A Pilot Feasibility Trial of a Tailored Intervention to Improve Adherence in Adolescents and Young Adults With Cancer
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
The proposed research includes a randomized clinical trial of a tailored adherence-promotion intervention (Tailored Program) as compared to uniform standard of care (Feedback Program) for adolescents and young adults with cancer. Up to 40 adolescents and young adults (AYAs) with cancer will be enrolled in this study. Participants who enroll in this trial will be given an eCAP electronic monitor, a pill bottle with a computer chip in the cap, to store their medication. After using the electronic monitor for 4 weeks to assess baseline adherence, participants who demonstrate non-adherence and have used the electronic monitor without difficulty will be asked to complete pre-treatment questionnaires. Next, participants will be randomly assigned to either the tailored adherence-promotion intervention group (Tailored Program) or the uniform standard of care group (Feedback Program). Participants will be assigned in a 1:1 ratio so that, at the end of the study, an equal number of participants will have been randomized to each group.
Participants in the tailored program will participate in 4 sessions with a coach, 1 every other week. During these sessions, the AYA will work with their coach to identify a barrier to adherence to target and create an action plan using evidence-based behavior change techniques to address this barrier. In between sessions (on alternating weeks), the coach will check-in with a text including a reminder about the action plan and a calendar of the AYA's eCAP adherence data. Participants in the Feedback Program will receive weekly text messages including: a calendar depicting their weekly adherence (per eCAP data) and guidance for requesting additional support as desired.
Adolescents and young adults will continue to use the electronic monitor to store their medication until approximately a month after their program ends. After their program ends, participants will complete post-treatment questionnaires regarding program usability and acceptability as well as their adherence.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Meghan E McGrady, PhD
- Phone Number: 513-803-8044
- Email: Meghan.McGrady@cchmc.org
Study Locations
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-
Ohio
-
Cincinnati, Ohio, United States, 45229
- Cincinnati Children's Hospital Medical Center
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-
Tennessee
-
Memphis, Tennessee, United States, 38105
- St Jude Children's Research Hospital
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-
Washington
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Seattle, Washington, United States, 98105
- Seattle Children's Hospital
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Patient between 15 and 24 years of age
- Patient diagnosis of cancer
- Patient prescribed oral chemotherapy or prophylactic medication
Exclusion Criteria:
- Patient is not fluent in English
- Patient evidences significant cognitive deficits per medical team
- Patient's medical status or treatment precludes participation per medical team, patient, or caregiver
- Patient demonstrates greater than or equal to 95% adherence during run-in period
- Patient declines to use electronic monitoring device
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Tailored Program
8-week tailored program including 4 coach visits and 4 bi-weekly text check-ins
|
Participants in the tailored program will participate in 4 sessions with a coach, 1 every other week.
During these sessions, the AYA will work with their coach to identify a barrier to adherence to target and create an action plan using evidence-based behavior change techniques to address this barrier.
In between sessions (on alternating weeks), the coach will check-in with a text including a reminder about the action plan and a calendar of the AYA's eCAP adherence data.
|
|
Other: Feedback Program
8-week feedback program including 8 weekly texts
|
Participants in the Feedback Program will receive weekly text messages including: a calendar depicting their weekly adherence (per eCAP data) and guidance for requesting additional support as desired.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Enrollment Rate
Time Frame: End of study enrollment period, approximately 12 months after enrollment initiation
|
Percent of approached eligible participants enrolling in the study
|
End of study enrollment period, approximately 12 months after enrollment initiation
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Retention Rate
Time Frame: From enrollment to study completion (approximately 4 weeks for patients deemed ineligible after run-in and approximately 16 weeks for patients deemed eligible after run-in)
|
The percent of participants completing all procedures for which they were eligible The numerator is calculated via the following formula: (n AYAs eligible to complete at least some study procedures [n enrolled AYAs - n AYAs meeting criteria for unenrollment prior to study start] - n AYAs who never started study procedures - n AYAs who did not complete at least some study procedures) The denominator (n AYAs eligible to complete at least some study procedures) is calculated via the following formula: (n enrolled AYAs - n AYAs meeting criteria for unenrollment prior to study start)
|
From enrollment to study completion (approximately 4 weeks for patients deemed ineligible after run-in and approximately 16 weeks for patients deemed eligible after run-in)
|
|
Intervention Fidelity: Contact
Time Frame: From randomization to the Tailored Program (at approximately week 4) to the completion of the Tailored Program (at approximately week 12) (total duration = approximately 8 weeks)
|
Percent of participants randomized to the Tailored Program who completed 4 intervention sessions
|
From randomization to the Tailored Program (at approximately week 4) to the completion of the Tailored Program (at approximately week 12) (total duration = approximately 8 weeks)
|
|
Intervention Fidelity: Length
Time Frame: From randomization to the Tailored Program (at approximately week 4) to the completion of the Tailored Program (at approximately week 12) (total duration = approximately 8 weeks)
|
Percent of participants randomized to the Tailored Program for whom all sessions were 30-45 minutes in length
|
From randomization to the Tailored Program (at approximately week 4) to the completion of the Tailored Program (at approximately week 12) (total duration = approximately 8 weeks)
|
|
Intervention Fidelity: Duration
Time Frame: From randomization to the Tailored Program (at approximately week 4) to the completion of the Tailored Program (at approximately week 12) (total duration = approximately 8 weeks)
|
Percent of randomized to the Tailored Program who completed all 4 intervention sessions during a 8-10 week period
|
From randomization to the Tailored Program (at approximately week 4) to the completion of the Tailored Program (at approximately week 12) (total duration = approximately 8 weeks)
|
|
Intervention Fidelity: Content
Time Frame: From randomization to the Tailored Program (at approximately week 4) to the completion of the Tailored Program (at approximately week 12) (total duration = approximately 8 weeks)
|
Percent of participants randomized to the Tailored Program who received all of the planned intervention content as defined in the fidelity checklist
|
From randomization to the Tailored Program (at approximately week 4) to the completion of the Tailored Program (at approximately week 12) (total duration = approximately 8 weeks)
|
|
Assessment Completion
Time Frame: From enrollment to the completion of post-intervention assessment which occurred approximately 4 weeks after program completion (total time frame = approximately 16 weeks)
|
Percent of enrolled participants with complete data
|
From enrollment to the completion of post-intervention assessment which occurred approximately 4 weeks after program completion (total time frame = approximately 16 weeks)
|
|
System Usability Scale
Time Frame: Post-intervention assessment, approximately 4 weeks after program completion and approximately 16 weeks after enrollment
|
A 10-item rating of usability, range = 0-100, better scores indicate better usability
|
Post-intervention assessment, approximately 4 weeks after program completion and approximately 16 weeks after enrollment
|
|
"Adjective Rating Scale" (Measure of Usability)
Time Frame: Post-intervention assessment, approximately 4 weeks after program completion and approximately 16 weeks after enrollment
|
1-item rating of user friendliness, range = 1 (worst imaginable) to 7 (best imaginable), higher scores indicate better usability
|
Post-intervention assessment, approximately 4 weeks after program completion and approximately 16 weeks after enrollment
|
|
Number of Participants Rating Behavioral Treatment Acceptability as 4 or Greater
Time Frame: Post-intervention assessment, approximately 4 weeks after program completion and approximately 16 weeks after enrollment
|
Rating of behavioral treatment acceptability - "I would recommend this program to other adolescents and young adults"; Possible range = 1 (strongly disagree) - 5 (strongly agree), better scores represent better acceptability; Dichotomous variable created representing whether participants scored this item as 1-3 (not acceptable) or 4-5 (acceptable)
|
Post-intervention assessment, approximately 4 weeks after program completion and approximately 16 weeks after enrollment
|
|
Medical Adherence Measure
Time Frame: Post-intervention assessment, approximately 4 weeks after program completion and approximately 16 weeks after enrollment
|
1-item self-report of missed doses
|
Post-intervention assessment, approximately 4 weeks after program completion and approximately 16 weeks after enrollment
|
|
Electronically Monitored Medication Adherence
Time Frame: Starting 4 weeks prior to treatment initiation (approximately weeks 1-4) and continuing until 4 weeks after program completion (approximately weeks 12-16)
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Each participant will be given an electronic monitoring device to store their medication.
The electronic monitoring device records each time the device is opened.
|
Starting 4 weeks prior to treatment initiation (approximately weeks 1-4) and continuing until 4 weeks after program completion (approximately weeks 12-16)
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Meghan E McGrady, PhD, Children's Hospital Medical Center, Cincinnati
Publications and helpful links
General Publications
- McGrady ME, Ketterl TG, Webster RT, Schwartz LE, Brock MY, Szulczewski L, Burke M, Hommel KA, Pai ALH, Mara CA, Steele AC, Regan GG, Norris RE. Feasibility pilot trial of a tailored medication adherence-promotion intervention for adolescents and young adults with cancer: Study design and protocol. Contemp Clin Trials. 2024 Apr;139:107483. doi: 10.1016/j.cct.2024.107483. Epub 2024 Feb 29.
- McGrady ME, Ketterl TG, Webster RT, Burns MMK, Bills SE, Burke M, Szulczewski L, Brock MY, Schwartz LE, Herriott JK, Hommel KA, Pai ALH, Mara CA, Norris RE. Feasibility Trial of a Tailored Adherence-Promotion Intervention for Adolescents and Young Adults With Cancer. Pediatr Blood Cancer. 2025 Oct 27:e32127. doi: 10.1002/pbc.32127. Online ahead of print.
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- R21CA268945 (U.S. NIH Grant/Contract)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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