Leveraging mHealth Messaging to Promote Adherence in Teens With CKD

Johns Hopkins University

Status: Completed

Conditions: Chronic Kidney Diseases; Adherence, Medication; Communication

Treatments: Behavioral: Standard mHealth Messaging Group; Behavioral: mHealth Messaging Intervention Group

Study type: Interventional

Funder types: Other

Identifiers

NCT03651596

IRB00167162

Details and patient eligibility

About

The overall goal of this study is to develop and test effectively framed mobile health (mHealth) messages to promote medication adherence in teens with chronic kidney disease (CKD).

Full description

Hypertension is a risk factor for chronic kidney disease (CKD) progression. Only 77% of adolescents with CKD are adherent to antihypertensive medications despite evidence that adherence slows disease progression. Mobile health (mHealth) applications show promise for improving adherence but most are not designed within health-promotion frameworks, only send medication reminders, use unreliable outcome measures, and/or have small effects on adherence. Nonadherence is a public health problem that may benefit from using health communication strategies to advance beyond reminders and improve mHealth efficacy. Highly effective health messages modify perceptions, attitudes, and skills to facilitate behavioral change; inappropriately framed messages (e.g., use of fear appeals) may have unintended, negative effects on health behaviors (i.e., reduce adherence). For adolescents with CKD, framing mHealth messages to motivate adherence may be a key factor in preventing disease progression; however, there has been little research to guide the use of this approach. Hence, the current study aims to develop and test effectively framed mobile health (mHealth) messages to promote medication adherence in teens with CKD.

Prior to study recruitment, the intervention messages will be developed by the research team and key stakeholders before testing in this pilot randomized controlled trial (RCT). Adolescents/young adults with CKD will be invited to participate in the pilot RCT to evaluate the intervention messages versus an active control condition; the primary outcome is antihypertensive medication adherence and secondary outcomes are participants' responses to surveys.

Enrollment: 35 patients

Sex: All

Ages: 11 to 21 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adolescents/young adults aged 11-21 years
• Physician diagnosis of CKD stage 1-4
• Currently prescribed an antihypertensive medication and anticipate staying on an antihypertensive through the study duration (switching medication classes is permitted)
• Must have daily access to a Wi-Fi-enabled electronic device (e.g. iOS, Android 4.2 or higher, phone, tablet, computer) to receive private health information.

Exclusion criteria

• Adolescents/young adults who are on dialysis or had a kidney transplant
• Sibling participating in the study, unable to comprehend spoken English
• Cognitive delay precluding completion of study procedures
• And prescribed a liquid form of an antihypertensive medication (cannot be monitored).

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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35 participants in 2 patient groups

Standard mHealth Messaging

Active Comparator group

Description:

Individuals randomized to the Standard mHealth Messaging Group will receive a standard messaging intervention that has shown some efficacy in improving adherence in other samples.

Treatment:

Behavioral: Standard mHealth Messaging Group

mHealth Messaging Intervention

Experimental group

Description:

Individuals randomized to the mHealth Messaging Intervention Group will receive the newly developed messaging intervention.

Treatment:

Behavioral: mHealth Messaging Intervention Group