• Total days on which the patient logged in to the app [ Time Frame: Up to 6 months ]
  Change in fatigue between T0 and T1 for the intervention group and between T1 and T2 for the wait-list control group will be entered as dependent variable in multiple regression models, with group allocation as covariate. Separate models will be computed including the different app-usage metrics assessed between T0 -T1 for the intervention group and T1-T2 for the control group as independent variable. These models will additionally be calculated for change in fatigue and use of the app between T0 and T2, for patients in the intervention arm only.
• Total number of activities completed on the app [ Time Frame: Up to 6 months ]
  Change in fatigue between T0 and T1 for the intervention group and between T1 and T2 for the wait-list control group will be entered as dependent variable in multiple regression models, with group allocation as covariate. Separate models will be computed including the different app-usage metrics assessed between T0 -T1 for the intervention group and T1-T2 for the control group as independent variable. These models will additionally be calculated for change in fatigue and use of the app between T0 and T2, for patients in the intervention arm only.
• Total number of completed assessments on the app [ Time Frame: Up to 6 months ]
  Change in fatigue between T0 and T1 for the intervention group and between T1 and T2 for the wait-list control group will be entered as dependent variable in multiple regression models, with group allocation as covariate. Separate models will be computed including the different app-usage metrics assessed between T0 -T1 for the intervention group and T1-T2 for the control group as independent variable. These models will additionally be calculated for change in fatigue and use of the app between T0 and T2, for patients in the intervention arm only.
• Change in negative affect (delta-NA) between T0-T1 [ Time Frame: Baseline up to 3 months ]
  The linear model described for the primary objective will be repeated.
• Change in positive affect (delta (PA) between T0-T1 [ Time Frame: Baseline up to 3 months ]
  The linear model described for the primary objective will be repeated.
• Change in depressive symptoms (delta-depr) between T0 and T1 [ Time Frame: Baseline up to 3 months ]
  The linear model described for the primary objective will be repeated.
• Personality traits [ Time Frame: Up to 6 months ]
  Personality traits and their interaction with group will be added as independent variables to the linear model described for the primary objective.
• Genotypes [ Time Frame: Up to 6 months ]
  Genotypes will be dichotomized (presence of minority alleles in the gene of interest) and added as covariates and in interaction with group to the models.

PRIMARY OBJECTIVES:

I. To assess the effectiveness of an online multidisciplinary psychological training program delivered via a smartphone-based application (the Untire app) in reducing patient-reported fatigue in cancer patients and survivors.

SECONDARY OBJECTIVES:

I. To determine the dose-response association between use of the Untire app and reduction in patient-reported fatigue severity.

II. To explore whether changes in positive and negative affect, depressive symptoms interact with the effects of the Untire app on fatigue severity.

III. To explore the predictive value of genetic markers (single-nucleotide polymorphisms) and personality characteristics for effectiveness of the Untire app in reducing patient-reported fatigue.

OUTLINE: Patients are randomized to 1 of 2 arms.

ARM I: Patients use Untire application intervention after baseline up to 6 months.

ARM II: Patients use Untire application intervention after 3 months up to 6 months.

• Cancer Survivor
• Malignant Neoplasm

• Other: Internet-Based Intervention
  Use Untire application after baseline up to 6 months
• Other: Internet-Based Intervention
  Use Untire application after 3 months up to 6 months
• Other: Quality-of-Life Assessment
  Ancillary studies
  Other Name: Quality of Life Assessment
• Other: Questionnaire Administration
  Ancillary studies

• Experimental: Arm I (Untire application)
  Patients use Untire application intervention after baseline up to 6 months.
  Interventions:

  • Other: Internet-Based Intervention
  • Other: Quality-of-Life Assessment
  • Other: Questionnaire Administration
• Active Comparator: Arm II (Untire application)
  Patients use Untire application intervention after 3 months up to 6 months.
  Interventions:

  • Other: Internet-Based Intervention
  • Other: Quality-of-Life Assessment
  • Other: Questionnaire Administration

Inclusion Criteria:

• Patients who present at the Cancer-Related Fatigue Clinic or the Psychiatric Oncology Clinic for an initial consult
• Patients who speak and read English
• Patients who are willing and able to review, understand, and provide written consent
• Patients who agree to comply with all study procedures
• Patients who are in possession of a smartphone or tablet that supports the Untire app software
• Patients rating their current fatigue severity as moderate to severe (= or > 4 on a 0-10 scale), assessed as part of the clinics' screening procedure

Exclusion Criteria:

• Case report of diagnosis of a formal thought disorder (e.g., schizophrenia)