The use of immune checkpoint inhibitors (ICIs) alone or in combination with other cancer treatments isincreasing dramatically with immune-related adverse events (irAEs) common (90%) during ICI treatment. MostirAEs are symptomatic and symptom self-management with timely reporting of moderate or severe symptomsto HCPs may reduce irAE severity by early recognition and management resulting in fewer treatmentinterruptions and unscheduled health services. Using a sequential multiple assignment randomized trial(SMART) design we will initially randomize 286 diverse survivors (30% Hispanic) who are within 12 weeks ofstarting ICIs and who also have elevated psychological distress to an Automated Telephone SymptomManagement (ATSM) or to an active control condition. ATSM consists of weekly telephone symptommonitoring using the PRO-CTCAE items by an automated voice response technology. Participants arereferred to a printed Handbook with information about symptoms evidence-based self-management strategiesand when to report symptoms to HCPs. ATSM automatically sends a weekly symptom summary to HCPs.Active control survivors will receive automated symptom monitoring only with reports sent to HCPs. Survivorsin ATSM whose psychological distress is still elevated for 2 consecutive weeks during weeks 2-8 (non-responders) will be randomized for the second time to add TIPC for 8 weeks or continue with ATSM alone. Wehypothesize adding TIPC will improve self-efficacy for symptom self-management including communicationwith HCPs and increase social support resulting in lower indices of psychological distress other PRO-CTCAEsymptoms clinician-documented irAES (primary outcomes) and unscheduled health services use and ICItreatment interruptions (secondary outcomes). With total intervention time of 16 weeks all survivors will beinterviewed at baseline and week 17 post-intervention and electronic health record data will be extracted forthe participation period. Specific aims: Aim 1. Determine if primary and secondary outcomes over weeks 1-17are lower (better) in the group created by the first randomization: the adaptive intervention that begins withATSM with the need-based addition of TIPC vs. active control group. Aim 2. Among those not responding toATSM on psychological distress during weeks 2-8 who enter the second randomization determine: a) ifprimary and secondary outcomes over weeks 8-17 are lower (better) in TIPC+ATSM vs. ATSM alone group; b)the extent to which the effects of adding TIPC to ATSM on primary and secondary outcomes are mediated byincreased social support self-efficacy for symptom management and for communication with HCP. Aim 3.Explore which baseline characteristics of the survivor cancer and cancer treatment are associated withoptimal primary and secondary outcomes resulting from three supportive care options: 1) symptom monitoringonly with automated reports to HCPs (active control); 2) ATSM alone for 16 weeks; or 3) addition of 8 weeks ofTIPC to ATSM if no response on psychological distress during weeks 2-8.