Grant Number:	1R34CA318298-01 Interpret this number
Primary Investigator:	Lauckner, Carolyn
Organization:	Henry Ford Health + Michigan State University Health Sciences
Project Title:	Development of a Digital Alcohol Reduction Intervention for Adolescent and Young Adult Cancer Survivors: Preparation for an Optimization Trial
Fiscal Year:	2026

PROJECT SUMMARY/ABSTRACT Adolescent and young adult cancer survivors (AYAs) are at elevated risk for alcohol misuse, a known risk factor for poor quality of life and mental health, cardiovascular disease, and cancer incidence and mortality. Roughly 75% of AYAs currently drink alcohol, over 50% exceed moderate drinking recommendations, and 20- 36% engage in heavy alcohol use. Unfortunately, existing interventions for alcohol misuse in the general population fail to target the unique cancer-related stressors AYAs face that can influence their drinking. These stressors include fear of cancer recurrence, worry about fertility, and financial toxicity. To address this critical intervention gap, we previously developed a brief, technology-based intervention called TRAC-AYA: Tracking and Reducing Alcohol Consumption in AYAs (R21 CA261844), which incorporated daily self-monitoring and four weekly phone-based counseling sessions targeting motivation, skills, and cancer-related alcohol triggers. The intervention demonstrated strong feasibility and acceptability; however, our preliminary research with oncology clinicians suggests that the resources required to implement this intervention may not be scalable within cancer care settings. Moreover, recognizing the competing life demands and busy schedules of AYAs, it may be useful to determine if all components of this intervention are necessary in order to achieve meaningful reductions in alcohol misuse. Thus, this proposal aims to adapt TRAC-AYA for fully asynchronous, digital delivery, guided by a conceptual model and containing the following four components: brief motivational intervention, behavioral skills training, emotion regulation training, and resources for cancer stressors. Following adaptation and usability testing (Aim 1), we will conduct a pilot optimization trial (N=80 post- treatment AYAs) as part of the Preparation phase of the Multiphase Optimization Strategy (MOST) in order to assess the feasibility and acceptability of the intervention components, which will utilize a highly efficient factorial design with 16 conditions (Aim 2). We will also evaluate how the intervention components are related to proposed mediators (readiness to change drinking, drink refusal self-efficacy, and problem-focused coping behaviors) and the primary outcome of alcohol misuse, in an effort to refine our conceptual model (Aim 3). The overall goal of this research is to prepare for a fully-powered optimization trial, which will allow us to identify an optimized version of the intervention that leads to the best expected effect on alcohol misuse while balancing efficiency. The research proposed in this application is innovative because it is testing a novel approach with respect to intervention content and is the first designed to address alcohol misuse among AYAs. It is significant because it will set the stage for a larger trial of an intervention that is responsive to the needs of AYAs and has high potential for broad dissemination given its scalable and accessible nature.





None