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

项目摘要/摘要 该项目寻求扩展当前项目(PI：Skeens，R00NR019115；提高遵从性 通过《儿童造血干细胞移植患者健康计划》，开展了一项随机对照试验干预试验。这个 母项目的目标是评估mHealth应用程序的可接受性、可行性和潜在疗效， BMT4Me，在急性期后与儿童照顾者进行的前瞻性、纵向试验性随机对照试验 HSCT。理由是，旨在向照顾者发送药物提醒的mHealth应用程序将增加 坚持免疫抑制药物，从而潜在地减少移植物抗宿主病(GVHD)， 再入院和死亡率。对西班牙语版本的BMT4Me遵守应用程序的需求来自于 在飞行员K99中获得的知识。三分之一的家庭说西班牙语，没有资格参加 在书房里。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的、可获得的和基于证据的方法，包括 语言不同的家庭，以增加接受血液干细胞移植的儿童的遵从性。 在这次R21期间，我们将把目前的BMT4Me转换成西班牙语。这款数字健康应用程序将药物 和补充提醒，实时跟踪错过剂量和症状的原因，创建每周摘要 导出并与提供商共享，并包括允许上传和存储图片的备注部分 与诊所的提供者进行沟通。该应用程序还将获得不遵守的原因，添加到我们的 了解在这一人群中遵守规则的障碍。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创造该应用程序；以及2) 在两个地点对接受HSCT的30名讲西班牙语的儿童照顾者进行用户测试，以进一步 完善BMT4Me以纳入正在进行的试点RCT。利用社区进行转世创造的基本原理 基于参与性研究(CBPR)的方法，是它积极寻求纳入投入和 双语母语为西班牙语的研究团队成员和社区合作伙伴在 用于缓解标准翻译中常见问题的翻译过程--回译 进程。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，帮助保持预期的意义，并就特定的文化提出建议 改装。该项目的成功完成将使我们能够将R00的注册人数扩大到 包括说西班牙语的家庭。该项目将支持响应文化的移动健康干预 这将大大促进坚持的科学，并为临床护理提供更公平的方法 对于接受高血球移植的语言不同的儿童，从而促进所有家庭在高血球移植后的健康公平。 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……里面 此外，还有很大的潜力使我们的工作适合患有其他慢性病的儿童。

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.