A pilot intervention of using a mobile health app (ONC Roadmap) to enhance health-related quality of life in family caregivers of pediatric patients with cancer.
A pilot intervention of using a mobile health app (ONC Roadmap) to enhance health-related quality of life in family caregivers of pediatric patients with cancer.
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DOI：
10.21037/mhealth-22-24
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发表时间：
2023
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开发了Roadmap移动的健康（mHealth）应用程序，为癌症患者的家庭护理人员提供健康相关的生活质量（HRQOL）支持。资格包括：自我报告为儿童癌症患者主要照顾者的家庭照顾者（年龄≥18岁）;在密歇根大学接受癌症治疗的患者（年龄≥5岁）。可行性计算为在120天研究持续时间的至少50%内，登录ONC路线图并每周至少参与两次的护理人员的百分比。还通过可行性和可接受性问卷和移动的应用程序评级量表评估了可行性和可接受性，以专门评估应用程序质量。还进行了探索性分析，以评估HRQOL自我或父母代理评估和生理数据采集。在2020年9月至2021年9月期间，100名参与者（或50名患者-患者配对）同意并参加了为期120天的ONC路线图研究。符合研究的可行性，其中大多数护理人员（N=32; 65%）登录ONC路线图，并在至少50%的研究持续时间内每周至少参与两次（在方案中先验定义）。可行性和可接受性调查问卷的答复表明，该研究是可行和可接受的，大多数（>50%）报告同意或强烈同意，每个领域的净有利度为正[（同意+强烈同意）-（不同意+完全不同意）]（例如，Fitbit使用、ONC路线图使用、完成纵向评估、参与类似的未来研究、研究预期）。在所有组的大多数精神HRQOL领域均观察到改善;尽管动力不足，但儿童（8-17岁）的HRQOL和焦虑以及抑郁和疲劳的特定方面有显著改善，8-17岁儿童的抑郁和成人患者的疲劳有改善的趋势。这项研究支持移动健康技术可能是一个有前途的平台，为儿童癌症患者的照顾者提供HRQOL支持。重要的是，研究结果表明，研究方案是可行的，参与者有利于参与未来的研究，这种干预措施与常规癌症护理提供。
The Roadmap mobile health (mHealth) app was developed to provide health-related quality of life (HRQOL) support for family caregivers of patients with cancer. Eligibility included: family caregivers (age ≥18 years) who self-reported as the primary caregiver of their pediatric patient with cancer; patients (age ≥5 years) who were receiving cancer care at the University of Michigan. Feasibility was calculated as the percentage of caregivers who logged into ONC Roadmap and engaged with it at least twice weekly for at least 50% of the 120-day study duration. Feasibility and acceptability was also assessed through a Feasibility and Acceptability questionnaire and the Mobile App Rating Scale to specifically assess app-quality. Exploratory analyses were also conducted to assess HRQOL self- or parent proxy assessments and physiological data capture. Between September 2020–September 2021, 100 participants (or 50 caregiver-patient dyads) consented and enrolled in the ONC Roadmap study for 120-days. Feasibility of the study was met, wherein the majority of caregivers (N=32; 65%) logged into ONC Roadmap and engaged with it at least twice weekly for at least 50% of the study duration (defined a priori in the Protocol). The Feasibility and Acceptability questionnaire responses indicated that the study was feasible and acceptable with the majority (>50%) reporting Agree or Strongly Agree with positive Net Favorability [(Agree + Strongly Agree) – (Disagree + Totally Disagree)] in each of the domains (e.g., Fitbit use, ONC Roadmap use, completing longitudinal assessments, engaging in similar future study, study expectations). Improvements were seen across the majority of the mental HRQOL domains across all groups; even though underpowered, there were significant improvements in caregiver-specific aspects of HRQOL and anxiety and in depression and fatigue for children (ages 8–17 years), and a trend toward improvement in depression for children ages 8–17 years and in fatigue for adult patients. This study supports that mHealth technology may be a promising platform to provide HRQOL support for caregivers of pediatric patients with cancer. Importantly, the findings suggest that the study protocol was feasible, and participants were favorable to participate in future studies of this intervention alongside routine cancer care delivery.