Family Building Decision Support for Female Adolescent and Young Adult Cancer Survivors

Feasibility will be assessed by study enrollment. The intervention will be considered feasible if N=48 AYAs enroll during the 10-month study period.

The intervention will be considered feasible if >80% of participants complete all four sessions.

Feasibility will be assessed by a novel questionnaire designed to assess use of program skills (intervention strategies). Participants will be asked to evaluate the frequency with which they used skills or ideas presented in the intervention program, on a scale from 1 (not at all) to 6 (every day), since their last study session.

Feasibility will be assessed by a novel questionnaire designed to assess use of program skills (intervention strategies). Participants will be asked to evaluate use of 16 specific program skills or strategies since their last study session, on a scale of 1 (not at all) to 5 (6 or more days per week).

The Client Satisfaction Questionnaire is an 8-item scale assessing participants' views of an intervention as acceptable and satisfactory. Items are rated on a 4-point scale (e.g., 1 "very dissatisfied" to 4 "very satisfied") and averaged. The intervention will be considered acceptable if >80% of intervention arm participants rate it as >3 out of 4.

The Treatment Acceptability Questionnaire is a six-item scale assessing participants' views of an intervention as acceptable, ethical, and effective. Items are rated on a 7-point Likert scale (e.g., 1 "very unacceptable" to 7 "very acceptable") and averaged. The intervention will be acceptable if >80% of intervention arm participants rate it as >5 out of 7 on the TAQ.

Participants will complete the 13-item Satisfaction with Therapy and Therapist Scale-Revised specific to the program they received. The first 12 items ask participants to rate their agreement with statements related to intervention satisfaction on a 5-point scale ranging from "strongly disagree" (1) to "strongly agree" (5). The 13th item asks "How much did the intervention help with your symptoms?" with 5 answer choices ranging from "made things a lot better" to "made things a lot worse."

Decisional conflict related to family building options will be assessed using the Decisional Conflict Scale. Participants will respond to 16 questions about decisional conflict related to family building from 0 (strongly agree) to 4 (strongly disagree). The total scores ranges from 0 to 64, with higher scores indicating greater conflict.

Self-efficacy will be assessed using the Decision Self-Efficacy Scale; items will be worded to assess self-efficacy for family building decision-making. Participants will respond to 11 items assessing decision self-efficacy from 0 (not at all confident) to 4 (very confident). The total score ranges from 0 to 44, with higher scores indicating greater self-efficacy.

Distress will be assessed using the 18-item Reproductive Concerns after Cancer Scale. Participants will respond to statements with ratings from 1 (strongly disagree) to 5 (strongly agree) about concerns related to having (more) biological children. The total score ranges from 18 to 90, with higher scores indicating greater reproductive-related concerns.

Distress will be assessed using the Fertility Problem Inventory, which asks participants to rate their agreement with 38 statements across 4 domains (social concerns, relationship concerns, rejection of childfree lifestyle, need for parenthood). Participants will rate each statement from 1 (strongly disagree) to 6 (strongly agree). The total score ranges from 38 to 228, with higher scores indicating greater fertility-related distress.

Knowledge will be assessed using an item pool developed for the study. Each participant will respond true (1) or false (0) to 10 items, with the specific items being dependent on the risk-based education provided and associated family building options discussed during the intervention sessions. Knowledge will be calculated as the percent of correct items.

Participants will respond to a novel 8-item questionnaire assessing unmet fertility information needs. Participants will respond yes (1) or no (0) to questions asking if they have as much information as they would like about different fertility-related topics. The total score ranges from 0 to 8, with higher scores indicating a greater number of unmet fertility information needs.

Family building priorities will be assessed by the Family Building Priorities Tool, a measure that presents 10 topics that people may consider when deciding which family building options to pursue. Participants are asked to rank each item from 10 (most important) to 1 (least important).

Participants will be asked to indicate yes (1) or no (0) to questions asking if they have spoken with anyone about family building goals, and if they have taken any action steps toward family building goals. Participants will also be asked who they spoke with about their family building goals (if anyone), what specific steps they have taken toward family building (if they have taken any steps)), and what barriers they have faced to working toward family building goals (if they have taken no steps).