an eight-week, (45 min/week), theory driven, virtually-delivered, tailored music-based relaxation (TiMBRe) intervention to decrease anxiety in AYA cancer survivors with clinically-relevant anxiety.

Standard of care study staff calls and cancer survivorship resources

1 & 2 Music Listening

• Live music played by the music therapist (e.g., guitar, voice) and AYA selected music will be used to facilitate attention to the present moment and provide cues for breathing/relaxation.

  3 & 4 Music Facilitated Breathing

• The therapist will lead participants in music facilitated breathing exercises using rhythmic features of the music to cue structured breathing for relaxation and self-awareness

  5 & 6 Music Facilitated Progressive Muscle Relaxation for Stress Reduction

• Using music as a structured auditory cue for tensing and releasing of muscles.

  7 Body Percussion

• The therapist will lead participants in a hands-on body percussion activity to bring attention to the sound of rhythm, sensation in their hands and body.

  8 Participants Choice

• will be selected by the participant.

mean scores for the Acceptability E-scale Items are ≥ 4/5

percent of patients recruited over three years

percent of TiMBRe participants to complete the baseline and 8 weeks patient report measures

percent of TiMBRe group participants self-report practicing music-based relaxation skills for at least 10 minutes on at least three days per week

Interviews will be transcribed by a professional HIPAA compliant transcription agency. We will analyze interview data using inductive content analysis.74 Transcripts will be entered into NVivo Qualitative Data Analysis Software (QSR International, Melbourne, Australia). The study team will read transcripts to derive codes, discuss labels to group codes into categories, and identify major themes and corresponding exemplar quotes. The interviewer will write reflexive memos after each interview and review memos with corresponding audio recordings to discern linkages, gaps, and questions.