Background/rationale
Fear of cancer recurrence (FCR) is the persistent fear of disease progression, relapse, or new malignancies. For survivors of childhood cancer, FCR begins to emerge around ages 13-25. These adolescent and early young adults (AeYA) may be especially vulnerable to clinically significant FCR due to their unique cognitive and social-emotional development. No interventions presently exist to support survivors of childhood cancer with FCR. Fear of Recurrence Therapy (FORT), an evidence-based group therapy for adults, has demonstrated efficacy in reducing FCR and improving quality of life. This study aims to adapt FORT for AeYA survivors of childhood cancer (FORT-AeYA), with the goal of optimizing content and language for this unique group.
Methods
Following the ADAPT framework, our adaptation team of 7 patient partners, 2 pediatric oncology physicians, and 5 clinical psychologists will meet regularly to modify the intervention and study materials between May – August 2025. Adaptations will focus on ensuring content relevance and developmental appropriateness. Adaptations will be tracked and reported using the Framework for Reporting Adaptations and Modifications – Enhanced (FRAME). A preliminary usability study is then planned with 9 AeYA participants to assess intervention acceptability, usefulness, and accessibility, and to inform additional modifications prior to pilot testing.
Impact on practice
FORT-AeYA addresses a critical gap in psychosocial care by adapting an established intervention to meet the unique needs of AeYA survivors of childhood cancer. Findings from the adaptation phase will provide a foundation for developing a targeted clinical support for this population.
Discussion
This presentation will describe the FORT-AeYA adaptation process, key lessons learned to date, and preliminary feedback from patient partners. These findings will guide the next phase of usability testing and pilot feasibility evaluation, with the long-term goal of improving psychosocial outcomes for AeYA survivors of childhood cancer.