Employed cancer survivors develop a peer-support intervention to improve social connections: a participatory design study.

Introduction: Among the 4.3 million working-age breast cancer survivors in the U.S., employment offers financial stability, purpose, and normalcy. However, many face barriers that hinder workforce participation, including social disconnection. Using a participatory intervention design approach that directly engages survivors, this study aimed to identify root causes of disconnection and prioritize solutions to support psychosocial wellbeing and work retention. Methods: This study recruited six employed breast cancer survivors for a design team that used the Intervention Design and Analysis Scorecard's (IDEAS) Steps 1-5 to develop and prioritize intervention options. The team, facilitated by university researchers, met for seven 1-h sessions. Qualitative data from IDEAS worksheets and meeting notes were analyzed. Results: Survivors identified three causes of social disconnection: (1) changes in self-concept and worldview, (2) symptom-related social withdrawal, and (3) unsupportive responses from others. The team developed and evaluated three intervention models, considering scope, effectiveness, resources, and barriers. An intervention including written materials, a website, a peer-led support group, and a social media forum, was prioritized as the most feasible and impactful option. A follow-up study will pilot-test the intervention to assess effects on wellbeing and work outcomes. Discussion: The team prioritized a multi-component intervention to foster connection and work engagement primarily targeting individual and interpersonal factors rather than workplace-level factors, likely reflecting the absence of a common employer. Findings highlight social connection as a modifiable target and support further intervention development and pilot-testing, with attention to accessibility and relevance across diverse survivor populations through cultural, economic, and structural adaptations.