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Psihogios AM, Rabbi M, Ahmed A, McKelvey ER, Li Y, Laurenceau JP, Hunger SP, Fleisher L, Pai A, Schwartz LA, Murphy S, Barakat LP
Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement During Cancer Treatment: Protocol for Ecological Momentary Assessment
Ecological Momentary Assessment to Understand Adolescent and Young Adult 6-mercaptopurine Adherence and mHealth Engagement during Cancer Treatment: A Protocol Paper
Alexandra M. Psihogios;
Mashfiqui Rabbi;
Annisa Ahmed;
Elise R McKelvey;
Yimei Li;
Jean-Philippe Laurenceau;
Stephen P Hunger;
Linda Fleisher;
Ahna Pai;
Lisa A. Schwartz;
Susan Murphy;
Lamia P. Barakat
ABSTRACT
Background:
Adolescents and young adults (AYA) with cancer demonstrate suboptimal oral chemotherapy adherence, increasing their risk of cancer relapse. It is unclear how everyday time-varying contextual factors (e.g., mood) impact 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 describes the following objectives: (1) determine the temporal associations between daily contextual factors and 6-mercaptopurine (6-MP) adherence and (2) explore the proximal impact of various engagement strategies on ecological momentary assessment (EMA) survey completion.
Methods:
At the Children’s Hospital of Philadelphia, AYA 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 use an EMA app called ADAPTS—a version of an open-source app that was modified for AYA with cancer through a user-centered process—and complete surveys in bursts over 6 months. Theory-informed engagement strategies are micro-randomized to estimate causal effects on proximal survey completion.
Results:
With funding from the National Cancer Institute and Institutional Review Board approval, 18 of the proposed 30 AYA-caregiver dyads have enrolled; 15 completed the study so far.
Conclusions:
This protocol represents an important first step towards pre-screening tailoring variables and engagement components for a just-in-time adaptive intervention designed to promote both 6-MP adherence and mHealth engagement. Clinical Trial: NCT03932903
Citation
Please cite as:
Psihogios AM, Rabbi M, Ahmed A, McKelvey ER, Li Y, Laurenceau JP, Hunger SP, Fleisher L, Pai A, Schwartz LA, Murphy S, Barakat LP
Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement During Cancer Treatment: Protocol for Ecological Momentary Assessment