Feasibility and Acceptability of Remote Saliva Collection

November 2, 2026 updated by: St. Jude Children's Research Hospital

The purpose of this study is to evaluate the practicality and acceptability of collecting biological samples and health information from childhood survivors of acute lymphoblastic leukemia (ALL) and their siblings. Participants will provide saliva, blood, hair, and fingernail samples, complete questionnaires, and participate in sleep monitoring. The information collected will help researchers understand how cancer treatment and neighborhood conditions may affect stress hormones, inflammation, and long-term health.

Primary Objective

- To evaluate the feasibility of collecting multiple biological specimens, surveys, and sleep assessment among child and adolescent survivors of ALL and their siblings.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

Childhood survivors of acute lymphoblastic leukemia (ALL) can experience long-term health problems after cancer treatment. Researchers believe that stress-related biological processes and social factors, such as neighborhood socioeconomic conditions, may influence long-term health outcomes. However, it is not known whether collecting multiple biological samples over several days is practical for survivors and their families.

This feasibility and acceptability study will enroll survivors of childhood ALL, their siblings, and caregivers. Participants may complete study activities through a combination of in-person and remote procedures or through a fully remote option.

Participants will complete an enrollment visit, a baseline visit conducted either in person or remotely, and a telehealth reminder visit. Survivors and siblings will provide saliva, blood, hair, and fingernail samples. Saliva samples will be collected at home five times per day over three days. Participants will also wear a WatchPAT sleep monitoring device and complete morning and evening diaries during the saliva collection period. Questionnaires will assess demographic information, sleep, emotional well-being, family relationships, health behaviors, and other factors that may influence cortisol measurements. Caregivers will complete questionnaires about household and demographic characteristics and provide feedback regarding study acceptability.

Blood samples will be used to measure markers of inflammation and hormone function. Saliva, hair, and fingernail samples will be used to evaluate cortisol, a biological marker related to stress and hypothalamic-pituitary-adrenal (HPA) axis functioning. The study will also explore associations between neighborhood socioeconomic status and biological measures of cortisol and inflammation. Findings from this feasibility study will be used to inform the design of future research investigating the effects of cancer treatment and social environments on long-term health outcomes among childhood ALL survivors.

Study Type

Observational

Enrollment (Estimated)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • United States
    • Tennessee
      • Memphis, Tennessee, United States, 38105
        • Recruiting
        • St. Jude Children's Research Hospital
        • Contact:
        • Principal Investigator:
          • Bria Gresham, PhD

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

8 years to 18 years (Child, Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Sampling Method

Non-Probability Sample

Study Population

The study population will include child and adolescent survivors of ALL, their siblings, and caregivers.

Description

Inclusion Criteria:

SURVIVORS

  • The survivor is a childhood survivor of Acute Lymphocytic Leukemia (ALL).

  • The survivor was treated on one of the following St. Jude Total Therapy Studies:

    1. TOTAL Therapy study XVI for Newly Diagnosed Patients with ALL (TOTXVI) OR
    2. Total Therapy for Children with Acute Lymphoblastic Leukemia and Lymphoma (TOT17)

  • The survivor is cancer-free.

  • The survivor is at least 5 years out from the ALL diagnosis.

  • The survivor is at least 2 years out from completion of treatment.

  • The survivor did not receive cranial therapy as part of ALL therapy.

  • The survivor is aged ≥8 to 18 years old at the time of enrollment.

  • The survivor has completed their After Completion of Therapy (ACT) clinic consultation.

  • The survivor is able to speak and read English.

  • The survivor has internet access.

SIBLINGS

  • The sibling has a brother or sister who is an ALL survivor participating in this study.
  • The sibling is aged ≥8 to18 years old at the time of enrollment.
  • The sibling is able to speak and read English.
  • The sibling has internet access.

CAREGIVERS

  • The caregiver provides primary care or support to an ALL survivor that is in this study.
  • The caregiver resides in the home full-time with enrolled survivor and sibling.
  • The caregiver is able to speak and read English.
  • The caregiver has internet access.
  • The caregiver is willing and able to assist with at home biospecimen collection.

Exclusion Criteria:

SURVIVORS and SIBLINGS

  • Survivor and/or sibling has a diagnosis of Down's Syndrome.
  • Survivor and/or sibling has a diagnosis of autism spectrum disorder.
  • Survivor and/or sibling has a diagnosis of another pervasive developmental disorder not listed above.
  • Survivor and/or sibling has a history of prolonged treatment with steroid medications or systemic glucocorticoids for reasons other than ALL.
  • Survivor and/or sibling resides outside of the United States.
  • Inability or unwillingness of survivor and/or sibling and/or legal guardian/representative to give written informed consent.

CAREGIVERS Note: There are no exclusion criteria for caregivers.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: COHORT
  • Time Perspectives: PROSPECTIVE

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Childhood ALL Survivors

Childhood survivors of acute lymphoblastic leukemia treated on St. Jude Total Therapy XVI or Total Therapy 17 protocols who meet survivorship and age eligibility requirements.
Diagnostic test: Salivary Cortisol Collection

Participants collect five saliva samples per day on three days within a 14-day period (wake, +30 min, +45 min, +60 min, bedtime) to assess diurnal cortisol rhythm and cortisol awakening response.

Other Names:
  • Saliva Sampling; Saliva Collection
Diagnostic test: Blood Biomarker Collection

Collection of blood samples to measure high-sensitivity C-reactive protein, pro-inflammatory cytokines, dehydroepiandrosterone, and luteinizing hormone. Hybrid participants undergo venipuncture (~3 mL blood). Remote participants use the FDA-approved RedDrop One capillary blood collection device.

Other Names:
  • Blood Collection; Blood Sampling; Venipuncture; RedDrop One Blood Collection
Diagnostic test: Hair Cortisol Collection

Collection of a small hair sample from the posterior vertex of the scalp to measure long-term cortisol exposure. Hair is cut close to the scalp and stored for laboratory analysis.

Other Names:
  • Hair Sample Collection
Diagnostic test: Nail Cortisol Collection

Fingernail clippings from all ten fingernails are collected to measure nail cortisol levels.

Other Names:
  • Fingernail Collection; Nail Sample Collection
Diagnostic test: WatchPAT Sleep Assessment

FDA-approved wearable sleep assessment device used to measure sleep/wake times and sleep quality during the saliva collection period.

Other Names:
  • WatchPAT 300; WatchPAT ONE; Wearable Sleep Monitor
Behavioral: Morning and Evening Diaries

Participants complete brief morning and evening diaries to record sleep, caffeine intake, medication use, symptoms, stress, affect, daily events, and other factors that may influence cortisol measurements.

Other: MEMS Cap Adherence Monitoring

Electronic caps used with saliva collection tubes to record date and time of each bottle opening, providing objective assessment of saliva collection adherence.

Other Names:
  • Aardex MEMS Caps; Medication Event Monitoring System Caps
Other: OnTimePoint Application

Mobile/web-based application that provides saliva collection reminders and records sample collection timing and participant-reported wake times.

Other: Survey and Questionnaire Assessment

Collection of demographic, psychosocial, sleep, medication, socioeconomic, acceptability, and health-related survey data from survivors, siblings, and caregivers.
Siblings of ALL Survivors

Biological or household siblings of enrolled ALL survivors, aged 8-18 years.
Diagnostic test: Salivary Cortisol Collection

Participants collect five saliva samples per day on three days within a 14-day period (wake, +30 min, +45 min, +60 min, bedtime) to assess diurnal cortisol rhythm and cortisol awakening response.

Other Names:
  • Saliva Sampling; Saliva Collection
Diagnostic test: Blood Biomarker Collection

Collection of blood samples to measure high-sensitivity C-reactive protein, pro-inflammatory cytokines, dehydroepiandrosterone, and luteinizing hormone. Hybrid participants undergo venipuncture (~3 mL blood). Remote participants use the FDA-approved RedDrop One capillary blood collection device.

Other Names:
  • Blood Collection; Blood Sampling; Venipuncture; RedDrop One Blood Collection
Diagnostic test: Hair Cortisol Collection

Collection of a small hair sample from the posterior vertex of the scalp to measure long-term cortisol exposure. Hair is cut close to the scalp and stored for laboratory analysis.

Other Names:
  • Hair Sample Collection
Diagnostic test: Nail Cortisol Collection

Fingernail clippings from all ten fingernails are collected to measure nail cortisol levels.

Other Names:
  • Fingernail Collection; Nail Sample Collection
Diagnostic test: WatchPAT Sleep Assessment

FDA-approved wearable sleep assessment device used to measure sleep/wake times and sleep quality during the saliva collection period.

Other Names:
  • WatchPAT 300; WatchPAT ONE; Wearable Sleep Monitor
Behavioral: Morning and Evening Diaries

Participants complete brief morning and evening diaries to record sleep, caffeine intake, medication use, symptoms, stress, affect, daily events, and other factors that may influence cortisol measurements.

Other: MEMS Cap Adherence Monitoring

Electronic caps used with saliva collection tubes to record date and time of each bottle opening, providing objective assessment of saliva collection adherence.

Other Names:
  • Aardex MEMS Caps; Medication Event Monitoring System Caps
Other: OnTimePoint Application

Mobile/web-based application that provides saliva collection reminders and records sample collection timing and participant-reported wake times.

Other: Survey and Questionnaire Assessment

Collection of demographic, psychosocial, sleep, medication, socioeconomic, acceptability, and health-related survey data from survivors, siblings, and caregivers.
Caregivers

Primary caregivers residing full-time with enrolled survivors and siblings.
Other: Survey and Questionnaire Assessment

Collection of demographic, psychosocial, sleep, medication, socioeconomic, acceptability, and health-related survey data from survivors, siblings, and caregivers.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Enrollment Feasibility
Time Frame: Baseline through study completion, approximately 3 months after enrollment

Proportion of participants approached that enroll in the study
Baseline through study completion, approximately 3 months after enrollment
Saliva Sampling Feasibility
Time Frame: Baseline through study completion, approximately 3 months after enrollment

Proportion of participants who complete the saliva sampling procedures will adhere to the timing of the saliva sampling
Baseline through study completion, approximately 3 months after enrollment
Blood Sampling Feasibility
Time Frame: Baseline through study completion, approximately 3 months after enrollment

Proportion of participants enrolled who complete the blood sample collection
Baseline through study completion, approximately 3 months after enrollment
Hair Sampling Feasibility
Time Frame: Baseline through study completion, approximately 3 months after enrollment

Proportion of participants enrolled that completed the hair sample collection
Baseline through study completion, approximately 3 months after enrollment
Fingernail Sampling Feasibility
Time Frame: Baseline through study completion, approximately 3 months after enrollment

Proportion of participants enrolled that completed the fingernail sample collection
Baseline through study completion, approximately 3 months after enrollment
Overall Study Procedure Feasibility
Time Frame: Baseline through study completion, approximately 3 months after enrollment

Proportion of participants enrolled that completed each study procedure
Baseline through study completion, approximately 3 months after enrollment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Saliva Sampling Acceptability-Acceptability Measure
Time Frame: Post study, approximately 3 months after enrollment

A measure of saliva sampling acceptability. Scores of ≥4 on a 5-point Likert scale will be indicative of intervention acceptability.
Post study, approximately 3 months after enrollment
Blood Sampling Acceptability-Acceptability Measure
Time Frame: Post study, approximately 3 months after enrollment

A measure of blood sampling acceptability. Scores of ≥4 on a 5-point Likert scale will be indicative of intervention acceptability.
Post study, approximately 3 months after enrollment
Hair Sampling Acceptability-Acceptability Measure
Time Frame: Post study, approximately 3 months after enrollment

A measure of hair sampling acceptability. Scores of ≥4 on a 5-point Likert scale will be indicative of intervention acceptability.
Post study, approximately 3 months after enrollment
Fingernail Sampling Acceptability-Acceptability Measure
Time Frame: Post study, approximately 3 months after enrollment

A measure of fingernail sampling acceptability. Scores of ≥4 on a 5-point Likert scale will be indicative of intervention acceptability.
Post study, approximately 3 months after enrollment
Overall Biospecimen Acceptability-Acceptability Measure
Time Frame: Post study, approximately 3 months after enrollment

A measure of overall biospecimen acceptability. Scores of ≥4 on a 5-point Likert scale will be indicative of intervention acceptability.
Post study, approximately 3 months after enrollment
Overall Study Procedure Acceptability-Acceptability Measure
Time Frame: Post study, approximately 3 months after enrollment

A measure of overall study acceptability. Scores of ≥4 on a 5-point Likert scale will be indicative of overall study acceptability.
Post study, approximately 3 months after enrollment
Neighborhood Socioeconomic Status (nSES)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with cortisol awakening response. Cortisol awakening response will be measured via the slope of four morning saliva samples (upon waking, +30 minutes, +45 minutes, +60 minutes) across three days, with values at each time point averaged across days.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Cortisol Diurnal Rhythm
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with cortisol diurnal rhythm. Cortisol diurnal rhythm will be measured via the slope of five daily saliva samples (upon waking, +30 minutes, +45 minutes, +60 minutes, bedtime) across three days, with values at each time point averaged across days.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Hair Cortisol Concentration
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with hair cortisol concentration. Hair cortisol concentration will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Nail Cortisol Concentration
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with nail cortisol concentration. Nail cortisol concentration will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and High-Sensitivity C-Reactive Protein (hs-CRP)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with high-sensitivity c-reactive protein (hs-CRP). Plasma hs-CRP will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Interferon gamma (IFN-y)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with interferon gamma (IFN-y). Plasma IFN-y will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Interleukin 1 beta (IL-1β)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with interleukin 1 beta (IL-1β). Plasma IL-1β will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Interleukin 2 (IL-2)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with interleukin 2 (IL-2). Plasma IL-2 will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Interleukin 4 (IL-4)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with interleukin 4 (IL-4). Plasma IL-4 will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Interleukin 6 (IL-6)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with interleukin 6 (IL-6). Plasma IL-6 will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Interleukin 10 (IL-10)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with interleukin 10 (IL-10). Plasma IL-10 will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Interleukin 12 (IL-12p70)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with interleukin 12 (IL-12p70). Plasma IL-12p70 will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Interleukin 17A (IL-17A)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with interleukin 17A (IL-17A). Plasma IL-17A will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends
Neighborhood Socioeconomic Status (nSES) and Tumor Necrosis Factor - alpha (TNF- α)
Time Frame: Post study, approximately 6 months after accrual ends

Determine whether neighborhood socioeconomic status (nSES), operationalizing using participants' address histories to estimate long-term neighborhood conditions, is associated with Tumor Necrosis Factor - alpha (TNF- α). Plasma (TNF- α) will be evaluated as a continuous measure.
Post study, approximately 6 months after accrual ends

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

St. Jude Children's Research Hospital

Collaborators

National Cancer Institute (NCI)

Investigators

  • Principal Investigator: Bria Gresham, PhD, St. Jude Children's Research Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

December 1, 2026

Primary Completion (Estimated)

April 1, 2028

Study Completion (Estimated)

October 1, 2029

Study Registration Dates

First Submitted

September 25, 2026

First Submitted That Met QC Criteria

October 13, 2026

First Posted (Actual)

October 20, 2026

Study Record Updates

Last Update Posted (Actual)

November 3, 2026

Last Update Submitted That Met QC Criteria

November 2, 2026

Last Verified

November 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • FARSC
  • U54CA302464 (U.S. NIH Grant/Contract)
  • NCI-2026-06979 (Other Identifier: NCI Clinical Trial Registration Program)

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

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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