PROJECT SUMMARY/ABSTRACT
A cancer diagnosis directly threatens sexual and reproductive health (SRH), an essential component of healthy
development in adolescents and young adults (AYAs). Nearly 60% of AYAs undergoing cancer treatment report
a need for SRH counseling, yet this need is rarely met. This gap in care leaves patients at high risk for making
uninformed decisions that can negatively impact short and long-term SRH. Although national guidelines advise
clinician responsibility for discussing SRH, clinicians rarely engage in these conversations. The proposed study
serves as a first step towards improving SRH outcomes for AYA cancer patients and survivors by developing an
intervention to 1) provide individualized, efficient, patient-centered care and 2) enhance patient-clinician
communication. Dr. Frederick will complete formal didactic coursework, workshops, and career development
programs focused on behavioral intervention science, mixed methods analysis, and clinical trial conduct, that
will prepare her to achieve this goal. She is guided by a robust mentorship team consisting of Primary Mentor,
Dr. Freyer (AYA oncology, quantitative research, clinical trials); Co-Mentor, Dr. Quinn (LGBTQ+ AYA cancer
care, oncofertility, mixed methods research, intervention science); and Co-Mentor, Dr. Bober (SRH in cancer,
qualitative methods, intervention science). This team is supported by a scientific advisory committee with
expertise in implementation science, technology-based communication interventions, and mHealth. In addition,
Dr. Frederick will have access to the abundant and diverse resources of Connecticut Children's and the
University of Connecticut School of Medicine. More specifically, the proposed project will develop, refine, and
assess proof-of-concept (POC) of the Reproductive and Sexual health Patient Education and Communication
Tool (ReSPECT), a novel, patient-centered, web-based intervention that allows AYAs to discreetly communicate
SRH questions and concerns to their oncology clinicians and offers a time-saving strategy for clinicians to assess
patient need and individualize counsel. ReSPECT consists of 3 parts: (1) an AYA-centered pre-visit
questionnaire (PVQ) to alert clinicians to a patient's SRH questions/concerns, (2) targeted patient education
based on PVQ topic selection, and (3) clinician-centered guidance for addressing specific SRH concerns.
Stakeholder interviews with AYAs, survivors, and pediatric oncology clinicians will guide development and
refinement of ReSPECT through qualitative interviews (Aim 1). Next, ReSPECT will undergo POC testing with
30 AYA/clinician pairs in outpatient oncology clinics at Connecticut Children's and Children's Hospital Los
Angeles to assess feasibility, acceptability, usability, and perceived impact on AYA-clinician SRH communication
(Aim 2), and to evaluate preliminary outcomes by comparing pre- and post-intervention survey data (Aim 3). At
study conclusion, ReSPECT will be ready for testing in a randomized controlled trial (planned R01). The
proposed intervention is the first step in developing a systematic program of research that will improve SRH care
for tens of thousands of AYA patients who currently do not have access to the vital resources they need.
