Nonadherence to immunosuppressant medications is common among adolescent
liver transplant recipients, and is a leading cause of chronic rejection and
graft loss, particularly following the transfer from pediatric to
adult-centered transplant care. There is a critical need to promote medication
adherence in this high risk group. The objective of this project is to design
and evaluate a tailored intervention delivered using web-based and cellphone
text messages to promote medication adherence in adolescent liver transplant
recipients who are transitioning from pediatric to adult-centered transplant
care. The iSTART (Individualized Self-management Training for Adolescent/Young
Adult Recipients of Transplantation) intervention is delivered using
technology to reduce the time and access constraints often encountered with
traditional adherence interventions.
Development of a Tailored Intervention to Promote Medication Adherence
Aim 1: Develop a tailored intervention to promote medication adherence in adolescent liver transplant recipients. The iSTART (Individualized Self-management Training for Adolescent/Young Adult Recipients of Transplantation) intervention involves tailored educational, motivational and behavioral strategies delivered through text messages and web-based modules. Tailoring variables include perceived adherence, allocation of responsibility for health management tasks, barriers to medication adherence, values, sources of motivation (e.g., intrinsic/extrinsic), and regimen knowledge.
Aim 2: Assess the relevance and usability of tailored text messages and web-based
modules that emphasize personalization, feedback and content matching.
Phase II: Pilot Feasibility Test of a Tailored Intervention to Promote Medication Adherence
Aim 3: Explore the impact of the intervention on medication adherence using a randomized, wait-list control design.
Aim 4: Examine the acceptability of the intervention among participants and parent/caregivers.