Evidence mapPaperPMID 41701968Full record

ArticleJMIR formative research2026

Exploring Strategies for a Digital Tool to Support Medication Adherence Among Adolescents and Young Adults Undergoing Hematopoietic Stem Cell Transplant and Their Care Partners: Qualitative Formative Study.

Gavin Raab, Zoe Bowen, Skyla Shea, Guy Shani, Michelle Rozwadowski, Susan Allbritton Murphy, Inbal Billie Nahum-Shani, Ziping Xu, Alexandra Psihogios, Sung Won Choi

Abstract read
In one paragraph

Article in JMIR formative research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

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No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Gavin Raab *Department of Pediatrics, University of Michigan, Michigan Medicine, Ann Arbor, MI, United States.ORCID https://orcid.org/0009-0008-8114-2196
Zoe Bowen *Department of Pediatrics, University of Michigan, Michigan Medicine, Ann Arbor, MI, United States.ORCID https://orcid.org/0009-0009-5789-0888
Skyla SheaDepartment of Pediatrics, University of Michigan, Michigan Medicine, Ann Arbor, MI, United States.ORCID https://orcid.org/0009-0009-0286-5300
Guy ShaniStrategy Area, Stephen M. Ross School of Business, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0002-7237-076X
Michelle RozwadowskiDepartment of Pediatrics, University of Michigan, Michigan Medicine, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0001-7864-383X
Susan Allbritton MurphyDepartments of Statistics and Computer Science, Harvard University, Cambridge, MA, United States.ORCID https://orcid.org/0000-0002-2032-4286
Inbal Billie Nahum-ShaniInstitute for Social Research, University of Michigan, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0001-6138-9089
Ziping XuDepartments of Statistics and Computer Science, Harvard University, Cambridge, MA, United States.ORCID https://orcid.org/0000-0002-2591-0356
Alexandra PsihogiosDepartment of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, IL, United States.ORCID https://orcid.org/0000-0002-4111-1191
Sung Won ChoiDepartment of Pediatrics, University of Michigan, Michigan Medicine, Ann Arbor, MI, United States.ORCID https://orcid.org/0000-0002-6321-3834

Funding

MI-SMART: Methods for Optimizing Multilevel Adaptive Implementation Strategies to Promote the Adoption of Effective SUD and HIV ServicesP50DA054039 · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2025 to 2025
$2.6M
NIDA NIH HHS P50 DA054039
6 · The paper itself

Abstract

backgroundAllogeneic hematopoietic stem cell transplant (HCT) is a complex but essential treatment for malignant and nonmalignant conditions, requiring strict posttransplant adherence to immunosuppressant medications to prevent complications such as graft-versus-host disease. Adolescents and young adults undergoing HCT face unique challenges, including balancing growing independence with ongoing reliance on care partners, often parents. Medication adherence in this group is often suboptimal, and few interventions address adolescent and young adult-care partner dyads. To address this gap, we aim to develop a mobile health (mHealth) app that engages both the patients and care partner to improve adherence.

objectiveAs formative research for early-stage intervention development, this study aimed to (1) explore current HCT medication adherence strategies and challenges; (2) understand attitudes toward digital technology, including dyadic perspectives on app use to support adherence; and (3) assess adolescent and young adult-care partner relationships, including views on care partner involvement. This process was intended to inform the design of a relevant, user-centered mHealth app.

methodsEligible participants included adolescents and young adult patients aged 12-39 years and primary care partners, such as parents, involved in medication management. Participants were recruited from a large academic medical center through direct outreach and electronic health records. Data collection involved 2 focus groups (6 dyads and 2 additional adolescents and young adults), 4 individual interviews (2 patients and 2 care partners), and 6 dyadic interviews. Semistructured sessions (in person or virtual) gathered feedback on medication adherence practices and app design preferences. All sessions were audio recorded with consent and professionally transcribed. Qualitative data were analyzed systematically: transcripts were deidentified, coded using both inductive and deductive strategies, and themes were refined through team consensus. Patterns were organized into major themes, and representative quotations were selected to illustrate findings. Data management was facilitated by NVivo (version 13; Lumivero) software.

resultsWe included 28 participants (15 adolescents and young adults and 13 care partners). The median age of adolescents and young adults was 18 (range 13-39) years and 53% (8/15) were female. Adolescents and young adults were 47% (7/15) White, 40% (6/15) Black, and 13% (2/15) mixed race. Care partners' median age was 48 (range 36-72) years, with 92% (12/13) female and 77% (10/13) White. Three principal themes emerged: (1) existing reminders and organizational tools are often insufficient for consistent adherence; (2) adherence barriers are multifaceted, often involving autonomy vs care partner support; and (3) both adolescents and young adults and care partners showed strong interest in a dyadic digital health intervention to foster collaboration and support shared adherence goals.

conclusionsThis formative study highlights the complex dynamics of medication adherence in adolescent and young adult-care partner dyads and supports the need for a dyadic mHealth app to enhance adherence, collaboration, and relationship quality.

Indexed as

CaregiversHematopoietic Stem Cell TransplantationMedication AdherenceMobile ApplicationsAdherence InterventionsAdolescentAdultChildDigital HealthFemaleFocus GroupsHumansMaleQualitative ResearchYoung Adultadherenceadolescentfamily caregiverfamily relationshematopoietic stem cell transplantmedicationmHealthmobile healthyoung adult

Identifiers

PMID41701968
PMCPMC12957942

What Socratic holds

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.