A232301CD AYA Access Study: An Enhanced eHealth and Chatbot Enabled Delivery Model for Clinical Genetic Services in Community AYA Cancer Patients

Investigating Digital Interventions for Genetic Counseling in Young Cancer Patients

Enrolling By Invitation
18 years or above
All
Phase N/A
535 participants needed
1 Location

Brief description of study

This phase III trial compares the use of a digital chatbot enabled intervention to standard remote genetic services for increasing uptake of genetic counseling and testing among adolescents and young adult (AYA) cancer patients. Genetic testing for cancer predisposition syndromes has become standard evidence-based practice and can inform enhanced screening and risk reducing measures to reduce cancer morbidity and mortality. Despite this, many AYAs are not receiving recommended genetic counseling and testing. Offering remote telehealth services can address access barriers and chatbots and texting interventions could enhance patient outcomes and reduce provider and staff time. The use of a digital chatbot enabled intervention may be equally as effective as standard remote genetic services in AYA cancer patients undergoing genetic testing.

Detailed description of study

The primary and secondary objectives of the study:

PRIMARY OBJECTIVES:

I. To evaluate the efficacy of an enhanced eHealth and chatbot enabled delivery model to increase uptake of genetic counseling.

II. To evaluate the efficacy of an enhanced eHealth and chatbot enabled delivery model to increase uptake of genetic testing.

SECONDARY OBJECTIVE:

I. To evaluate the efficacy of an enhanced eHealth and chatbot enabled delivery model to provide non-inferior short-term and longitudinal cognitive (e.g. knowledge), affective (e.g. distress), and behavioral outcomes (e.g. cancer screening and communication to relatives) and costs.

EXPLORATORY OBJECTIVES:

I. To test for moderators of uptake of counseling and testing (primary objectives).

II. To test for moderators of short-term and longitudinal patient outcomes (secondary objectives).

III. To identify facilitators and barriers to implementation of the enhanced eHealth and chatbot enabled delivery model and standard remote services.

OUTLINE: Patients are randomized to 1 of 2 arms. Non-patient participants are assigned to arm 3.

ARM I: Patients attend a standard of care telehealth visit with a genetic counselor for pretest genetic education. Patients then undergo standard of care genetic testing and attend a telehealth visit with a genetic counselor for disclosure of results.

ARM II: Patients receive access to the Genetic Journey Chatbot and choose to complete digital pre-test genetic education via the digital tool or via telehealth visit with a genetic counselor. Via the chatbot, patients may request a telehealth visit with a genetic counselor at any time to answer unresolved questions. Patients then undergo standard of care genetic testing and attend a telehealth visit with a genetic counselor for disclosure of results. The chatbot remains available to answer questions, assess barriers, and provide reminders for next steps during the testing period.

ARM III: Non-patient participants complete an interview on study.

After completion of study intervention, patients are followed up at 6 and 12 months.

Eligibility of study

You may be eligible for this study if you meet the following criteria:

  • Conditions: Miscellaneous Neoplasm, Nos, Non-Neoplastic Condition, Nos
  • Age: 18 years or above
  • Gender: All

  • PATIENTS: Age ≥ 18 years and ≤ 39 years at the time of enrollment
    • PATIENTS: AYA cancer patients and survivors. This includes patients at any stage of diagnosis (e.g., newly diagnosed, in treatment, in survivorship) and a cancer diagnosis (including pediatric cancers) at any age ≤ 39 years old. Given targeted therapies for BRCA+ and microsatellite instability (MSI)-high/Lynch Syndrome patients and benefit to relatives, patients with metastatic cancer are included. Any history of cancer, regardless of being in treatment or not
    • PATIENTS: Language: In order to complete the mandatory patient-completed measures and receive genetic education and counseling, participants must be able to speak and read English or Spanish
    • PATIENTS: No known diagnosis of dementia or cognitive impairment. Persons with impaired decision-making capacity are ineligible as they need to be able to understand genetic test results, its implications for the patient and family, and explain genetic test results to their family members
    • PATIENTS: No persons with a known psychiatric or documented developmental disorder that affects cognitive or emotional functions to the extent that the capacity for judgment and reason is significantly diminished, such that they cannot participate based on the judgment of the treating physician
    • PATIENTS: Participants must meet National Comprehensive Cancer Network (NCCN) guidelines for genetic testing assessment provided by Penn Telegenetics by the Eligibility Verification Assessment (EVA) chatbot, or paper forms and genetic counselor's review
    • NON-PATIENT PARTICIPANT: Non-patient participants eligible for this study include: oncology providers, members of the care team and clinic staff, genetic counselors, and insurers (i.e., people who work in financial services and/or for insurance companies) who participate in oncology care among AYA in community for this study
    • NON-PATIENT PARTICIPANT: Age ≥ 18 years
    • NON-PATIENT PARTICIPANT: Non-patient participants must be able to speak and read English or Spanish in order to participate in the key informant interviews

This study investigates the use of a digital chatbot-enabled intervention compared to standard remote genetic services to increase the uptake of genetic counseling and testing among adolescents and young adult (AYA) cancer patients. Genetic testing helps identify cancer predisposition syndromes, which can guide enhanced screening and preventive measures. However, many AYA patients do not receive recommended genetic counseling and testing. This study explores whether a digital approach, including chatbots and telehealth, can be as effective as traditional methods in providing these services.

Participants in the study are divided into two arms. In Arm I, patients receive standard telehealth genetic counseling and testing. In Arm II, patients use the Genetic Journey Chatbot for digital pre-test education and can request telehealth visits as needed. Both arms undergo standard genetic testing and have telehealth visits for results disclosure. The chatbot in Arm II offers continuous support and reminders during the testing period. Non-patient participants, such as healthcare providers, are involved in interviews to gather insights.

  • Who can participate: Participants are adolescents and young adults aged 18 to 39 years who have been diagnosed with cancer at any stage or are survivors, including those with BRCA+ and MSI-high/Lynch Syndrome. They must be able to speak and read English or Spanish. Non-patient participants include healthcare providers and staff involved in oncology care for AYA patients.
  • Study details: Participants will either engage with a digital chatbot for genetic education or undergo traditional telehealth sessions. The chatbot allows for flexibility in accessing information and scheduling telehealth visits. Non-patient participants will provide insights through interviews.
Updated on 02 Jul 2026. Study ID: 25-1305
If you need assistance finding a non-cancer clinical research study or if you have any questions, please email psom-ocr@pobox.upenn.edu For Cancer trials contact Penn Medicine's Cancer Trial Navigator at: PMCancerResearch@pennmedicine.upenn.edu or 215-349-8245

Study is selecting its participants from a population, or group of people, decided on by the researchers in advance.

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