THRIVE intervention development: using participatory action research principles to guide a mHealth app-based...

Area of Science:

• Oncology
• Digital Health
• Patient-Reported Outcomes

Background:

• Adherence to adjuvant endocrine therapy (AET) is crucial for reducing recurrence and mortality in early-stage, hormone receptor-positive breast cancer.
• Adverse symptoms associated with AET often lead to poor patient adherence.
• Participatory Action Research (PAR) principles were used to enhance a web-enabled app for better patient-provider communication regarding AET adherence barriers.

Purpose of the Study:

• To refine and enhance a web-enabled app intervention (THRIVE) using participatory methods.
• To improve patient-provider communication about AET-related symptoms and adherence barriers.
• To tailor the app to meet the needs of a diverse patient population and healthcare providers.

Main Methods:

• Four focus groups (N=28) with early-stage breast cancer patients on AET, stratified by race and time on therapy.
• A fifth mixed-race focus group (N=6) refined app content and developed tailored messages.
• Interviews with oncology nurses (N=5) from a randomized controlled trial of the THRIVE app.

Main Results:

• Patients preferred weekly reminders, free-text symptom entry, and specific app aesthetics and features (e.g., body map, dashboard).
• Participants co-developed and refined intervention messages for appropriateness and sensitivity.
• Nurses reported seamless integration of THRIVE alerts into workflow, increased communication, and no usability concerns.

Conclusions:

• The THRIVE app, co-designed with diverse patients and providers, incorporates patient-requested features and content.
• The app has the potential to improve AET adherence and quality of life for breast cancer survivors.
• Facilitating communication can reduce disparities in mortality rates for Black women.