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Accepted for/Published in: JMIR Research Protocols

Date Submitted: Aug 10, 2021
Open Peer Review Period: Aug 10, 2021 - Aug 16, 2021
Date Accepted: Aug 16, 2021
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

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

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

JMIR Res Protoc 2021;10(10):e32789

DOI: 10.2196/32789

PMID: 34677129

PMCID: 8571686

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

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

JMIR Res Protoc 2021;10(10):e32789

DOI: 10.2196/32789

PMID: 34677129

PMCID: 8571686

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