Abstract
Radioactive iodine (RAI) therapy is routinely used among patients diagnosed with differentiated thyroid cancer
(DTC), with approximately 76% of patients receiving RAI. Patients with DTC post RAI treatment report
extensive short-term and late effects of treatment, symptom burden, and unmet informational needs about
treatment related side effects. However, thyroid cancer is frequently referred to as the “good cancer” and is an
understudied cancer population for survivorship research and web-based interventions. One way to address
these gaps is through digital technologies such as a web-based intervention, which can empower patients with
direct access to educational and support tools to reduce symptom burden. I propose to develop and evaluate a
web-based intervention, called iSupport (informational support among patients post RAI treatment), to reduce
symptom burden among patients diagnosed with DTC post RAI. I propose the following aims: Aim 1 (K99).
Develop iSupport, a web-based intervention, for patients with DTC post RAI therapy. Aim 2 (K99). Test the
usability of the newly developed iSupport intervention among patients with DTC post RAI. Aim 3 (R00).
Assess the feasibility and acceptability of the iSupport intervention. Aim 4 (R00). Test the preliminary efficacy
of the iSupport intervention vs. treatment as usual (TAU) among patients with DTC on symptom burden. The
K99 phase will involve: 1) conducting patient focus groups (N=32) and individual stakeholder interviews (N=12)
to develop iSupport and 2) testing the usability of the iSupport intervention among patients with DTC post RAI
therapy (N=8). The R00 phase will involve conducting a pilot randomized controlled trial (RCT; N=72) to: 1)
assess the feasibility and acceptability of iSupport and 2) test the preliminary efficacy of iSupport compared to
a (TAU) control group with DTC patients on RAI-related symptom burden, patient bioheath indicators (oral
mucositis; oral health problems), knowledge of DTC and RAI, self-efficacy for coping with side effects, cancer-
related distress, and health-related quality of life. The overall objective of the K99/R00 is to provide Dr. Carr
with training and mentorship to become an independent cancer control investigator with expertise in digital
technology evidenced-based interventions among cancer patients. The K99 training goals include: 1) increase
knowledge of clinical concerns and symptoms among patients with DTC post RAI, 2) obtain advanced training
in technology-based intervention design and development, 3) develop expertise in behavioral intervention
clinical trials design and testing, and 4) refine grant writing and leadership skills for future independence. Dr.
Carr’s mentorship team includes Drs. Kristi Graves (primary), Jacqueline Jonklaas (co-mentor), and Kristen
Miller (co-mentor) who are committed to her career development. The proposed training plan will facilitate Dr.
Carr’s transition to independence as a cancer control researcher with expertise in digital health interventions to
reduce symptom burden and improve health-related quality of life in cancer patient outcomes after treatment.
