Identifying Adaptations to an mHealth Alcohol Reduction Intervention for Reducing Alcohol Use in Adolescent and Young Adult Cancer Survivors: Qualitative Study.

Background: Adolescent and young adult survivors of cancer (aged 15-39 years) frequently engage in hazardous alcohol use, which can have multiple mental and physical health effects. Objective: The aim of this study was 2-fold, to identify the necessary adaptations to an existing motivational interviewing-based mHealth (mobile health) alcohol reduction intervention, called Tracking and Reducing Alcohol Consumption (TRAC), for posttreatment adolescents and young adults, and to develop a tailored intervention for this vulnerable and underserved population. Methods: This was a qualitative study consisting of key informant interviews with posttreatment adolescents and young adults aged 18-39 years, oncology and psych-oncology providers, and community advocates (n=15) to inform the adaptation of TRAC. Thematic qualitative analysis of interview findings was conducted to determine necessary changes to the intervention protocol and content, which would ultimately lead to the development of the new TRAC adolescent and young adult intervention. 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. They also indicated the need to provide education on the link between alcohol and cancer and to reduce the time burden of the intervention, given the many competing life demands of adolescents and young adults. Significant changes were made to the TRAC intervention to create the TRAC adolescent and young adult. We reduced the number of required sessions from 8 to 4, introduced a session devoted to managing cancer-specific triggers, and provided survivors with more information about alcohol and its relationship to cancer. Conclusions: There is potential to increase alcohol intervention relevance and fit for adolescents and young adults by including tailored content relevant to their life experiences while also maintaining core components of such interventions, such as self-monitoring and goal-setting. Remote, brief interventions are important for ensuring acceptability. The new TRAC adolescent and young adult intervention represents a potentially valuable tool in addressing high rates of hazardous alcohol use among this population and warrants further evaluation in randomized trials.