the use of mobile technology and peer navigation to promote adolescent and young adult (aya) cancer survivorship care: results of a randomized controlled trial

Adolescent and young adult (aya) cancer survivors experience unique barriers that compromise receipt of survivorship care; therefore, development of innovative educational interventions to improve rates of aya survivorship care is needed. the efficacy of text-messaging and peer navigation interventions was compared to standard-of-care survivorship educational materials to increase ayas’ (1) late effects knowledge and (2) knowledge, attitudes, and self-efficacy towards seeking survivor-focused care. this was a three-armed, prospective, randomized controlled trial with one control group and two intervention groups. the control group received current standard-of-care educational materials. one intervention group participated in a text-messaging program, and the second participated in a peer navigator program. participants completed pre- and post-intervention questionnaires. study outcome variables were quantified using fisher exact tests, two-sample t tests, exact mcnemar tests, conditional logistic regression models, and analysis of covariance. seventy-one survivors completed the study (control n = 24; text-messaging n = 23; peer navigation n = 24). late effects knowledge was high at baseline for all groups. the text-messaging group had increased survivorship care knowledge compared to the control group (p < 0.05); the peer navigation group had increased survivorship care self-efficacy compared to the control group; p < 0.05. both intervention groups showed increased attitudes towards seeking survivor-focused care compared to the control group (text-messaging p < 0.05; peer navigation p < 0.05). each intervention demonstrated significant benefits compared to the control group. given the preliminary effectiveness of both interventions, each can potentially be used in the future by aya cancer survivors to educate and empower them to obtain needed survivorship care.