NCT07138040

Brief Summary

The goal of this clinical trial is to test the efficacy (how well they work) of different digital interventions that deliver information to adolescent and young adult (AYA) survivors of childhood cancer to promote re-engagement in cancer-related long-term follow-up care (LTFU). The main aims are:

  • To test the efficacy of adaptive interventions (AIs) that begin with low touch intervention (LTI) as compared to written information (WI) on attending an appointment, and self-reported self-management among AYA.
  • To identify the most efficacious second-stage strategy for those who initially schedule/attend an appointment (maintenance vs. step-up) and for those who do not (step-up vs. step-up maximum).
  • To assess multilevel factors contributing to the effects of re-engaging AYA and how best to integrate AIs into practice. Throughout the duration of the study, participants will complete four surveys, receive a series of interventions, and may be asked to participate in an interview (post-intervention).

Trial Health

77
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
530

participants targeted

Target at P75+ for not_applicable cancer

Timeline
22mo left

Started Aug 2025

Typical duration for not_applicable cancer

Geographic Reach
1 country

3 active sites

Status
recruiting

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Progress32%
Aug 2025Apr 2028

Study Start

First participant enrolled

August 1, 2025

Completed
14 days until next milestone

First Submitted

Initial submission to the registry

August 15, 2025

Completed
7 days until next milestone

First Posted

Study publicly available on registry

August 22, 2025

Completed
2.7 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

April 30, 2028

Expected
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

April 30, 2028

Last Updated

February 18, 2026

Status Verified

February 1, 2026

Enrollment Period

2.7 years

First QC Date

August 15, 2025

Last Update Submit

February 16, 2026

Conditions

Keywords

SurvivorAdolescents and Young AdultsDigital Health InterventionAdaptive InterventionSequential Multiple Assignment Randomized TrialLong Term Follow Up CareSurvivorship Care Plan

Outcome Measures

Primary Outcomes (1)

  • Re-Engagement in Care - by T4

    Percentage of participants who re-engage in care (attend a LTFU appointment) by T4 as measured by electronic health record (EHR) review. If attendance is not viewable in EHR, it will be ascertained by self-report (yes/no).

    36 weeks (T4)

Secondary Outcomes (7)

  • Re-Engagement in Care - by T3

    20 weeks (T3)

  • AYA Self-Management (Health Knowledge Inventory)

    2 times - at 20 weeks (T3) and 36 weeks (T4)

  • AYA Self-Management (Transition Readiness Questionnaire)

    2 times - at 20 weeks (T3) and 36 weeks (T4)

  • AYA Self-Management (Self-Management Skills)

    2 times - at 20 weeks (T3) and 36 weeks (T4)

  • AYA Self-Management (Health Goal Progress)

    2 times - at 20 weeks (T3) and 36 weeks (T4)

  • +2 more secondary outcomes

Study Arms (7)

Written Intervention + Written Intervention (Responders)

EXPERIMENTAL

Start with written intervention (WI) in stage 1, those who respond (schedule an appointment) in stage 1 continue receiving WI in stage 2 (maintenance).

Behavioral: Stage 1 Written InformationBehavioral: Stage 2 Written Information

Written Intervention + Low Touch Intervention (Responders)

EXPERIMENTAL

Start with written intervention (WI) in stage 1, those who respond (schedule an appointment) in stage 1, step up to receive low touch intervention (LTI) in stage 2.

Behavioral: Stage 1 Written InformationBehavioral: Stage 2 Low Touch Intervention

Written Intervention + Low Touch Intervention (Non-Responders)

EXPERIMENTAL

Start with written intervention (WI) in stage 1, those who don't respond (do no schedule an appointment in stage 1), step up to receive low touch intervention (LTI) in stage 2.

Behavioral: Stage 1 Written InformationBehavioral: Stage 2 Low Touch Intervention

Written Intervention + High Touch Intervention (Non-Responders)

EXPERIMENTAL

Start with written intervention (WI) in stage 1, those who don't respond (schedule and appointment) in stage 1, step up (maximum) to receive high touch intervention (HTI) in stage 2.

Behavioral: Stage 1 Written InformationBehavioral: Stage 2 High Touch Intervention

Low Touch Intervention + Low Touch Intervention (Responders)

EXPERIMENTAL

Start with low touch intervention (LTI) in stage 1, those who respond (schedule an appointment in stage 1), continue receiving LTI in stage 2 (maintenance).

Behavioral: Stage 1 Low Touch InterventionBehavioral: Stage 2 Low Touch Intervention

Low Touch Intervention + High Touch Intervention (Responders)

EXPERIMENTAL

Start with low touch intervention (LTI) in stage 1, those who respond (schedule an appointment in stage 1), step up to receive high touch intervention (HTI) in stage 2.

Behavioral: Stage 1 Low Touch InterventionBehavioral: Stage 2 High Touch Intervention

Low Touch Intervention + High Touch Intervention (Non-Responders)

EXPERIMENTAL

Start with low touch intervention (LTI) in stage 1, those who don't respond (don't schedule an appointment) in stage 1, step up to receive high touch intervention (HTI) in stage 2.

Behavioral: Stage 1 Low Touch InterventionBehavioral: Stage 2 High Touch Intervention

Interventions

Stage 1 WI: consists of a letter from the survivorship care team with information about long-term follow-up care and relevant contacts to schedule an appointment.

Also known as: S1 WI
Written Intervention + High Touch Intervention (Non-Responders)Written Intervention + Low Touch Intervention (Non-Responders)Written Intervention + Low Touch Intervention (Responders)Written Intervention + Written Intervention (Responders)

Stage 1 LTI: consists of the WI stage 1 letter, a copy of their treatment summary with instructions for creating their own survivorship care plan, and one text message per week with information to schedule a follow-up care appointment.

Also known as: S1 LTI
Low Touch Intervention + High Touch Intervention (Non-Responders)Low Touch Intervention + High Touch Intervention (Responders)Low Touch Intervention + Low Touch Intervention (Responders)

Stage 2 WI: consists of a letter from the survivorship care team with information about what to expect at a long-term follow-up care appointment.

Also known as: S2 WI
Written Intervention + Written Intervention (Responders)

Stage 2 LTI: consists of the WI stage 2 letter, a copy of their treatment summary with instructions for creating their own survivorship care plan, and two to three non-tailored (generic) text messages per week related to scheduling an appointment, overcoming barriers to follow-up care, and health self-management.

Also known as: S2 LTI
Low Touch Intervention + Low Touch Intervention (Responders)Written Intervention + Low Touch Intervention (Non-Responders)Written Intervention + Low Touch Intervention (Responders)

Stage 2 HTI: consists of personalized mobile-friendly dashboard containing the WI letters, their treatment summary, survivorship care plan, and a growing discover section with helpful tailored resources. They will also receive four to six text messages per week with personalized messages related to their chosen health goal, personal barriers to attending cancer-related follow-up care, treatment-related risks, information about scheduling their long-term follow-up appointments, health self-management, and fun texts consisting of celebrity quotes, memes, and altruistic messages.

Also known as: S2 HTI, HTI
Low Touch Intervention + High Touch Intervention (Non-Responders)Low Touch Intervention + High Touch Intervention (Responders)Written Intervention + High Touch Intervention (Non-Responders)

Eligibility Criteria

Age15 Years - 29 Years
Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64)

You may qualify if:

  • years old
  • History of a childhood cancer diagnosis, diagnosed prior to age 22
  • Has not had a cancer-related follow-up visit in at least 15 months (or is 3 months past recommended follow-up)
  • U.S. resident (not international patient)
  • Has previously attended a cancer-related appointment at Children's Hospital of Philadelphia, or Nationwide Children's Hospital or Penn
  • At least 2 years from end of treatment and 5 years from diagnosis
  • English proficient
  • For AYA under age 18, must have a caregiver to provide informed consent

You may not qualify if:

  • Cognitive impairment limiting participation
  • Received surgery only treatment
  • Transferred to primary care
  • Currently living with cancer diagnosis (either new, metastatic, recurrence, or relapse)
  • Absence of documentation of treatment history
  • Primary caregiver or other support person (e.g. partner, sibling, other caregiver)
  • At least 18 years old
  • U.S. resident
  • English proficient
  • No involvement in the AYA's healthcare
  • AYA Decline support person's participation

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (3)

Nationwide Children's Hospital

Columbus, Ohio, 43205, United States

RECRUITING

Children's Hospital of Philadelphia

Philadelphia, Pennsylvania, 19104, United States

RECRUITING

Penn Medicine

Philadelphia, Pennsylvania, 19104, United States

RECRUITING

MeSH Terms

Conditions

Neoplasms

Central Study Contacts

Lisa Schwartz, PhD

CONTACT

Sara King-Dowling, PhD

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
HEALTH SERVICES RESEARCH
Intervention Model
SEQUENTIAL
Model Details: Sequential Multiple Assignment Randomized Trial with 2 stages of randomization
Sponsor Type
OTHER
Responsible Party
SPONSOR

Study Record Dates

First Submitted

August 15, 2025

First Posted

August 22, 2025

Study Start

August 1, 2025

Primary Completion (Estimated)

April 30, 2028

Study Completion (Estimated)

April 30, 2028

Last Updated

February 18, 2026

Record last verified: 2026-02

Locations