Table 4.

Feedback from Intervention Development Interviews and Ways Feedback Informed the Prototype Intervention

Theme	Participant comments	Intervention considerations
Need for the proposed intervention: symptom experience of YAs	1. Post-treatment pain, fatigue, and emotional distress are common and serve as reminders of cancer and contribute to additional distress	• Include cognitive defusion strategies to become unhooked from thoughts and continue on the path toward valued and meaningful activities
	2. Experience of grief/loss about areas of life that had changed or were different than they had hoped/planned	• Include strategies to build meaning and identify and work toward the legacy they would like to live and give to others
	3. Post-treatment symptoms impact YAs' relationships with others	• Help participants identify members of their support network who can provide different types of support (i.e., emotional, task, both), and assist them with matching their support needs with individuals who can best provide the support • Include assertive communication strategies for asking for support and saying no to close others
Symptom management strategies	1. Value of social support for managing symptoms	• Deliver intervention sessions in a group format • Review their support networks and learn how best to communicate (i.e., making requests, saying no) with these individuals to receive support in the service of symptom management (e.g., through assertive communication strategies)
	2. Importance of communicating with the medical team about symptoms and for identifying symptom management strategies	• Include strategies for communicating with the medical team (e.g., “Doc Talk Cards”)
	3. Physical activity as a strategy for coping with pain, fatigue, and emotional distress	• Include a home-based physical activity program and provide participants with wireless activity trackers to increase awareness of physical activity
	4. Changes in prioritization of values and focus on value-consistent meaningful activities	• Include a values clarification exercise to help participants identify and prioritize their values and identify value-consistent goals • Create actionable goals using the SMART framework
	5. Use of activity pacing, self-compassion, relaxation training, meditation, and positive self-talk for managing symptoms in the service of working toward goals	• Include the following symptom management strategies: (1) activity–rest cycling; (2) exercises to build self-compassion; (3) relaxation training/meditations (e.g., progressive muscle relaxation, loving kindness mediation, guided imagery); (4) identifying workable self-talk
Utility of the intervention and feedback on intervention structure/format	1. Value in meeting other young survivors who understood their experience for normalizing and reducing stigma around post-treatment symptoms	• Deliver the intervention in a group format • Provide extra time for participants to have more casual interactions with one another
	2. Importance of keeping the group sizes small to increase comfort with contributing	• Groups will be no larger than five participants led by two group leaders
	3. Positive response to a mobile application to access symptom coping skills on-the-go	• Introduce the mobile application as a way to access skills learned in the group-based sessions on the go and reinforce skill use outside of sessions
	4. Value of being able to chat with group members and group leaders outside of session	• Include a moderated chat function within the mobile application
Barriers to intervention participation	1. Being in the midst of treatment/close to cancer diagnosis	• Eligible participants will have completed primary treatments
	2. Travel distance/time to get to the cancer center with in-person sessions	• Deliver the intervention remotely through Zoom
	3. Differences in group members' experiences due to differences in diagnosis/treatments received, prognosis, and ages/life stages may make it harder for participants to relate to one another	• Address broad topics of relevance to YAs (e.g., communicating with work/school, engaging your support network, communicating with your medical team) • Point out similarities in participants experiences (e.g., symptom experience, follow-up care, etc.) in spite of differences (e.g., cancer and treatment types, age) • Recruit participants at a similar stage of their cancer care (e.g., within 2 years of treatment completion) • Restrict the eligibility to include only those aged 18–39
	4. Not having access to the internet or a Smartphone/Tablet	• Provide YAs with a tablet that includes a data plan to access Zoom calls or mobile application, as necessary
	5. Mobile application only being compatible with Android or iPhone operating systems	• Create a mobile application that operates on both Android and iPhone devices
	6. Competing demands (work/school/childcare) interfering with participation	• Offer the intervention sessions in the evenings, early in the morning, or on weekends • Provide individual make up sessions if a participant has to miss the group

SMART, specific, measurable, achievable, relevant, time-oriented; YA, young adult.