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The protocol targets a three-arm randomized hybrid type 1 effectiveness and implementation design within the Childhood Cancer Survivor Study population, enrolling 360 participants. Arm A uses videoconferencing, Arm B uses phone-based delivery, and Arm C provides usual care. 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Henderson 1*, Mary Ashley Allen1, Rajia Mim2, Brian Egleston3, Linda Fleisher3, Elena Elkin4,  \nKevin Oeffinger5, Kevin Krull6, Demetrios Ofidis2, Briana Mcleod2, Hannah Griffin2, Elizabeth Wood2, Cara Cacioppo2, Michelle Weinberg2, Sarah Brown2, Sarah Howe2, Aaron McDonald6, Chris Vukadinovich6, Shani Alston6, Dayton Rinehart6, Gregory T. Armstrong6 and Angela R. Bradbury2,7  \nAbstract  \nBackground Germline cancer genetic testing has become a standard evidence-based practice, with established risk reduction and screening guidelines for genetic carriers. Access to genetic services is limited in many places, which leaves many genetic carriers unidentified and at risk for late diagnosis of cancers and poor outcomes. This poses a problem for childhood cancer survivors, as this is a population with an increased risk for subsequent malignant neoplasms (SMN) due to cancer therapy or inherited cancer predisposition. The ENGaging and Activating cancer survivors in Genetic services (ENGAGE) study evaluates the effectiveness of an in-home, collaborative PCP model of remote telegenetic services to increase uptake of cancer genetic testing in childhood cancer survivors compared to usual care options for genetic testing.  \nMethods The ENGAGE study is a 3-arm randomized hybrid type 1 effectiveness and implementation study  \nwithin the Childhood Cancer Survivor Study population which tests a clinical intervention while gathering information on its delivery during the effectiveness trial and its potential for future implementation among 360 participants. Participants are randomized into three arms. Those randomized to Arm A receive genetic services via videoconferencing, those in Arm B receive these services by phone, and those randomized to Arm C will receive usual care services. Discussion With many barriers to accessing genetic services, innovative delivery models are needed to address this gap and increase uptake of genetic services. The ENGAGE study evaluates the effectiveness of an adapted model of remote delivery of genetic services to increase the uptake of recommended genetic testing in childhood cancer survivors. This study assesses the uptake in remote genetic services and identify barriers to uptake to inform future  \n*Correspondence:  \nTara O. Henderson  \n[thenderson@bsd.uchicago.edu](thenderson@bsd.uchicago.edu)  \nFull list of author information is available at the end of the article  \n© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ()[. The Creative Commons Public Domain Dedication waiver (](http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domai","cbCaibBJvkc57VgQ","https://ap.wps.com/l/cbCaibBJvkc57VgQ","pdf",2487100,18,"English","# Abstract\n## Background\n## Methods\n## Discussion\n## Trial registration\n## Keywords","[{\"question\":\"What problem does the ENGAGE study address?\",\"answer\":\"Access to cancer genetic services is limited for many patients, leaving genetic carriers unidentified and at risk of late cancer diagnosis. For childhood cancer survivors, this gap matters because of increased risk of subsequent malignant neoplasms.\"},{\"question\":\"How are participants assigned across the three study arms?\",\"answer\":\"Participants are randomized into three arms: Arm A receives genetic services via videoconferencing, Arm B receives services by phone, and Arm C receives usual care.\"},{\"question\":\"What is the main goal of this hybrid effectiveness and implementation protocol?\",\"answer\":\"The protocol tests a clinical intervention to increase uptake of recommended genetic testing while also collecting information on delivery and barriers to support future implementation beyond the study population.\"}]","The ENGAGE study - Study Protocol - Open Access | PDF",1789995618,45]