Fear Of cancer Recurrence Group-based intervEntion (FORGE): Study protocol for the co-design of a psychological intervention for young adult cancer survivors

<ns3:p> Background Fear of cancer recurrence (FCR) represents one of the most frequently reported unmet needs among cancer survivors, with young adults demonstrating heightened susceptibility to its effects. Although a range of specialist-delivered psychological interventions has shown efficacy in managing FCR across adult populations, much of this evidence is derived from one-to-one therapeutic formats. Adapting such interventions to a group setting, both to enhance peer support and to improve resource efficiency, necessitates careful adaptation to ensure the programme is appropriately tailored to the group context. The aim of this study is to co-design the adaptation of an existing one-to-one FCR psychological intervention to a group-based setting to support psychosocial distress across the spectrum of FCR needs of young adult cancer survivors in Ireland. Methods This co-design study will use the ADAPT framework to conduct a series of workshops that adopt a modified Nominal Group Technique (NGT) model. Two groups of co-design stakeholders will be recruited nationally (i) <ns3:italic>Experts by Experience</ns3:italic> (Cancer survivors and family caregivers); (ii) <ns3:italic>Experts by Profession</ns3:italic> (e.g., doctors, nurses, psychologists). Three individual workshops with representatives from both groups will be held in different locations across Ireland. A consensus workshop will be held online to collate results via a voting system and establish the design of an adapted group-based FCR intervention. The workshops will be co-facilitated by the lead researcher, a Patient and Public Involvement (PPI) partner and a member of the project steering committee. Discussion Group-based interventions offer an efficient way to deliver targeted FCR support for young adult cancer survivors, while providing peer connection. The adapted peer-co-designed group-based FCR intervention will subsequently undergo feasibility evaluation to determine its acceptability and potential for broader implementation across Irish cancer centres. </ns3:p>