Internet and Social-Media Program for Improving Quality of Life in Long-Term Cancer Survivors Who Underwent Stem Cell Transplant

• PHQ-8 depression score as reported on the PCA, using binary outcomes [ Time Frame: Up to 12 months ] [ Designated as safety issue: No ]
  
• Cancer and treatment distress (CTXD) score as reported on the PCA using binary outcomes [ Time Frame: Up to 12 months ] [ Designated as safety issue: No ]
  
• Proportion of adherence to recommended survivorship preventive care and barriers to PCA [ Time Frame: Up to 12 months ] [ Designated as safety issue: No ]
  

• Physical function, as assessed by the PROMIS scale [ Time Frame: Up to 12 months ] [ Designated as safety issue: No ]
  
• Total minutes per week of moderate to vigorous intensity exercise as assessed by the Godin Leisure Time Exercise Questionnaire [ Time Frame: Up to 12 months ] [ Designated as safety issue: No ]
  This measure is a measure of leisure time physical activity.
  
  
• Health behaviors [ Time Frame: Up to 12 months ] [ Designated as safety issue: No ]
  Health behaviors are scored for: non-smoking, alcohol less than one glass a day for women or two glasses a day for men, moderate to vigorous physical activity > 150 min a week, regular use of sunscreen of SPF > 30, food intake of 5 servings of fruits and vegetables a day, body mass index 25 or less, sleep averaging > 7 hours a night. Items are matched to NHANES or BRFSS for normative comparisons.
  
  

PRIMARY OBJECTIVES:

I. Determine whether 2-10 year hematopoietic cell transplant (HCT) survivors with elevated depression or cancer-related distress who are randomized to receive access to a tailored internet-based program report reduced depression and distress when compared with control group survivors who receive access to an internet site with links to transplant and cancer-specific online resources and delayed access to the internet site (active control).

II. Determine whether survivors with low survivorship preventive care adherence (PCA) who are randomized to receive access to the tailored internet-based program, including a survivorship preventive care plan, report increased PCA when compared with the active control group survivors.

SECONDARY OBJECTIVES:

I. Secondary outcomes will include process measures of internet study reach and utilization, as well as physical function, physical activity level, and knowledge of survivorship needs. Further analyses will identify risk factors for disparities in survivorship preventive care adherence in HCT survivors.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Participants receive full access to the INSPIRE internet site comprising a an individually tailored program with a greeting home page with links to each target area, self-care tips and tool pages for each complication and major issues for HCT survivors, a section for each complication (mood, energy, heart health, strengthening bones, second cancers), a discussion board for input from other survivors, resource pages, opportunities to send secure messages with questions or comments on any topic, opportunities to request additional assistance or information, mobile texting options, and social media links.

ARM II: Participants receive website links to existing transplant and cancer survivor sites, followed by delayed access to the INSPIRE internet program after 1 year.