{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:38:31Z","timestamp":1782794311165,"version":"3.54.5"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Adolescent and young adult (AYA) cancer survivors ages 18\u201339 report elevated stress and poor health\u2010related quality of life (HRQOL), yet few evidence\u2010based stress management interventions exist that meet their specific needs. Our team designed TOGETHER, a 10\u2010week eHealth group\u2010delivered behavioral intervention designed to improve HRQOL via stress management skills training. To date, TOGETHER has been delivered to seven groups of AYAs, and its feasibility and acceptability have been well established.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This proof\u2010of\u2010concept analysis explored TOGETHER's impact on patient\u2010reported outcomes among AYAs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were English\u2010speaking AYAs aged 18\u201339 who were diagnosed with cancer while aged 15\u201339 and had completed curative treatment within the past five years. Patient\u2010reported outcomes were assessed at baseline and post\u2010intervention and included HRQOL, stress management skills self\u2010efficacy, coping strategies, and depression and anxiety symptoms. Pre\u2010to\u2010post\u2010intervention changes were assessed with paired\u2010samples <jats:italic>t<\/jats:italic>\u2010tests among those with complete data (<jats:italic>n<\/jats:italic>\u00a0=\u00a039) and using a series of imputation strategies. The proportion of participants achieving clinically meaningful change was computed when possible.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants (<jats:italic>N<\/jats:italic>\u00a0=\u00a051) had an average age of 29\u00a0years and were predominantly female (78%), White (69%), and non\u2010Hispanic (80%). HRQOL significantly improved from pre\u2010to post\u2010intervention with small\u2010to\u2010moderate effect sizes (<jats:italic>g<\/jats:italic>s ranged from 0.32\u20130.60), and more than half of participants (51%\u201359%) demonstrated clinically meaningful improvement. Statistically significant improvements were found for stress management skills self\u2010efficacy, coping, and depression symptoms, but not anxiety symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Results provide proof\u2010of\u2010concept evidence that TOGETHER can meaningfully improve patient\u2010reported outcomes among AYA survivors, supporting continued evaluation of the intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial Registration<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>; NCT05048316, NCT05054569, NCT05597228, NCT05952492.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.70234","type":"journal-article","created":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T04:18:27Z","timestamp":1753244307000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["An HRQOL Proof\u2010Of\u2010Concept Analysis of the eHealth TOGETHER Intervention for Adolescent and Young Adult Cancer Survivors: A Brief Report"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4307-5259","authenticated-orcid":false,"given":"Rina S.","family":"Fox","sequence":"first","affiliation":[{"name":"Division of Nursing and Health Sciences University of Arizona College of Nursing  Tucson Arizona USA"},{"name":"University of Arizona Cancer Center  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2403-9562","authenticated-orcid":false,"given":"Terry A.","family":"Badger","sequence":"additional","affiliation":[{"name":"Division of Nursing and Health Sciences University of Arizona College of Nursing  Tucson Arizona USA"},{"name":"University of Arizona Cancer Center  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha","family":"Moya","sequence":"additional","affiliation":[{"name":"University of Arizona Mel and Enid Zuckerman College of Public Health  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M.","family":"Gudenkauf","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Behavior Moffitt Cancer Center  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjorie A.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Division of Nursing and Health Sciences University of Arizona College of Nursing  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1881-2758","authenticated-orcid":false,"given":"Riley M.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Arizona College of Science  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline J.","family":"Leete","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Arizona College of Science  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney E.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Psychology University of Arizona College of Science  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Katsanis","sequence":"additional","affiliation":[{"name":"University of Arizona Cancer Center  Tucson Arizona USA"},{"name":"Department of Pediatrics University of Arizona College of Medicine\u2010Tucson  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3530-8633","authenticated-orcid":false,"given":"David E.","family":"Victorson","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences Northwestern University Feinberg School of Medicine  Chicago Illinois USA"},{"name":"Robert H. Lurie Comprehensive Cancer Center  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacy D.","family":"Sanford","sequence":"additional","affiliation":[{"name":"Robert H. 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