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AYA ACCESS Study: An enhanced eHealth and Chat-bot enabled delivery model for clinical genetic services in community AYA cancer patients

Award Number: R01CA284748
ORGANIZATION: NATIONAL CANCER INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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AYA ACCESS Study: An enhanced eHealth and Chat-bot enabled delivery model for clinical genetic services in community AYA cancer patients - Each year, approximately 90,000 adolescents and young adults (AYA; National Cancer Institute defined age 15- 39 years at cancer diagnosis) are diagnosed with cancer. Despite increasing recognition that over 10% of AYAs harbor a pathogenic or likely pathogenic germline mutation in cancer predisposition genes, we know that many AYA do not get genetic testing, particularly at centers where there is limited access to genetic services. Focused efforts on the delivery of genetic services in the community setting, where many AYAs receive their care are needed to improve outcomes in this population. To address this important gap in genetic testing among AYAs and to address the need for innovative and effective models for delivery of genetic services in community oncology practices, we propose that an enhanced multimodality eHealth remote genetic services delivery model could increase uptake of genetic counseling and genetic testing among AYA. Our enhanced eHealth delivery model builds upon related research demonstrating high uptake of web-based pre-test counseling as an alternative to pre-test counseling with a genetic counselor with no difference in patient reported outcomes (R01 CA190871:Bradbury). Further, we propose to incorporate chatbot technology into our web-based alternative to address patient-specific questions and to increase engagement and provide service reminders and educational support throughout the delivery model. The overall goal of the study is to evaluate if our enhanced eHealth and chatbot enabled delivery model can increase uptake of genetic services and provide non-inferior patient reported outcomes as compared to the standard model for remote services. We will recruit AYA patients through the NCORP (National Cancer Institute Community Oncology Research Program). We propose a randomized study in 396 AYA cancer patients (18-39 YO at enrollment) in community practices to evaluate the efficacy of an enhanced eHealth and chatbot enabled delivery model as compared to remote genetic counseling and testing to increase uptake of cancer genetic testing in AYA (Aim 1). In Aim 2, we will evaluate the efficacy of the enhanced eHealth and chatbot enabled delivery model to provide non-inferior short-term and longitudinal cognitive (e.g. knowledge), affective (e.g. distress), and behavioral outcomes (e.g. cancer screening and communication to relatives) and costs (Aim 2a), and moderators of these short-term and longitudinal patient outcomes to understand who benefits more or less from the delivery intervention (Aim 2b). Concurrently, we will conduct a CFIR (Consolidated Framework for Implementation Research)-informed process evaluation to understand moderators of intervention usage and patient outcomes and facilitators and barriers to future implementation and sustainability of these delivery models to AYA cancer patients (Aim 3).


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $687,745 )
2025	2025	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cancer Cause and Prevention Research	000	2	3/11/2025	NON-COMPETING CONTINUATION	$618,971
2025	2025	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cancer Cause and Prevention Research	001	2	5/21/2025	NON-COMPETING CONTINUATION	$68,774
														Subtotal = $687,745

Issue Date FY: 2024 ( Subtotal = $754,398 )
2024	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Cancer Cause and Prevention Research	000	1	3/14/2024	NEW	$754,398
														Subtotal = $754,398

Grand Total All Awards = $1,442,143

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AYA ACCESS Study: An enhanced eHealth and Chat-bot enabled delivery model for clinical genetic services in community AYA cancer patients

Award Number: R01CA284748

ORGANIZATION: NATIONAL CANCER INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

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