title: Guided internet-administered self-help to reduce symptoms of anxiety and depression among adolescents and young adults diagnosed with cancer during adolescence (U-CARE: YoungCan): a study protocol for a feasibility trial.
abstract: A subgroup of adolescents and young adults diagnosed with cancer during adolescence reports elevated levels of anxiety and depressive symptoms and unmet needs for psychological support. Evidence-based psychological treatments tailored for this population are lacking. This protocol describes a feasibility study of a guided-internet-administered self-help programme (YoungCan) primarily targeting symptoms of anxiety and depression among young persons diagnosed with cancer during adolescence and of the planned study procedures for a future controlled trial.
  
  
  
  The study is an uncontrolled feasibility trial with a pre-post and 3-month follow-up design. Potential participants aged 15-25 years, diagnosed with cancer during adolescence, will be identified via the Swedish Childhood Cancer Registry. 30 participants will be included. Participants will receive YoungCan, a 12-week therapist-guided, internet-administered self-help programme consisting primarily of cognitive-behavioural therapy organised into individually assigned modules targeting depressive symptoms, worry and anxiety, body dissatisfaction and post-traumatic stress. Interactive peer support and psychoeducative functions are also available. Feasibility outcomes include: recruitment and eligibility criteria; data collection; attrition; resources needed to complete the study and programme; safety procedures; participants' and therapists' adherence to the programme; and participants' acceptability of the programme and study methodology. Additionally, mechanisms of impact will be explored and data regarding symptoms of anxiety, depression, post-traumatic stress, body dissatisfaction, reactions to social interactions, quality of life, axis I diagnoses according to the Mini International Neuropsychiatric Interview and healthcare service use will be collected. Exploratory analyses of changes in targeted outcomes will be conducted.
  
  
  
  This feasibility protocol was approved by the Regional Ethical Review Board in Uppsala, Sweden (ref: 2016/210). Findings will be disseminated to relevant research, clinical, health service and patient communities through publications in peer-reviewed and popular science journals and presentations at scientific and clinical conferences.
  
  
  
  ISRCTN97835363.
authors.affiliation: Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Ander
authors.affiliation: Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Wikman
authors.affiliation: Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Brjánn
authors.initials: B
authors.lastname: Ljótsson
authors.affiliation: Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Helena
authors.initials: H
authors.lastname: Grönqvist
authors.affiliation: Pediatric Oncology, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Gustaf
authors.initials: G
authors.lastname: Ljungman
authors.affiliation: Clinical Education Development and Research (CEDAR), Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
authors.forename: Joanne
authors.initials: J
authors.lastname: Woodford
authors.affiliation: Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Annika
authors.initials: A
authors.lastname: Lindahl Norberg
authors.affiliation: Clinical Psychology in Healthcare, Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Louise
authors.initials: L
authors.lastname: von Essen
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology / Q000628:therapy*; D001828:Body Image / Q000523:psychology; D000073116:Cancer Survivors / Q000523:psychology*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020407:Internet; D008297:Male; D010342:Patient Acceptance of Health Care; D036301:Qualitative Research; D000073278:Self-Management / Q000379:methods*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology / Q000628:therapy*; D013548:Sweden; D013813:Therapy, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: adolescence; cognitive behavioural therapy; feasibility study; neoplasms; psychological treatment