quality (R01CA249988, R18HS029807)
  • National Cancer Institute (R21CA261884, R01CA215155, R01CA278229, R01CA275066, R01CA239178)
  • National Institutes of Health
  • National Institute of Environmental Health Sciences
  • Centers for Disease Control and Prevention (U01DP006639)
  • Fogarty International Center (D43TW012456, R01TW010664, D43ES030927)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
Keywords
young adult cancer survivors, psychosocial needs, digital health interventions, hope, acceptance and commitment therapy, quality of life, intervention adaptation, feasibility and acceptability
MeSH terms
Mentoring, Cancer Survivors, Psychosocial Intervention, Adolescent, Adult, Anxiety, Depression, Female, Humans, Male, Quality of Life, Research Design, Randomized Controlled Trials as Topic, Young Adult, Hope

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read under definition version 3 (extract-v3) on 2026-09-28.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

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