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

Alexandra M. Psihogios; Mashfiqui Rabbi; Annisa Ahmed; Elise R. McKelvey; Yimei Li; Jean Philippe Laurenceau; Stephen P. Hunger; Linda G. Fleisher; Ahna L.H. Pai; Lisa Schwartz; Susan A. Murphy; Lamia P. Barakat

doi:10.2196/32789

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

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

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

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.

Original language	English
Article number	A18
Pages (from-to)	e32789
Journal	JMIR Research Protocols
Volume	10
Issue number	10
DOIs	https://doi.org/10.2196/32789
State	Published - Oct 2021

Keywords

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2196/32789

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Psihogios, A. M., Rabbi, M., Ahmed, A., McKelvey, E. R., Li, Y., Laurenceau, J. P., Hunger, S. P., Fleisher, L. G., Pai, A. L. H., Schwartz, L., Murphy, S. A., & Barakat, L. P. (2021). Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement during Cancer Treatment: Protocol for Ecological Momentary Assessment. JMIR Research Protocols, 10(10), e32789. Article A18. https://doi.org/10.2196/32789

@article{6d29782fcb844f7a8eb123c8e2fbd001,

title = "Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement during Cancer Treatment: Protocol for Ecological Momentary Assessment",

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.",

keywords = "adolescents, cancer, ecological momentary assessment, mHealth, mobile phone, oncology, self-management, young adults",

author = "Psihogios, {Alexandra M.} and Mashfiqui Rabbi and Annisa Ahmed and McKelvey, {Elise R.} and Yimei Li and Laurenceau, {Jean Philippe} and Hunger, {Stephen P.} and Fleisher, {Linda G.} and Pai, {Ahna L.H.} and Lisa Schwartz and Murphy, {Susan A.} and Barakat, {Lamia P.}",

note = "{\textcopyright}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.",

year = "2021",

month = oct,

doi = "10.2196/32789",

language = "English",

volume = "10",

pages = "e32789",

journal = "JMIR Research Protocols",

issn = "1929-0748",

publisher = "JMIR Publications Inc.",

number = "10",

}

Psihogios, AM, Rabbi, M, Ahmed, A, McKelvey, ER, Li, Y, Laurenceau, JP, Hunger, SP, Fleisher, LG, Pai, ALH, Schwartz, L, Murphy, SA & Barakat, LP 2021, 'Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement during Cancer Treatment: Protocol for Ecological Momentary Assessment', JMIR Research Protocols, vol. 10, no. 10, A18, pp. e32789. https://doi.org/10.2196/32789

TY - JOUR

T1 - Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement during Cancer Treatment

T2 - Protocol for Ecological Momentary Assessment

AU - Psihogios, Alexandra M.

AU - Rabbi, Mashfiqui

AU - Ahmed, Annisa

AU - McKelvey, Elise R.

AU - Li, Yimei

AU - Laurenceau, Jean Philippe

AU - Hunger, Stephen P.

AU - Fleisher, Linda G.

AU - Pai, Ahna L.H.

AU - Schwartz, Lisa

AU - Murphy, Susan A.

AU - Barakat, Lamia P.

N1 - ©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.

PY - 2021/10

Y1 - 2021/10

N2 - 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.

AB - 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.

KW - adolescents

KW - cancer

KW - ecological momentary assessment

KW - mHealth

KW - mobile phone

KW - oncology

KW - self-management

KW - young adults

UR - http://www.scopus.com/inward/record.url?scp=85117916581&partnerID=8YFLogxK

U2 - 10.2196/32789

DO - 10.2196/32789

M3 - Article

C2 - 34677129

SN - 1929-0748

VL - 10

SP - e32789

JO - JMIR Research Protocols

JF - JMIR Research Protocols

IS - 10

M1 - A18

ER -

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

Abstract

Keywords

UN SDGs

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