Developing a culturally tailored mHealth symptom monitoring intervention to improve adherence to endocrine therapy among Black women with breast cancer

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PROJECT SUMMARY Candidate Goals. My career goal is to reduce breast cancer health disparities in outcomes by addressing cancer care delivery issues in minority cancer populations. I received a solid foundation in observational epidemiological methods which I have applied to cancer survivorship research, but my training has not provided the skills I need to develop mHealth behavioral interventions or culturally-tailor and test behavioral interventions. The K08 provides an ideal opportunity to develop the necessary skills to achieve my long-term career goal as an independent clinical scientist. Candidate Career Development Plan. In this application, I propose training to develop the skills necessary to become a leader in the field of developing mHealth behavioral interventions for medication adherence and other cancer care delivery issues in minority cancer survivors. Training will be obtained through participation in scientific conferences, methods workshop, coursework, and structed mentorship from experts in developing culturally tailored behavioral interventions (Dr. Clement Gwede), adherence to endocrine therapy among patients with breast cancer (Dr. Dawn Hershman), mHealth methodology (Dr. Brian Gonzalez), randomized clinical trials of behavioral interventions (Dr. Heather Jim), recruitment and retention of minority participants to clinical studies (Dr. Susan Vadaparampil), and Biospecimen quality and testing (Dr. Shelley Tworoger). This training will ensure that I achieve my short-term goals after which I will be uniquely positioned to bridge gaps across disciplines, including: 1) Clinical breast cancer care, 2) Behavioral intervention development, cultural tailoring, and testing, and 3) Using mobile health technologies and biologic specimens in studies among vulnerable populations. Institutional Environment. The research environment, facilities, and resources at Moffitt Cancer Center are ideal for career development and I have the full support of my Department Chair, Dr. Czerniecki and Associate Center Director of the Division of Population Sciences, Dr. Shelley Tworoger. Research Plan. We propose an iterative approach to develop and pilot test a new mHealth behavioral intervention for AET adherence that is culturally tailored to Black breast cancer survivors. We will first use qualitative methods informed by Black breast cancer survivors to develop a blueprint of the intervention (Aim 1). We will then iteratively refine and culturally tailor the mHealth intervention focusing on symptom monitoring and management (Aim 2). Lastly, we will test the intervention for acceptability, feasibility, and preliminary efficacy (Aim 3). This project will address quality of life (symptom burden) and care delivery (medication adherence) issues in a health disparity population.