Abstract B043: The MedSupport multilevel intervention to improve pediatric medication adherence: Results from a pilot study
Bibliographic record
Abstract
Abstract Introduction: Nonadherence to oral chemotherapy is a well-documented problem in pediatric oncology. Medical innovations have dramatically increased the range of treatment that can be administered at home, increasing the responsibility placed on families in contributing to pediatric cancer outcomes. Yet, caregivers experience numerous barriers to adherence. Using the Health Belief Model, we developed MedSupport, a multi-level medication adherence that is designed to address root barriers to medication adherence. Design, Setting, Participants, and Measures: The MedSupport intervention was developed in collaboration with Pediatric Cancer Caregiver and Healthcare Provider Advisory Boards and includes three components. (1) Universal screening for adherence barriers (2) Tailored virtual education enhancement and (3) Communication of barriers to activate multidisciplinary healthcare teams. To assess feasibility and acceptability of the intervention following Bowen’s model, we recruited caregivers of pediatric acute lymphoblastic leukemia (ALL) patients ages 1 to 18 on oral home-based chemotherapy. All eligible families receiving outpatient-based chemotherapy at Roswell Park during April and May 2023 were approached for participation. Multidisciplinary healthcare providers who were on the care teams of enrolled patients were invited to participate. Acceptability among caregivers and healthcare providers was assessed using standardized measures aligned with the Implementation Outcomes Framework. Results: We implemented a pilot study of the MedSupport intervention at Roswell Park and we successfully implemented all study procedures. We demonstrated feasibility through: (1) Demand: 100% of eligible caregivers (N = 6) and healthcare providers (N = 8) approached agreed to participate. (2) Practicality: 100% of families completed the barriers screening questionnaire on the first prompt.All families endorsed adherence barriers (Range: 3-14). Families received between 2 and 6 educational videos based upon barriers endorsed. All families rated the length of videos as “just right.” Sending barrier alerts to healthcare providers was feasible, and we did not encounter any technical problems sending barrier alerts. (3) Acceptability: Caregivers rated the intervention as acceptable (Mean: 4.92), appropriate (Mean: 4.71), and feasible (Mean: 5). Healthcare providers rated the intervention as acceptable (Mean: 4.68), appropriate (Mean: 4.61), and feasible (Mean: 4.68). In qualitative feedback providers described the intervention as low burden and clinically helpful. Conclusions and Relevance: The MedSupport intervention is an innovative, low-cost, and scalable intervention to enhance home-based medication adherence in pediatric ALL that has potential for translation to clinical practice. Citation Format: Kara Kelly, Paula Vincent, Hital Patel, Justine Kahn, Kira Bona, Thai Hoa Tran, Elisa Rodriguez, Kristopher Attwood, Elizabeth Bouchard. The MedSupport multilevel intervention to improve pediatric medication adherence: Results from a pilot study [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pediatric Cancer Research; 2024 Sep 5-8; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl):Abstract nr B043.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".