- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03932903
Mobile Health Intervention to Support Oral Chemotherapy Adherence in Adolescents and Young Adults With Leukemia
Using Real Time Mobile Health Approaches to Understand and Promote Oral Chemotherapy Adherence in Adolescents and Young Adults With Leukemia
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
This is a 28-day micro-randomized pilot trial (i.e., a sequential factorial design) of a just-in-time adaptive intervention (JITAI) called ADAPTS (ADherence Assessments and Personalized Timely Support). ADAPTS is an app that integrate contextually-tailored mobile messages designed to promote oral chemotherapy adherence. Participants in the study will electronically-monitor 6MP adherence with eCAPs and complete short ecological momentary assessment (EMA) surveys each afternoon, at the same time prior to the evening 6MP dose, for the 28-day period.
ADAPTS will deliver contextually-tailored text messages triggered based on EMA responses (e.g., based on fatigue, mood) and objective data (e.g., time of day, weekend vs. weekday). After receiving a contextually-tailored message, AYA will be asked to acknowledge receipt of the message by pressing a "thumbs up" or "thumbs down" button, to indicate whether or not they liked the message, or a "snooze" button indicating that it was not a good time to receive the message.
Following the 28-day intervention period, eCAPS will be returned and downloaded during the clinic appointment. AYA will complete a brief acceptability survey electronically via REDCAP, rating ADAPTS on a 5-point Likert scale to assess satisfaction, perceived appropriateness, perceive positive effects, perceived demands, and potential for future use. Exit interviews will also be conducted, audio-recorded, and transcribed to further assess acceptability. For feasibility, the following variables will be tracked: (1) screening rates, (2) recruitment rates, (3) % acknowledged micro-randomized messages, (4) technical difficulties (e.g., micro-randomized messages received when intended), (5) retention rates, and (6) completed assessments (EMA, eCAPS, post-measures).
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Alexandra M Psihogios, Ph.D.
- Phone Number: 240-994-6546
- Email: alex.psihogios@northwestern.edu
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Ages 14-29
- Diagnosed with acute lymphoblastic leukemia (ALL) or lymphoma
- In the maintenance phase, completed at least one cycle and has at least one month of maintenance therapy remaining
- Prescribed 6-mercaptopurine (6MP)
- English language proficiency
- For AYA <18, must have informed consent from their caregiver.
Exclusion Criteria:
- Cognitive impairments that would limit ability to complete measures, determined by the medical team
- Absence of inclusion criteria above.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Supportive Care
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Contextually-tailored Mobile Messages for Adherence
All participants will be micro-randomized to receive contextually-tailored mobile messages designed to promote their oral chemotherapy adherence, with a 60% probability of receiving a contextually-tailored message each day.
|
AYA ADAPTS is a mobile app intervention that integrates contextually-tailored mobile messages and decision rules about when to deliver the messages, with the ultimate goal of improving oral chemotherapy adherence in adolescents and young adults with acute lymphoblastic leukemia.
Each participant will be micro-randomized to receive messages on some days that are adapted to their current characteristics (e.g., mood, pain, location) and designed to promote adherence, and no messages (no intervention) on other days.
|
No Intervention: No messages
All participants will also be micro-randomized to not receive messages on some days of the intervention (~40% of the time).
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Screening Rate
Time Frame: Up to 12 months
|
Number of AYA patients referred and screened per month
|
Up to 12 months
|
Recruitment Rate
Time Frame: Up to 12 months
|
Number of AYA patients enrolled in the study per month
|
Up to 12 months
|
Retention Rate
Time Frame: Up to 12 months
|
Number of AYA subjects who complete the intervention, out of the total number of AYA subjects enrolled in the study
|
Up to 12 months
|
Intervention Engagement
Time Frame: 28-day intervention period
|
Number of acknowledged micro-randomized text messages; categorized by "thumbs up", "thumbs down", and "snooze" responses
|
28-day intervention period
|
Technical Difficulties
Time Frame: 28-day intervention period
|
Number of technical glitches and errors experienced in implementing the intervention
|
28-day intervention period
|
Intervention Satisfaction
Time Frame: At completion of 28-day intervention
|
5-point numerical Likert scale; ranging from 0 (not at all) to 4 (completely)
|
At completion of 28-day intervention
|
Intervention Perceived Appropriateness
Time Frame: At completion of 28-day intervention
|
5-point numerical Likert scale; ranging from 0 (not at all) to 4 (completely)
|
At completion of 28-day intervention
|
Intervention Perceived Positive Effects
Time Frame: At completion of 28-day intervention
|
5-point numerical Likert scale; ranging from 0 (not at all) to 4 (completely)
|
At completion of 28-day intervention
|
Intervention Perceived Demands
Time Frame: At completion of 28-day intervention
|
5-point numerical Likert scale; ranging from 0 (not at all) to 4 (completely)
|
At completion of 28-day intervention
|
Potential for Intervention Future Use
Time Frame: At completion of 28-day intervention
|
5-point numerical Likert scale; ranging from 0 (not at all) to 4 (completely)
|
At completion of 28-day intervention
|
Collaborators and Investigators
Sponsor
Investigators
- Principal Investigator: Alexandra M Psihogios, Ph.D., Northwestern University
Publications and helpful links
General Publications
- Butow P, Palmer S, Pai A, Goodenough B, Luckett T, King M. Review of adherence-related issues in adolescents and young adults with cancer. J Clin Oncol. 2010 Nov 10;28(32):4800-9. doi: 10.1200/JCO.2009.22.2802. Epub 2010 Mar 8.
- Klasnja P, Hekler EB, Shiffman S, Boruvka A, Almirall D, Tewari A, Murphy SA. Microrandomized trials: An experimental design for developing just-in-time adaptive interventions. Health Psychol. 2015 Dec;34S(0):1220-8. doi: 10.1037/hea0000305.
- Nahum-Shani I, Smith SN, Spring BJ, Collins LM, Witkiewitz K, Tewari A, Murphy SA. Just-in-Time Adaptive Interventions (JITAIs) in Mobile Health: Key Components and Design Principles for Ongoing Health Behavior Support. Ann Behav Med. 2018 May 18;52(6):446-462. doi: 10.1007/s12160-016-9830-8.
- Modi AC, Pai AL, Hommel KA, Hood KK, Cortina S, Hilliard ME, Guilfoyle SM, Gray WN, Drotar D. Pediatric self-management: a framework for research, practice, and policy. Pediatrics. 2012 Feb;129(2):e473-85. doi: 10.1542/peds.2011-1635. Epub 2012 Jan 4.
- Bhatia S, Landier W, Hageman L, Kim H, Chen Y, Crews KR, Evans WE, Bostrom B, Casillas J, Dickens DS, Maloney KW, Neglia JP, Ravindranath Y, Ritchey AK, Wong FL, Relling MV. 6MP adherence in a multiracial cohort of children with acute lymphoblastic leukemia: a Children's Oncology Group study. Blood. 2014 Oct 9;124(15):2345-53. doi: 10.1182/blood-2014-01-552166. Epub 2014 May 14.
- Psihogios AM, Li Y, Butler E, Hamilton J, Daniel LC, Barakat LP, Bonafide CP, Schwartz LA. Text Message Responsivity in a 2-Way Short Message Service Pilot Intervention With Adolescent and Young Adult Survivors of Cancer. JMIR Mhealth Uhealth. 2019 Apr 18;7(4):e12547. doi: 10.2196/12547.
- Psihogios AM, Fellmeth H, Schwartz LA, Barakat LP. Family Functioning and Medical Adherence Across Children and Adolescents With Chronic Health Conditions: A Meta-Analysis. J Pediatr Psychol. 2019 Jan 1;44(1):84-97. doi: 10.1093/jpepsy/jsy044.
- McGrady ME, Brown GA, Pai AL. Medication adherence decision-making among adolescents and young adults with cancer. Eur J Oncol Nurs. 2016 Feb;20:207-14. doi: 10.1016/j.ejon.2015.08.007. Epub 2015 Sep 12.
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 19-016325
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
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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