{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:09:02Z","timestamp":1790190542486,"version":"4.1.0"},"reference-count":54,"publisher":"American Medical Association (AMA)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Young adults (YAs; ages 18-39 years) diagnosed with cancer face unique psychosocial challenges, including high distress and poor health-related quality of life (HRQOL). There are few efficacious interventions tailored to their needs.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To evaluate the efficacy of Bright IDEAS-YA, a problem-solving skills training intervention tailored for YAs, in reducing distress and improving HRQOL.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This randomized clinical trial was conducted at 3 academic medical centers and enrolled participants between February 2021 and March 2024. Eligible participants were aged 18 to 39 years, within 4 months of a first cancer diagnosis, and undergoing systemic therapy. Participants completed surveys at baseline and 3, 6, 12, and 24 months.<\/jats:p>\n <\/jats:sec>\n \n Intervention<\/jats:title>\n Bright IDEAS-YA is a 6-session, one-on-one intervention that teaches a structured approach to problem-solving. Enhanced usual care (EUC) included standard psychosocial care plus a list of adolescent and YA resources.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Primary outcomes were depression and anxiety (Patient-Reported Outcomes Measurement Information System Short Forms) and HRQOL (Functional Assessment of Cancer Therapy-General) at 6 months. Problem-solving ability (Social Problem-Solving Inventory-Revised Short Form) was examined as a mediator. Analyses used linear mixed effects models and mediation analysis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Of the 1128 YAs screened, 344 YAs (median [IQR] age, 31.27 [25.78-36.38] years; 251 female [62.5%]) enrolled, with 171 allocated to intervention and 173 allocated to control. Overall, 296 YAs (86.0%) and 280 YAs (81.4%) completed 3- and 6-month surveys, respectively. At 6 months, the intervention group showed significantly greater improvements than EUC in depression (effect size estimate, \u22123.23 points; 95% CI, \u22124.93 to \u22121.53 points;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), anxiety (effect size estimate,\u22122.43 points; 95% CI, \u22124.05 to \u22120.81 points;\n P<\/jats:italic>\n \u2009=\u2009.003), and HRQOL (effect size estimate, 3.40 points; 95% CI, 0.34 to 6.45 points;\n P<\/jats:italic>\n \u2009=\u2009.03). These changes were clinically meaningful. Mediation analyses showed that improvements in depression and anxiety were partially due to increased problem-solving ability, particularly reductions in negative problem orientation. Sex and education were moderators of treatment effect, with the treatment effect on anxiety being greater for males (effect size estimate, \u22125.29 points; 95% CI, \u22127.97 to \u22122.60 points) and the treatment effect on anxiety (effect size estimate, \u22126.94 points; 95% CI, \u221210.50 to \u22123.43 points) and depression (effect size estimate, \u22127.47 points; 95% CI, \u221211.20 to \u22123.74 points;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) being greater for those with lower education.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this randomized clinical trial of Bright IDEAS-YA, intervention participants had significantly reduced distress and improved HRQOL relative to control. These findings suggest that Bright IDEAS-YA may be offered as supportive care for YAs with cancer to improve psychosocial outcomes.<\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT04585269<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.7997","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T15:00:21Z","timestamp":1776783621000},"page":"e267997","source":"Crossref","is-referenced-by-count":1,"title":["Bright IDEAS-YA Skills Training and Psychosocial Outcomes of Young Adults With Cancer"],"prefix":"10.1001","volume":"9","author":[{"given":"Katie A.","family":"Devine","sequence":"first","affiliation":[{"name":"Pediatric Population Science, Outcomes, and Disparities Research Section, Division of Pediatric Hematology and Oncology, Department of Pediatrics, Rutgers Cancer Institute, New Brunswick, New Jersey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Barnett","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine A.","family":"Donovan","sequence":"additional","affiliation":[{"name":"Moffitt Cancer Center, Tampa, Florida"},{"name":"Mayo Clinic, Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lora M. 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