Feasibility and Usability of a Spanish-Transcreated Pediatric Post-Transplant Adherence App (BMT4me)

西班牙翻译的儿科移植后依从性应用程序 (BMT4me) 的可行性和可用性

• 批准号: 10782256
• 负责人: Micah Skeens
• 金额: $ 21.2万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-21 至 2025-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10782256
• 关键词: Acute; Address; Adherence; Adoption; Adult; Affect; Age; Attention; Caregivers; Caring; Child; Childhood; Chronic; Chronic Disease; Clinic; Clinical; Communities; Complex; Data; Disparity; Dose; Education; Emergency department visit; Enrollment; Equity; Ethnic Origin; Ethnic Population; Face; Family; Goals; Health; Health Care Costs; Healthcare; Hematopoietic Stem Cell Transplantation; Hispanic Populations; Home; Hospitalization; Immunosuppressive Agents; Intervention; Intervention Trial; Knowledge; Language; Latino; Latino Population; Linguistics; Malignant Childhood Neoplasm; Measures; Methods; Minority Groups; Mobile Health Application; Modeling; National Institute on Minority Health and Health Disparities; Oral; Organ Transplantation; Outcome; Patient Noncompliance; Patients; Pharmaceutical Preparations; Phase; Population; Population Heterogeneity; Positioning Attribute; Process; Provider; Quasi-experiment; Race; Recommendation; Reduce health disparities; Regimen; Reporting; Research; Science; Site; Solid; Symptoms; System; Technology; Telephone; Testing; Time; Translating; Translation Process; Translations; Transplant Recipients; Work; adherence rate; bilingualism; chemotherapy; clinical care; community based participatory research; design; digital; digital health; digital intervention; ethnic diversity; evidence base; graft vs host disease; health disparity; health equity; high risk; hospital readmission; improved; individualized medicine; innovation; mHealth; marginalization; medication compliance; medication nonadherence; member; mortality; multidisciplinary; novel; parent project; pediatric patients; pilot test; post-transplant; prevent; prospective; provider communication; relapse risk; successful intervention; systematic review; underserved minority; usability

PROJECT SUMMARY/ABSTRACT This project seeks to expand upon a current project (PI:Skeens, R00NR019115; Improving Adherence Through mHealth for Pediatric Hematopoietic Stem Cell Transplant Patients), a pilot RCT intervention trial. The goal of the parent project is to assess the acceptability, feasibility, and potential efficacy of the mHealth app, BMT4me, in a prospective, longitudinal pilot RCT with caregivers of children during the acute phase post- HSCT. The rationale is that a mHealth app designed to send medication reminders to caregivers will increase adherence to immunosuppressant medication, thereby potentially reducing graft vs host disease (GVHD), readmissions, and mortality. The need for a Spanish version of the BMT4me adherence app came from knowledge gained in the pilot K99. One-third of families spoke Spanish and were ineligible to participate in the study. Additionally, only 20% of medication apps offer alternative languages. Thus, there is an urgent need to develop and evaluate innovative, accessible, and evidence-based approaches, inclusive of linguistically diverse families, to increase adherence among children receiving HSCT. During this R21, we will transcreate the current BMT4me to Spanish. The digital health app sends medication and refill reminders, tracks reasons for missed doses and symptoms in real time, creates a weekly summary to be exported and shared with providers, and includes a notes section that allows for picture upload and storage to communicate with providers in clinic. The app will also obtain reasons for non-adherence, adding to our knowledge of barriers to adherence in this population. The specific aims of this project are to: 1) use a community-based participatory research approach to transcreate the app for Spanish-speaking families; and 2) conduct user testing with 30 Spanish-speaking caregivers of children receiving HSCT at two sites to further refine BMT4me for inclusion in the ongoing pilot RCT. The rationale for transcreation, using a community based participatory research (CBPR) approach, is that it actively seeks to incorporate the input and recommendations of bilingual native Spanish-speaking research team members and community partners in the translation process to mitigate problems commonly encountered with the standard translation-backtranslation process. A Community Advisory Board will engage in an iterative review of study content and the intervention to improve cultural accuracy, assist in maintaining intended meaning, and advise on culture-specific alterations. The successful completion of this project will enable us to expand enrollment in the R00 to be inclusive of Spanish-speaking families. This project will support a culturally-responsive, mHealth intervention that will significantly advance the science of adherence and inform more equitable approaches to clinical care for linguistically diverse children receiving HSCT, thereby, advancing health equity for all families post-HSCT. The goal is to promote more equitable care and reduce health disparities among children receiving HSCT. In addition, there is great potential to adapt our work for children with other chronic conditions.

项目摘要/摘要 该项目旨在扩展当前项目（PI：Skeens，R00NR019115；改善依从性 通过小儿造血干细胞移植患者的MHealth），一项试验RCT干预试验。这 母公司项目的目标是评估MHealth应用程序的可接受性，可行性和潜在功效， BMT4ME，在一个前瞻性的纵向飞行员RCT中 HSCT。理由是，旨在向看护人发送药物提醒的MHealth应用程序将增加 遵守免疫抑制剂药物，从而有可能减少移植物与宿主疾病（GVHD）， 再入院和死亡率。需要西班牙版的BMT4ME依从性应用程序来自 试点K99获得的知识。三分之一的家庭说西班牙语，没有资格参加 在研究中。此外，只有20％的药物应用程序提供替代语言。因此，有一个 迫切需要开发和评估创新，可访问和循证的方法，包括 语言上多样化的家庭，以增加接受HSCT的儿童的依从性。 在此R21期间，我们将把当前的BMT4ME转换为西班牙语。数字健康应用发送药物 和补充提醒，跟踪实时遗漏剂量和症状的原因，每周都会摘要 将出口并与提供商共享，并包含一个允许上传和存储的注释部分 与诊所的提供者进行交流。该应用程序还将获得不遵守的原因，增加了我们的 了解该人群遵守的障碍。该项目的具体目的是：1）使用 基于社区的参与性研究方法，用于针对讲西班牙语家庭的应用程序；和2） 对30位讲西班牙语的儿童的护理人员进行用户测试，该儿童在两个地点接受HSCT以进一步 精炼BMT4ME将纳入正在进行的飞行员RCT中。使用社区的构造基本原理 基于的参与性研究（CBPR）方法是，它积极寻求纳入意见和 双语本地讲西班牙语的研究团队成员和社区合作伙伴的建议 翻译过程，以减轻标准翻译 - 反向转换通常遇到的问题 过程。社区咨询委员会将对研究内容和干预进行迭代审查 为了提高文化准确性，协助维持预期的意义，并为特定文化提供建议 改变。该项目的成功完成将使我们能够扩大R00的入学人数 包括说西班牙语的家庭。该项目将支持具有文化响应的MHealth干预措施 这将大大提高依从性的科学并为更公平的临床护理方法提供信息 对于接受HSCT的语言多样化的儿童，HSCT后所有家庭的健康公平。 目的是促进更公平的护理并减少接受HSCT的儿童的健康差异。在 此外，对于患有其他慢性疾病的儿童，我们的工作有很大的潜力。