Improving Goals of Care Conversations Between Doctors and Young Adults With Cancer

The purpose of this study is to adapt a goals of care communication tool, called Jumpstart, for adolescent and young adult cancer patients (also called AYAC). Goals of care conversations are discussions between patients and their doctors about the patient's wishes, values, and priorities for their care. The Jumpstart tool was created for adult patients to help start these conversations during doctor's appointments. This study will adapt the tool so that it works better for adolescent and young adult patients with cancer. We will also look at whether the tool is practical and useful for AYAC and for medical doctors who see or treat AYAC patients.

Inclusion Criteria: Patient (All Aims) * Between ages 18-39; * Has a diagnosis of Stage III or IV cancer as per clinician note in the EMR; * Attended at least one, but no more than three, appointments with their oncologist as per EMR or self-report; * English as their primary language in the EMR; * Can independently consent to study procedures without a surrogate or legally authorized representative; * MSK treating oncologist answers "no" to the question, "Would you be surprised if this patient died within the next year?" * AIMS 2 \& 3 ONLY: Did not participate in previous aims Clinician (All Aims) * are 18 or older; * are an MSK oncologist who sees AYAC patients * AIMS 2 \& 3 ONLY: Did not participate in previous aims Exclusion Criteria: * Clinician (Aims 1 \& 2): none * Patient (Aim 3 ONLY) * if a GOCC has previously been documented in the EMR