Development of an mHealth Alcohol Reduction Intervention for Adolescent and Young Adult Cancer Survivors (Preprint)

BACKGROUND Adolescent and young adult survivors of cancer (AYAs, aged 15-39) frequently engage in hazardous alcohol use, which can have multiple mental and physical health effects. OBJECTIVE The aim of this study was to adapt and refine an existing motivational interviewing-based mHealth alcohol reduction intervention, called Tracking and Reducing Alcohol Consumption (TRAC), for post-treatment AYAs. METHODS This was a two-phase, mixed methods study consisting of key informant interviews with post-treatment AYAs aged 18-39, oncology and psycho-oncology providers, and community advocates (n=15) to inform the adaptation of TRAC. After qualitative analysis of interview findings led to the development of the new TRAC-AYA intervention, 4 AYAs completed an open trial of the 4-week intervention and provided feedback on content and protocols through a qualitative exit interview. Descriptive statistics were used to provide data on intervention feasibility and adherence. RESULTS Key informant interviews revealed a need for the intervention to address cancer-specific alcohol use triggers such as scan-related anxiety, financial toxicity, and reproductive health concerns. TRAC-AYA was well-received by open trial participants—enrollment and retention were above target rates (67% and 75%, respectively) and 100% of participants completed at least 3/4 intervention sessions. Participants reported high satisfaction with TRAC-AYA content and its impact on their drinking. CONCLUSIONS Post-treatment AYAs have unique triggers for alcohol use, which should be considered in the development of alcohol reduction interventions for this population. TRAC-AYA represents a potentially valuable tool in addressing high rates of hazardous alcohol use among this population and warrants further evaluation in larger randomized trials. CLINICALTRIAL ClinicalTrials.gov NCT05087875