PROJECT SUMMARY/ABSTRACT Adolescent and young adult cancer survivors (AYACSs) face multiple disparities, including impaired psychosocial health, isolation, limited access to psychological services, and unmet needs for psychosocial support. Despite these disparities, there is a lack of interventions to mitigate these disparities and improve the quality of life (QOL) of AYACSs. Furthermore, previous studies among AYACSs have often overlooked their diverse developmental stages and preferences concerning psychosocial care. While expressive writing interventions have demonstrated positive effects on various health outcomes among older adult cancer survivors and healthy young adults, they have primarily been implemented as individual-based approaches. One innovative idea to adapt such interventions for AYACSs is to combine individual-based writing with social support from a group of peers experiencing similar challenges. Thus, this proposed study aims to develop and evaluate a virtual, group-based expressive writing intervention, grounded in a conceptual framework tailored to the unique developmental needs of AYACSs and incorporating their communication preferences. The overarching goal is to enhance the QOL and reduce stress of AYACSs. Aim 1(K99) is to develop a virtual, group-based expressive writing intervention and assess the feasibility and acceptability. To promote group cohesion, group composition preferences (i.e., age-similar or general groups) will be assessed before the intervention. Aim 2 (K99) is to refine and optimize the intervention based on quantitative and qualitative data obtained from Aim 1, in collaboration with stakeholders such as the MD Anderson Young Adult Advisory Council, AYA clinic providers, and AYA organizations, as well as the PI’s mentorship team. Finally, Aim 3 (R00) is to assess the effects of the intervention on QOL, perceived stress, and stress biomarkers compared to a control group. If successful, this intervention will be ready for widespread expansion, including to underserved communities with limited resources and support. The PI’s long-term career and research goal is to become an independent oncology nurse scientist in the areas of cancer prevention and control, developing and evaluating novel psychosocial interventions to improve QOL and eliminate health disparities among AYACSs. To achieve this goal, the PI seeks specialized training in various areas, such as psychosocial and behavioral interventions, understanding the diverse developmental needs of AYACSs, proficiency in quantitative, qualitative, mixed-methods research, and stress biomarkers, and professional development. The proposed training areas will be obtained through hands-on training with mentors, taking formal courses, and active participation in conferences and institutional trainings. In summary, the proposed research plan and training will enable the PI to transition to independence by providing the necessary skills and preliminary data to successfully compete for future R01-level grants.

PROJECT NARRATIVE Adolescent and young adult cancer survivors (AYACSs) encounter psychosocial challenges that are often not addressed by existing interventions, leading to disparities in their quality of life (QOL). In response, the proposed study aims to develop and evaluate a virtual, group-based expressive writing intervention that takes into account developmental stages and communication preferences of AYACSs to improve their QOL and reduce stress. If successful, this intervention will be ready for widespread expansion, including to underserved communities with limited resources and support.