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
Affiliations
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States.
- Department of Statistics, Harvard University, Boston, MA, United States.
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, United States.
- Children's Hospital of Philadelphia, La Salle University, Philadelphia, PA, United States.
- Department of Psychology, University of Delaware, Newark, DE, United States.
- Health Communications and Health Disparities, Fox Chase Cancer Center, Philadelphia, PA, United States.
- 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
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