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.

项目总结/摘要 本项目旨在扩展当前项目（PI：Skeens，R 00 NR 019115;提高粘附性 通过mHealth for Pediatric Hematopoietic Stem Cell Transplant Patients），一项试点RCT干预试验。的 母项目的目标是评估移动健康应用程序的可接受性、可行性和潜在功效， BMT 4 me，在一项前瞻性纵向试点RCT中，在急性期后儿童的照顾者中， HSCT。理由是，一个旨在向护理人员发送药物提醒的mHealth应用程序将增加 坚持使用免疫抑制剂药物，从而潜在地减少移植物抗宿主病（GVHD）， 再入院和死亡率。对BMT 4 me依从性应用程序西班牙语版本的需求来自于 在K99飞行员中获得的知识。三分之一的家庭讲西班牙语，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， 迫切需要制定和评价创新的、可获得的和以证据为基础的方法， 语言多样的家庭，以提高接受HSCT的儿童的依从性。 在R21期间，我们将把当前的BMT 4 me翻译成西班牙语。数字健康应用程序发送药物 和重新填充提醒，跟踪错过剂量和症状的原因在真实的时间，创建每周总结， 可以导出并与提供商共享，并包括一个笔记部分，允许图片上传和存储 与诊所的供应商沟通。该应用程序还将获得不遵守的原因，添加到我们的 了解该人群中依从性的障碍。该项目的具体目标是：1）使用 以社区为基础的参与性研究方法，为讲西班牙语的家庭翻译应用程序;以及2） 在两个研究中心与30名接受HSCT的儿童的西班牙语护理人员进行用户测试， 完善BMT 4 me以纳入正在进行的试点RCT。使用社区进行创译的基本原理 基于参与式研究（CBPR）的方法，是它积极寻求纳入的投入， 双语母语西班牙语研究小组成员和社区合作伙伴的建议， 翻译过程中，以减轻常见的问题与标准的解释回译 过程社区咨询委员会将对研究内容和干预措施进行反复审查 提高文化的准确性，帮助保持预期的含义，并就特定的文化提出建议。 改变。该项目的成功完成将使我们能够扩大R 00的入学人数， 包括西班牙语家庭。该项目将支持一种文化上敏感的移动健康干预措施 这将大大推进依从性科学，并为临床护理提供更公平的方法， 为接受HSCT的语言多样的儿童，从而促进HSCT后所有家庭的健康公平。 其目标是促进更公平的护理，减少接受HSCT的儿童之间的健康差距。在 此外，我们的工作还很有可能为患有其他慢性病的儿童作出调整。