# Using Real Time Mobile Health Approaches to Understand and Promote Oral Chemotherapy Adherence in Adolescents and Young Adults with Leukemia

> **NIH NIH K08** · CHILDREN'S HOSP OF PHILADELPHIA · 2022 · $11,747

## Abstract

PROJECT SUMMARY/ABSTRACT
Stagnant survival and relapse rates for adolescents and young adults (AYA) with cancer are partially attributed
to a modifiable health behavior—suboptimal cancer treatment adherence. Yet, effective interventions are
lacking. Aligned with priorities of the NCI and other federal agencies, the long-term objective of this K08
application is to help resolve disparities in cancer treatment outcomes in AYA by targeting nonadherence to
life-saving cancer treatments. The goal of this proposal is to employ novel real time mobile health
methodologies to examine and intervene on the time-varying, contextual factors that influence AYA adherence
to an oral chemotherapy called 6-mercaptopurine, which must be taken daily in the maintenance phase to
prevent relapse. In Aim 1, the PI and her mentorship team will determine the temporal associations between
time-varying contextual factors (such as fatigue, motivation) and daily 6-mercaptopurine adherence. This Aim
will utilize a 6-month intensive longitudinal design that employs bursts of mobile-based ecological momentary
assessment with AYA patients and their caregivers (n=30 pairs). In Aim 2, the investigative team will begin to
develop a just-in-time adaptive mobile intervention, designed to promote 6-mercaptopurine adherence in this
population, by developing contextually-tailored mobile messages and decision rules about the conditions under
which to deliver the messages. Just-in-time mobile interventions are well-suited to address limitations of
previous interventions by providing personalized adherence support, at the right time, only when it is needed.
The creation of messages and decision rules will follow a rigorous mobile health development approach by
iteratively incorporating self-management theory, empirical evidence, expert input, and stakeholder feedback.
Focus groups with 15 AYA from Aim 1 will be conducted to user-test and refine the messages. In Aim 3, the
just-in-time adaptive mobile intervention called AYA ADAPTS (Adherence Assessments and Personalized
Timely Support) will be pilot tested in a micro-randomized trial with 30 newly recruited patients. AYA ADAPTS
will integrate the tailored mobile messages and decision rules developed and refined in Aim 2. The research
team will determine the feasibility and acceptability of this intervention in preparation for the PI's larger-scale
optimization trial (R01 proposal). This proposal has methodological, theoretical, clinical, and technological
innovations. The research and career development plan, supported by a multi-disciplinary team of experts in a
rich academic environment, will support the PI's transition to an independent clinician-scientist who possesses
the skills and expertise to use cutting-edge mobile health methods to design the most potent adherence-
promotion interventions for pediatric cancer patients. This K08 will provide opportunities to acquire skills and
knowledge in: (1) ecological momentary assessment and m...

## Key facts

- **NIH application ID:** 10463577
- **Project number:** 5K08CA241335-04
- **Recipient organization:** CHILDREN'S HOSP OF PHILADELPHIA
- **Principal Investigator:** Alexandra Psihogios
- **Activity code:** K08 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $11,747
- **Award type:** 5
- **Project period:** 2019-09-01 → 2022-09-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10463577

## Citation

> US National Institutes of Health, RePORTER application 10463577, Using Real Time Mobile Health Approaches to Understand and Promote Oral Chemotherapy Adherence in Adolescents and Young Adults with Leukemia (5K08CA241335-04). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10463577. Licensed CC0.

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