Objective: This study aimed to test the inter-rater reliability, construct validity, and feasibility of the modified “Which Health Approaches and Treatments Are You Using?” (WHAT) questionnaires in pediatric oncology. Methods: A sample of parent-child dyads was invited to complete self- and proxy-report modified WHAT, Pediatric Quality of Life Inventory, demographics, a diary of child recent use of CHA, and a questionnaire assessing aspects of feasibility. Parents were also asked to complete a satisfaction of children’s use of CHA survey. Results: Twenty-four dyads completed the study. The mean weighted kappa showed strong inter-rater reliability (k=0.77, SE=0.056); and strong agreements between the modified WHAT and the diary (self-report [k=0.806, SE=0.046], proxy-report [k=0.894, SE=0.057]). Significant relationships were found only between recent and non-recent CHA users in relation to easy access to CHA (self-report [p=0.02], proxy-report [p<0.001]). The mean scores of the feasibility scale (out of 7.0) for the self- and proxy-report were 5.64 (SD=0.23) and 5.81 (SD=0.22), respectively, indicating the feasibility of the modified WHAT. Conclusions: The findings of this study provide initial evidence of the reliability and validity of the modified WHAT questionnaires and their feasibility in assessing child CHA use and initiating clinical discussions about CHA with children and their parents. Further research is needed to test the theoretical relationships and to further explore the validity and reliability of the modified WHAT.

Background: Adolescents with cancer routinely report feelings of isolation and exclusion, including from medical decision-making. To address this problem and support adolescents, we designed and implemented into clinical practice the novel, virtual, weekly Teens4Teens peer support group and patient education program. Objective: We examined the views of participating adolescents, program guest speakers, and program moderators as they pertained to the need for the program and its feasibility, acceptability, and perceived impact. Methods: We recruited all available adolescents, moderators, and guest speakers who participated in Teens4Teens to take part in audio-recorded, semi-structured interviews. Interviews were transcribed, coded, and analyzed using thematic analysis. Results: We conducted 21 interviews across participant groups. We identified four broad themes: pathways into the Teen4Teens program, Teens4Teens implementation capacity, perspectives of the positive impact of Teens4Teens and suggestions to improve Teens4Teens. These themes described a perceived need for adolescent-centered psychosocial programing in pediatric cancer care, provided lessons on how best to build and apply such a program in practice, and highlighted the value of the program for both adolescents and clinicians’ acceptability, feasibility, and perceived utility. Conclusion: Adolescents, guest speakers, and moderators valued Teens4Teens and made suggestions to retain or improve capacity to routinely implement the program. Adolescent-tailored psychosocial programming such as Teens4Teens is positioned to be integrated into clinical care with relative ease and may serve to improve the cancer care experience of adolescents and their families.