TY  - JOUR
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
AU  - Pai, Ahna LH
AU  - Schwartz, Lisa A
AU  - Murphy, Susan A
AU  - Barakat, Lamia P
PY  - 2021
DA  - 2021/10/22
TI  - Understanding Adolescent and Young Adult 6-Mercaptopurine Adherence and mHealth Engagement During Cancer Treatment: Protocol for Ecological Momentary Assessment
JO  - JMIR Res Protoc
SP  - e32789
VL  - 10
IS  - 10
KW  - mHealth
KW  - ecological momentary assessment
KW  - adolescents
KW  - young adults
KW  - oncology
KW  - cancer
KW  - self-management
KW  - mobile phone
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 
SN  - 1929-0748
UR  - https://www.researchprotocols.org/2021/10/e32789
UR  - https://doi.org/10.2196/32789
UR  - http://www.ncbi.nlm.nih.gov/pubmed/34677129
DO  - 10.2196/32789
ID  - info:doi/10.2196/32789
ER  -