No abstract

Objective: Social media is a large facet of contemporary culture, particularly for adolescents and young adults (AYAs). Likewise, digital health interventions have proliferated. Yet understanding of how social media can be leveraged to deliver empirically informed adherence interventions is more limited. This topical review provides a synthesis of literature related to improving AYA treatment adherence through social media approaches. To illustrate a clinical application, we describe an initiative that codeveloped and codisseminated adherence education with AYAs with cancer via TikTok. Methods: Literature searches were conducted on databases including PubMed and PsycINFO, using keywords such as adolescents or young adults; social media; and adherence, self-management, or health. Adherence TikTok videos were developed through user-centered design approaches with AYAs with cancer and clinicians/staff. Results: Results from the review suggested that AYAs use social media to research general health information and obtain support. Research-derived adherence-promotion interventions with social-media-like features appear to be acceptable, and some have led to improvements in adherence. Our process of translating empirically informed adherence education to TikTok was rapid and low cost and obtained 30,797 views. Conclusions: Social media has great promise for advancing the uptake and reach of evidence-based adherence care for AYAs. We highlight opportunities for advancing current clinical practices and future research in this area, including forming clinical partnerships with AYAs to disseminate credible adherence content via the social media platforms that are already part of their daily technology use. Implications for Impact StatementThis topical review found that AYAs currently use social media for health purposes-with or without expert input-and adherence-promotion interventions that incorporate social media features have been acceptable to AYAs. We highlight the potential for and one application of leveraging commercial social Alexandra M. Psihogios https://orcid.org/0000-0002-4111-1191Data from this topical review and clinical initiative have not been presented or published elsewhere. The authors have no conflicts of interest. The adherence clinical initiative was supported by residual funds from a grant entitled "Real-Time Medication Adherence Assessments Among Adolescents and Young Adults With Leukemia" from the Mattie Miracle Cancer Foundation. The writing of this article was supported by a grant from the National Cancer Institute (K08CA241335). The authors express their sincere gratitude to clinicians and staff involved, including Danielle Clerico, Shana Mcgonigle, Jeneane Miller, and Jennifer Lee at the Children's Hospital of Philadelphia.

Background Adolescents and young adults (AYAs) with cancer demonstrate suboptimal oral chemotherapy adherence, increasing their risk of cancer relapse. It is unclear how everyday time-varying contextual factors (eg, mood) affect their adherence, stalling the development of personalized mobile health (mHealth) interventions. Poor engagement is also a challenge across mHealth trials; an effective adherence intervention must be engaging to promote uptake. Objective This protocol aims to determine the temporal associations between daily contextual factors and 6-mercaptopurine (6-MP) adherence and explore the proximal impact of various engagement strategies on ecological momentary assessment survey completion. Methods At the Children’s Hospital of Philadelphia, AYAs with acute lymphoblastic leukemia or lymphoma who are prescribed prolonged maintenance chemotherapy that includes daily oral 6-MP are eligible, along with their matched caregivers. Participants will use an ecological momentary assessment app called ADAPTS (Adherence Assessments and Personalized Timely Support)—a version of an open-source app that was modified for AYAs with cancer through a user-centered process—and complete surveys in bursts over 6 months. Theory-informed engagement strategies will be microrandomized to estimate the causal effects on proximal survey completion. Results With funding from the National Cancer Institute and institutional review board approval, of the proposed 30 AYA-caregiver dyads, 60% (18/30) have been enrolled; of the 18 enrolled, 15 (83%) have completed the study so far. Conclusions This protocol represents an important first step toward prescreening tailoring variables and engagement components for a just-in-time adaptive intervention designed to promote both 6-MP adherence and mHealth engagement. International Registered Report Identifier (IRRID) DERR1-10.2196/32789

No abstract