Grant Number:	1R01CA303658-01A1 Interpret this number
Primary Investigator:	Marchak, Jordan
Organization:	Emory University
Project Title:	Using Survivorlink to Re-Engage Adults in Cancer Care After Transition (Survivorlink Re-Acct)
Fiscal Year:	2026

SurvivorLink RE-ACCT- Project Summary Facilitating the successful healthcare transition (HCT) of survivors from the pediatric to adult setting is critical to the long-term health of the growing childhood cancer survivor population. The National Academy of Medicine and Children's Oncology Group (COG) recommend lifelong risk-based surveillance for survivors because many late effects do not emerge until years after treatment. However, most young adult survivors of childhood cancer (YASCC) no longer engage in survivor care after leaving the pediatric setting, discontinuing risk-based surveillance as they become increasingly vulnerable to late effects. This project seeks to facilitate re- engagement in survivor care among YASCC using the Cancer SurvivorLinkTM platform as a critical foundation for a novel mobile application (app) to address the complex system- and patient-level barriers experienced by YASCC after HCT. We propose to co-design a mobile app with YASCC and clinicians (Aim 1), followed by a randomized clinical trial (RCT) with N=170 YASCC (Aim 2) and organizational readiness assessments among 20 pediatric cancer centers (Aim 3). In Aim 1, we will engage in iterative co-design and usability testing with YASCC (N=30) and clinicians (N=20) to inform adaptations to the existing SurvivorLink app—focused on information sharing—into the novel SurvivorLink RE-ACCT mobile app, which will also support self- management and deliver educational content to aid HCT. In Aim 2, we will assess the efficacy and implementation of the SurvivorLink RE-ACCT mobile app through an RCT with N=170 YASCC (≤29.99 years old) who are transferring from pediatric to adult survivor care (e.g., next visit to be in adult setting). Efficacy outcomes include: 1) re-engagement in survivor care (i.e., attendance at ≥1 risk-based surveillance appointment) within 18 months post-discharge from pediatrics, and 2) patient-reported health beliefs, cancer communication, self-efficacy, and transition readiness. Implementation outcomes include: 1) reach and 2) patient-level adoption from SurvivorLink usage data over 18 months, and 3) implementation assessed by surveys and interviews to determine the acceptability, feasibility, and appropriateness of the RE-ACCT mobile app. In Aim 3, we will assess the readiness for implementation of the SurvivorLink HCT mobile app and implementation strategies for delivery through a mixed-methods study among 20 COG institutions serving YASCC. We will assess readiness for implementation and delivery capacity in terms of resources, optimal workflow, and recommended implementation strategies among pediatric institutions that transfer YASCC to adult survivor care. These data will inform the implementation strategies for intervention sites for a future scalability trial. Our approach to leverage mobile health technology to support communication and care navigation following HCT in pediatric oncology is novel, meets an identified need, and can be readily scaled for use at pediatric cancer clinics nationwide.





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