The use of mobile technology and peer navigation to promote adolescent and young adult (AYA) cancer survivorship care: results of a randomized controlled trial

J Cancer Surviv. 2019 Aug;13(4):580-592. doi: 10.1007/s11764-019-00777-7. Epub 2019 Jul 26.


Purpose: Adolescent and young adult (AYA) cancer survivors experience unique barriers that compromise receipt of survivorship care; therefore, development of innovative educational interventions to improve rates of AYA survivorship care is needed. The efficacy of text-messaging and peer navigation interventions was compared to standard-of-care survivorship educational materials to increase AYAs' (1) late effects knowledge and (2) knowledge, attitudes, and self-efficacy towards seeking survivor-focused care.

Methods: This was a three-armed, prospective, randomized controlled trial with one control group and two intervention groups. The control group received current standard-of-care educational materials. One intervention group participated in a text-messaging program, and the second participated in a peer navigator program. Participants completed pre- and post-intervention questionnaires. Study outcome variables were quantified using Fisher exact tests, two-sample t tests, exact McNemar tests, conditional logistic regression models, and analysis of covariance.

Results: Seventy-one survivors completed the study (control n = 24; text-messaging n = 23; peer navigation n = 24). Late effects knowledge was high at baseline for all groups. The text-messaging group had increased survivorship care knowledge compared to the control group (p < 0.05); the peer navigation group had increased survivorship care self-efficacy compared to the control group; p < 0.05. Both intervention groups showed increased attitudes towards seeking survivor-focused care compared to the control group (text-messaging p < 0.05; peer navigation p < 0.05).

Conclusions: Each intervention demonstrated significant benefits compared to the control group.

Implications for cancer survivors: Given the preliminary effectiveness of both interventions, each can potentially be used in the future by AYA cancer survivors to educate and empower them to obtain needed survivorship care.

Keywords: Adolescents and young adults; Cancer survivors; Cancer survivorship care; Peer navigation; Text-messaging.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Cancer Survivors* / statistics & numerical data
  • Child
  • Female
  • Humans
  • Male
  • Mobile Applications / statistics & numerical data*
  • Neoplasms / epidemiology
  • Neoplasms / rehabilitation
  • Neoplasms / therapy*
  • Palliative Care* / methods
  • Palliative Care* / statistics & numerical data
  • Patient Acceptance of Health Care / statistics & numerical data
  • Patient Navigation / methods*
  • Patient Navigation / organization & administration
  • Patient Navigation / statistics & numerical data
  • Peer Group*
  • Prospective Studies
  • Psychosocial Support Systems
  • Surveys and Questionnaires
  • Survivorship*
  • Telemedicine / statistics & numerical data
  • Text Messaging
  • Young Adult