Project Summary This application is being submitted in response to the Notice of Special Interest (NOSI) NOT-CA-23- 041. In the parent grant, we are developing a telehealth treatment program for addressing cancer survivors' risk behaviors (STELLAR). In early conversations as a part of this work, clinicians have indicated interest in following patients' progress through STELLAR and providing encouragement along the way. Therefore, this project focuses on the creation of reports to facilitate patient-provider communication about patients' STELLAR progress, and an evaluation of these reports on patient health outcomes. Most oncologists do not discuss risk behaviors with cancer survivors. Time constraints and insufficient training in addressing risk behaviors are two widespread barriers to this important communication. Activating this communication is a critical step in supporting cancer survivors' health behavior change, especially as they progress through a tailored intervention. We will employ user-centered design (UCD) methods to develop reports that focus on clinicians' priorities and can be easily implemented into existing clinical workflows. The association between patient-provider communication and patient health outcomes has been well established in the literature. However, little research has looked at explaining how communication impacts health. STELLAR provides an opportunity to test defined and explicit communication pathways including proximal and intermediate outcomes. Through this evaluation, we will be able to better determine the mechanisms through which oncologist communication results in a reduction of cancer risk behaviors and develop future communication support tools that focus on activating these specific pathways. By using UCD methods and studying communication pathways in the pilot trial, we will determine the effectiveness of EMR reports that summarize cancer survivors' progress through STELLAR. Our aims are to: 1. Identify the type of support that oncologists want to see within the medical record to facilitate communication with cancer survivors about their risk behaviors and STELLAR progress. We will use a user-centered design process to create easy to use reports and to ensure we are addressing the needs and preferences of clinicians. 2. Evaluate pathways through which use of the EMR modification influences patient-provider communication and subsequent health outcomes. During the STELLAR pilot trial we will collect and analyze data to evaluate if and how EMR report use changes patient-provider communication and results in improved health outcomes. We will compare: 1) the interactive self-guided intervention, 2) the interactive intervention with human coaching, and 3) digital information about PASC, without an illness uncertainty intervention. We will compare patients enrolled in the STELLAR intervention arm (providers will receive EMR notifications) to those in the control arm (providers will not receive E...