Testing the Feasibility of a Virtual Application to Support Breast and Colorectal Cancer Survivors

• virtual self-management intervention (Behavioral): The intervention is a supportive information and self-management tool housed on the SeamlessMD mobile app, created in collaboration with the SeamlessMD development program and informed by foundational research. The application will be used as an information hub and self-management/navigation tool alongside usual care, to address the physical, psychosocial, and practical needs of breast and colorectal cancer survivors. Note that the intervention will not seek to change or impact a survivor's follow-up care plan, as decided upon by the participant and their care team.

Primary outcomes

• Recruitment [During enrollment]: Case report forms will be used to track recruitment metrics. The following demographics will be collected to monitor the diversity of those participating: cancer type (breast, colorectal), stage at diagnosis (in situ, stage 1, stage 2, stage 3, do not know), age (in years, prefer not to say), sex assigned at birth (male, female, intersex, prefer not to say), gender (man, woman, non-binary, other, prefer not to say), residence (rural, suburban, urban, prefer not to say), and highest level of education achieved (less than high school, high school, some post-secondary (college or university), diploma or degree, prefer not to say).
• Retention [Enrollment to day 180]: Case report forms will be used to track retention metrics.
• Usage of the Intervention [Baseline to day 180]: Usage metrics will be collected using the SeamlessMD software to determine the following: 1) how often the intervention was accessed by participants, 2) what elements of the intervention were accessed most, and 3) what elements of the program were utilized the least.
• Survivor and Provider Acceptability and Experience [Interviews with survivor participants will be conducted after having access to the intervention for 180 days.]: Assessed via one-on-one semi-structured interviews with a sub-sample of study participants and providers at both study sites. Semi-structured interviews were chosen over focus groups for this component because the research team is seeking individual experiences with the intervention. Interviews will be carried out by a member of the research team on video conferencing software using a predetermined interview guide and will take approximately 45 minutes. The questions will center around the study participant's follow-up care experience while being supported by the intervention. Interviews with providers will focus on the feasibility and acceptability of the supportive self-management tool.

Secondary outcomes

• Fear of Recurrence [Outcomes will be captured at baseline (study entry), on days 90 and 180, directly through the Seamless MD app software.]: Will be assessed using the 6-item Cancer Worry Scale, a validated patient-reported instrument. Cancer Worry Scale (CWS) scores range from 6 to 24 points. A score of 6 points indicates low worry, while a score of 24 points indicates very high worry.
• Patient Activation [Outcomes will be captured at baseline (study entry), on days 90 and 180, directly through the Seamless MD app software.]: Will be assessed with the 13-item Patient Activation Measure (PAM), a validated patient-reported instrument. PAM includes 13 questions that produce a score on a 0-100 scale, which correlates with 1 of 4 activation levels. A level 1 score indicates low activation, while a level 4 score indicates a high activation.
• Information Provision [Outcomes will be captured at baseline (study entry), on days 90 and 180, directly through the Seamless MD app software.]: There are no validated instruments to assess information provision on its own. Therefore, these will be assessed using modified survey items from the Canadian Transitions Survey, a national survey on survivors' needs and experiences after completing cancer treatment.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Adults older than 18 years, capable of providing informed consent
* Diagnosed with stage I-III breast or colorectal cancer, and have completed primary treatment for their cancer (surgery and/or adjuvant systemic or radiation therapy) 6 months - 5 years ago