Peer Support Intervention for Patients Undergoing Hematopoietic Stem Cell Transplantation (STEPP)

The proposed STEPP intervention will be deemed feasible if at least 60% of eligible patients are enrolled in the study, and of those enrolled and randomized to the intervention, at least 60% complete at least 3/5 of the intervention sessions.

The 8-item Client Satisfaction Questionnaire (CSQ) will assess patient satisfaction with the STEPP intervention. Each question is scored from 0-4 to result in a total of 0-24. Higher scores indicate increased acceptability of the intervention. Acceptability will also be assessed using weekly ratings of ease and utility of each intervention session (0=very difficult/not helpful; 10=very easy/very helpful). The mean ease and utility of each exercise and overall will be calculated, and will use a threshold of a mean combined score of 7.0/10 for acceptability.

The Hospital Anxiety Subscale (HADS), comprised of 7 items, will assess symptoms of anxiety in all study participants during the past week. The questionnaire consists of a four-point item response form that quantifies the degree to which participants experience mood symptoms. Scores on each subscale range from 0 to 21, with a cutoff of 8 or greater denoting clinically significant anxiety. The mean anxiety score will be reported for each cohort.

The 45-item Functional Assessment of Cancer Therapy-Bone Marrow Transplant (FACT-BMT) will assess quality of life (QOL) by cohort. The FACT-BMT consists of five subscales assessing well-being across four domains (physical, functional, emotional, social, and bone marrow transplant symptoms). Each question is scored from 0 ("Not at all") to 4 ("Very Much"). The final score will be presented as a percentage, calculated by tallying the total score out of 180. A higher score coincides with a better quality of life. The mean QOL score will be reported for each cohort.

Assessed by the Hospital Depression Subscale (HADs) and Patient Health Questionnaire-9 (PHQ-9). The Hospital Depression Subscale (HADS), comprised of 7 items, will assess symptoms of depression in all study participants during the past week. The questionnaire consists of a four-point item response form that quantifies the degree to which participants experience mood symptoms. Scores on each subscale range from 0 to 21, with a cutoff of 8 or greater denoting clinically significant depression. The PHQ-9 is a 9-item measure that measures participant symptoms over the previous two weeks. Answers range from 0 to 3 with 0 representing "Not At All" to 3 representing "Nearly Every Day." A higher total score represents a greater severity of depression. The mean depression score will be reported for each cohort.

The mean score for post-traumatic stress disorder (PTSD) will be reported by cohort. It will be evaluated using the Post-Traumatic Stress Disorder Checklist - Civilian Version (PCL-C) to assess symptoms of post-traumatic stress in participants. The PCL is a 17 item self-reported measure that evaluates symptoms of post-traumatic stress disorder according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV. Each item is scored from 1-5 for a total of 185 potential points. A higher score indicates higher levels of PTSD.