Attention Bias Modification for the Improvement of Anxiety in Adolescent and Young Adult Cancer Survivors

N/ACompletedNCT06682039

Fred Hutchinson Cancer Center70 enrolled

Overview

This clinical trial studies how well attention bias modification (ABM) improves anxiety in adolescent and young adult (AYA) cancer survivors. Cancer-related anxiety is the most prevalent mental health problem affecting AYA cancer survivors. Cancer-related anxiety is associated with long-term negative outcomes such as poor quality of life, depression, distress, substance use, sleep problems, fatigue, and pain. ABM uses techniques to help patients change the way they react to environmental triggers that may cause a negative reaction. ABM uses brief self-guided smartphone applications. Patients complete repetitive association reaction-time tasks targeting automatic and unconscious negative attention biases to retrain attention away from perceived threat and towards a neutral or positive stimuli. Gratitude-finding and savoring activities are also provided to maintain and increase positive emotions. Using ABM plus gratitude-finding and savoring activities may improve anxiety in AYA cancer survivors.

OUTLINE: Patients are randomized to 1 of 2 arms. ARM I: Patients engage in ABM over 10 minutes twice a week (BIW) and respond daily to text messaging prompts activity for 4 weeks. ARM II: Patients engage in inert attention task sessions over 10 minutes BIW for 4 weeks. Patients also receive and respond to text messaging prompts QD for 4 weeks. After completion of study intervention, patients are followed up at 4 weeks. After completion of this 4 week follow up survey, patients are given access to all components of ABM and texts on study.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Enrollment

Conditions

Interventions

Internet-Based InterventionOTHER

Engage in ABM + text messaging prompts

Internet-Based InterventionOTHER

Engage in inert attention task sessions

InterviewOTHER

Ancillary studies

Questionnaire AdministrationOTHER

Ancillary studies

Text Message-Based Navigation InterventionOTHER

Participants will respond to daily messaging prompts.

Eligibility

Sex: ALLMin age: 15 YearsMax age: 29 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age 15-29 years * Diagnosis of cancer malignancy * Received active/curative cancer treatment OR received/actively receiving cancer survivorship care at Seattle Children's Hospital (SCH) or other study referring site (e.g. St. Jude) * Currently off active/curative cancer treatment * Patient able to understand/read/write English language * Cognitively able to participate in ABM intervention and complete surveys * Patient has access to smartphone able to send and receive text messages * Patient has access to computer or smartphone for Inquisit program Exclusion Criteria: * Patients on active/curative cancer treatment * Cognitively or physically unable to participate in ABM intervention and surveys * Patients who cannot understand/read/write English will be excluded from the research because the ABM intervention is currently only available in English * Furthermore, patients who do not have access to technology (smartphone/computer) will be excluded from the study as this technology is absolutely required to engage in the study intervention

Outcomes

Primary Outcomes

Clinic recruitment rates

Feasibility will be assessed via clinic recruitment rates, defined as (number \[#\] of adolescent and young adults \[AYAs\] who enroll in the study) / (total # of AYAs screened as eligible). Attention bias modification (ABM) will be considered feasible with ≥ 50% enrollment.

Time frame: Up to 4 weeks post-intervention

Retention rates

Uptake will be assessed via retention rates, defined as (# of AYAs who complete 4-week treatment duration of ABM) / (# of AYAs who enroll in the study). ABM will be considered feasible with ≥ 70% retention.

Time frame: Up to 4 weeks post-intervention

Patient acceptability of ABM: Client Satisfaction Questionnaire (CSQ-8)

Will be assessed using the Client Satisfaction Questionnaire (CSQ-8). The CSQ-8 is an 8-item questionnaire used to assess level of satisfaction with care. Items are scored on a Likert scale from 1 (low satisfaction) to 4 (high satisfaction) with different descriptors for each response point. Total scores range from 8 to 32, with higher scores indicating greater satisfaction(scores ≥26 indicate satisfaction).

Time frame: At 4 weeks post intervention

Patient acceptability of ABM: System Usability Scale (SUS)

Will be assessed using the System Usability Scale (SUS). The SUS is a well-validated and widely used 10-item scale to evaluate the perceived usability of digital interventions. Items are rated on a 5-point Likert scale for a total score ranging from 0-100, and scores ≥ 70 considered adequate usability.