Development of a text messaging system to improve receipt of survivorship care in adolescent and young adult survivors of childhood cancer

Abstract

Purpose This study aimed to develop and examine the acceptability, feasibility and usability of a text messaging, or Short Message Service (SMS), system for improving the receipt of survivorship care for adolescent and young adult (AYA) survivors of childhood cancer. Methods Researchers developed and refined the text messaging system based on qualitative data from AYA survivors in an iterative 3-stage process. In stage 1, a focus group (n=4) addressed acceptability; in stage 2, key informant interviews (n=10) following a 6-week trial addressed feasibility; and in stage 3, key informant interviews (n=23) following a 6-week trial addressed usability. Qualitative data were analyzed using a constant comparative analytic approach exploring in-depth themes. Results The final system includes programmed reminders to schedule and attend late effects screening appointments, tailored suggestions for community resources for cancer survivors, and messages prompting participant feedback regarding the appointments and resources. Participants found the text messaging system an acceptable form of communication, the screening reminders and feedback prompts feasible for improving the receipt of survivorship care, and the tailored suggestions for community resources usable for connecting survivors to relevant services. Participants suggested supplementing survivorship care visits and forming AYA survivor social networks as future implementations for the text messaging system. Conclusions The text messaging system may assist AYA survivors by coordinating late effects screening appointments, facilitating a partnership with the survivorship care team, and connecting survivors with relevant community resources. Implications for Cancer Survivors The text messaging system has the potential to improve the receipt of survivorship care.

Promoting adherence in adolescents and young adults with cancer to optimize outcomes: A developmentally oriented narrative review

“…Similar interventions with potential promise include internet‐ and mobile phone–based engagement programs . These have been shown to facilitate individualized health promotion, peer support, and improved clinic attendance in AYA cancer survivors and AYAs with sickle cell disease, though have not been explicitly studied as an adherence‐enhancing strategy for AYAs with cancer . The acceptability of smartphone‐based applications to AYAs with cancer has been demonstrated …”

“…68 These have been shown to facilitate individualized health promotion, peer support, and improved clinic attendance in AYA cancer survivors and AYAs with sickle cell disease, though have not been explicitly studied as an adherence-enhancing strategy for AYAs with cancer. [69][70][71][72][73] The acceptability of smartphone-based applications to AYAs with cancer has been demonstrated. 74,75 AYAs with cancer identify developmentally targeted services as important to supporting disease self-management.…”

“…including moderate-to-severe symptoms of depression and/or anxiety, referral to specialized mental health services may be warranted where available. 56,94,95 Interventions that address simple forgetfulness include reminder systems such as adherence aids, mnemonic devices, alarms, medication scorecards, text message reminders, preloaded medication cases, 33,59,69 and organizational skills training. 15 However, a recent study of a medication-reminder smartphone application did not demonstrate an effect on pharmacoadherence among AYAs with cancer, 54 with study authors suggesting that the design and content of such reminder systems need to be better tailored to individual users.…”

Can the theory of planned behavior help explain attendance to follow‐up care of childhood cancer survivors?

“…A recent study explored and demonstrated the usability of a textmessaging service to improve the receipt of follow-up care by childhood cancer survivors. 33 In earlier studies, we have shown that women rated multidisciplinary models for follow-up care higher than men. 21 Increasing choice and flexibility of environmental support has been reported as successful strategy to optimize perceived control.…”

“…A recent study explored and demonstrated the usability of a text‐messaging service to improve the receipt of follow‐up care by childhood cancer survivors . The system included reminders and provided suggestions for community resources.…”