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JMIR Res Protoc. 2021 Oct 22;10(10):e32789. doi: 10.2196/32789.

Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement During Cancer Treatment: Protocol for Ecological Momentary Assessment.

JMIR research protocols

Alexandra M Psihogios, Mashfiqui Rabbi, Annisa Ahmed, Elise R McKelvey, Yimei Li, Jean-Philippe Laurenceau, Stephen P Hunger, Linda Fleisher, Ahna Lh Pai, Lisa A Schwartz, Susan A Murphy, Lamia P Barakat

Affiliations

  1. Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States.
  2. Department of Statistics, Harvard University, Boston, MA, United States.
  3. Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
  4. Children's Hospital of Philadelphia, La Salle University, Philadelphia, PA, United States.
  5. Department of Psychology, University of Delaware, Newark, DE, United States.
  6. Health Communications and Health Disparities, Fox Chase Cancer Center, Philadelphia, PA, United States.
  7. Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States.

PMID: 34677129 PMCID: PMC8571686 DOI: 10.2196/32789

Abstract

BACKGROUND: Adolescents and young adults (AYAs) with cancer demonstrate suboptimal oral chemotherapy adherence, increasing their risk of cancer relapse. It is unclear how everyday time-varying contextual factors (eg, mood) affect their adherence, stalling the development of personalized mobile health (mHealth) interventions. Poor engagement is also a challenge across mHealth trials; an effective adherence intervention must be engaging to promote uptake.

OBJECTIVE: This protocol aims to determine the temporal associations between daily contextual factors and 6-mercaptopurine (6-MP) adherence and explore the proximal impact of various engagement strategies on ecological momentary assessment survey completion.

METHODS: At the Children's Hospital of Philadelphia, AYAs with acute lymphoblastic leukemia or lymphoma who are prescribed prolonged maintenance chemotherapy that includes daily oral 6-MP are eligible, along with their matched caregivers. Participants will use an ecological momentary assessment app called ADAPTS (Adherence Assessments and Personalized Timely Support)-a version of an open-source app that was modified for AYAs with cancer through a user-centered process-and complete surveys in bursts over 6 months. Theory-informed engagement strategies will be microrandomized to estimate the causal effects on proximal survey completion.

RESULTS: With funding from the National Cancer Institute and institutional review board approval, of the proposed 30 AYA-caregiver dyads, 60% (18/30) have been enrolled; of the 18 enrolled, 15 (83%) have completed the study so far.

CONCLUSIONS: This protocol represents an important first step toward prescreening tailoring variables and engagement components for a just-in-time adaptive intervention designed to promote both 6-MP adherence and mHealth engagement.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/32789.

©Alexandra M Psihogios, Mashfiqui Rabbi, Annisa Ahmed, Elise R McKelvey, Yimei Li, Jean-Philippe Laurenceau, Stephen P Hunger, Linda Fleisher, Ahna LH Pai, Lisa A Schwartz, Susan A Murphy, Lamia P Barakat. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 22.10.2021.

Keywords: adolescents; cancer; ecological momentary assessment; mHealth; mobile phone; oncology; self-management; young adults

References

  1. Curr Opin Syst Biol. 2020 Jun;21:1-8 - PubMed
  2. Pediatr Blood Cancer. 2021 Feb;68(2):e28767 - PubMed
  3. Ann Behav Med. 2021 Mar 01;: - PubMed
  4. J Adolesc Health. 2013 May;52(5):578-83 - PubMed
  5. Curr Opin Pediatr. 2017 Feb;29(1):41-45 - PubMed
  6. J Mob Technol Med. 2017 Apr;6(1):39-45 - PubMed
  7. J Natl Compr Canc Netw. 2018 Jan;16(1):66-97 - PubMed
  8. Am Psychol. 2000 May;55(5):469-80 - PubMed
  9. J Pediatr Psychol. 2021 Jun 3;46(5):504-513 - PubMed
  10. Proc ACM Int Conf Ubiquitous Comput. 2017 Sep;2017:790-798 - PubMed
  11. J Pediatr Psychol. 2017 Mar 01;42(2):232-244 - PubMed
  12. J Pediatr Hematol Oncol. 2006 Dec;28(12):816-23 - PubMed
  13. J Pain Symptom Manage. 2007 Mar;33(3):267-75 - PubMed
  14. Pediatrics. 2012 Feb;129(2):e473-85 - PubMed
  15. J Res Adolesc. 2015 Jun 1;25(2):377-386 - PubMed
  16. Transl Behav Med. 2015 Sep;5(3):335-46 - PubMed
  17. Psychooncology. 2014 Nov;23(11):1220-8 - PubMed
  18. IEEE Pulse. 2013 Nov-Dec;4(6):32-3 - PubMed
  19. J Pediatr Psychol. 2018 Mar 1;43(2):172-184 - PubMed
  20. J Pediatr Oncol Nurs. 2018 Jan/Feb;35(1):36-42 - PubMed
  21. IEEE Pulse. 2013 Nov-Dec;4(6):41-7 - PubMed
  22. Health Commun. 2021 Nov;36(13):1719-1730 - PubMed
  23. Mhealth. 2020 Jan 05;6:7 - PubMed
  24. J Clin Oncol. 2010 Nov 10;28(32):4800-9 - PubMed
  25. Blood. 2014 Oct 9;124(15):2345-53 - PubMed
  26. J Pediatr Oncol Nurs. 2011 Jul-Aug;28(4):203-23 - PubMed
  27. Health Psychol. 2014 Mar;33(3):255-63 - PubMed
  28. J Clin Oncol. 2012 Jun 10;30(17):2094-101 - PubMed
  29. J Pediatr Psychol. 2017 Nov 1;42(10):1087-1107 - PubMed
  30. J Adolesc Young Adult Oncol. 2020 Dec;9(6):651-661 - PubMed
  31. Ann Behav Med. 2018 May 18;52(6):446-462 - PubMed
  32. Eur J Oncol Nurs. 2016 Feb;20:207-14 - PubMed
  33. Transl Behav Med. 2016 Jun;6(2):317-28 - PubMed
  34. Ann Intern Med. 2018 Sep 18;169(6):419-422 - PubMed
  35. J Med Internet Res. 2017 Apr 26;19(4):e132 - PubMed
  36. Biometrika. 2021 Aug 12;108(3):551-555 - PubMed
  37. Diabetes Technol Ther. 2018 Jul;20(7):465-474 - PubMed
  38. Am J Lifestyle Med. 2019 Apr 25;14(3):289-293 - PubMed
  39. J Pediatr Psychol. 2008 Jul;33(6):590-611 - PubMed
  40. IEEE Pulse. 2013 Nov-Dec;4(6):34-40 - PubMed
  41. Nurs Res. 2017 Jul/Aug;66(4):275-285 - PubMed
  42. J Pediatr Oncol Nurs. 2015 Mar-Apr;32(2):103-13 - PubMed
  43. J Phys Act Health. 2011 Jan;8 Suppl 1:S103-8 - PubMed
  44. PLoS One. 2014 Mar 11;9(3):e90347 - PubMed
  45. Behav Modif. 2016 Jan;40(1-2):257-80 - PubMed
  46. Health Educ Behav. 1998 Oct;25(5):545-63 - PubMed
  47. Cancer. 2016 Apr 1;122(7):988-99 - PubMed
  48. Pediatrics. 2008 Aug;122(2):e305-17 - PubMed
  49. Br J Health Psychol. 2015 Feb;20(1):130-50 - PubMed
  50. Stat Med. 2010 Jan 15;29(1):97-107 - PubMed
  51. J Pediatr Oncol Nurs. 2018 Mar/Apr;35(2):86-93 - PubMed
  52. Proc ACM Int Conf Ubiquitous Comput. 2017 Sep;2017:781-789 - PubMed
  53. Stat Med. 1993 Jul 15;12(13):1259-68 - PubMed
  54. J Pediatr Psychol. 2014 Sep;39(8):918-31 - PubMed
  55. J Natl Cancer Inst. 2002 May 1;94(9):652-61 - PubMed

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