Adolescent and Young Adult (AYA) cancer survivors are expected to assume primary responsibility for their healthcare when they reach adulthood. However, only a minority (lt18%) of adult childhood cancer survivors obtain risk-based follow-up care. Transition readiness is a critical precursor to adult self-management of care, and adult self-management improves health status and reduces healthcare utilization. A growing body of research in other populations has generally shown positive associations between transition readiness and adherence to adult care and better health outcomes. While there is strong evidence demonstrating that the transition to adult-oriented healthcare is critical, there are few formal transition programs available, and no theoretically driven survivor-focused interventions. In this project, we will adapt and extend a prototype digital health intervention, Managing Your Health (MYH), that features guided peer mentor interaction with tailored expert content that addresses survivor-related barriers to transition readiness including inadequate knowledge of cancer treatment and late effect risks, lack of self-management skills, low self-efficacy for managing care, concern about impersonal relationships with adult providers, poor communication with parents and providers, and lower perceived priority of health compared with competing developmental pursuits. Informed by a cohort of key stakeholders and representative users, we will develop the next generation of the intervention of MYH and evaluate it for usability and feasibility among a sample of pediatric cancer survivors.
