Targeting wellBeing in AdoLescent and young Adult treated for CaNCEr (BALANCE)

The BALANCE intervention was developed with adolescents and adults (AYAs) experienced with cancer and clinicians specialising in youth and young adult in cancer care. The intervention consists of different components: Educational modules The BALANCE intervention consists of a selection of online lifestyle modules and three individual one-hour coaching sessions with the interventionists (psychologists, social workers or nurses experienced in cancer care and specifically trained in the intervention) delivered over an 8-week period. Modules will be delivered within 3 domains: Body, Mind, and Connections. The Body modules covers sub-modules on movement, nourishment, rest, reproduction, pain and health screening; the Mind module encompasses emotional wellbeing; and the Connections module aims to support social wellbeing, with a focus of friends, family, intimacy, and the wider world such as negotiating schoolwork, university or employment. The educational information will be delivered in various forms: text, short videos, podcasts, and links to reputable websites. The length of each topic varies between 30 and 90 minutes to complete. Participants will be able to pause and return to the module or skip topics that may not interest them. AYAs have varying needs; hence the intervention ‘prescribed’ by the clinician is individually tailored to each participant during their first intervention consultation. However, the modules covering movement, nourishment and emotional distress are mandatory (and consistently measured at each time point), whereas the remaining modules are non-compulsory. Participants will have the flexibility to complete intervention modules based on their interests and needs, completing them at their own pace and preferred time. Within the coaching sessions, interventionists will guide participants to additional modules mutually considered to be suitable for their needs, creating personalised support. For participants with specific concerns or quantified distress, a mechanism has been developed for evaluation and referral to specialists at Canteen or within the Youth Cancer Services. Interactive components There are also interactive components within the BALANCE program, which comprise: 1. Motivational messages for eight weeks via an interactive eBook, animations and video podcasts accessible via the project’s secure web platform. 2. Online diary and journaling tools contextualised to the program, which are confidential to the participant and not able to be accessed by project staff. 3. A private and fully moderated online community (Canteen Connect) for participants to foster peer support and encouragement to achieve their individual goals. 4. A link to the project’s online data collection platform to enable participants to fill out study questionnaires at the specified time points. Virtual consultations All participants will undertake three individual one-hour consultations with Canteen staff (cancer nurses, psychologists and social workers) trained in the intervention over the 8-week intervention period. All participants will have an introductory session with a research assistant to ascertain their baseline health and wellbeing needs. Coaching sessions will occur at Weeks 2, 5 and 8 via Zoom, enabling remote access to expert advice and support in the participant’s choice of location. In keeping with privacy guidelines, virtual consultations will occur in a private environment and will not be recorded. The structure of the three coaching sessions will include: 1. Rapport building, assessment of personal risk factors, exploration of personal aims, collaborative goal setting for behavioural changes relevant to personal risk factors and participant aims, and discussions on movement, nourishment, and emotional well-being. 2. Checking in with the participant's progress in the program, reviewing and addressing any issues, discussing relevant learning modules, exploring the integration of self-care into their weekly routine, and addressing strategies for managing setbacks. 3. Reflecting on the participant's feelings about the program, reviewing and addressing any issues, revisiting goals and making necessary adjustments, discussing ways to stay motivated, and emphasizing the importance of establishing lifelong healthy habits. Adherence will be measured in several ways: website analytics to monitor completion of online modules and attendance at coaching sessions.