The purpose of this project is to test the efficacy of Planet K, a mobile and web-based technology infrastructure specifically designed to (a) enhance youths' chronic kidney disease- and treatment-related knowledge through interactive and game-based educational materials; (b) support adherence to the treatment regimen through customized task prompts via mobile and web-based delivery; and (c) promote patient-provider communication through real-world data collection and feedback loops. Investigators will examine the effectiveness of the Planet K mobile app and website in improving treatment adherence, disease-related knowledge, transition readiness, condition management, and the psychological correlates of these variables in adolescents and young adults with chronic kidney disease (CKD).
Advances in medical treatment options over the past several decades have translated into substantially higher survival rates for those who suffer with chronic illness. Consequently, the prevalence of chronic illness has risen significantly in recent years, such that one out of every four youth in the United States currently lives with a chronic illness. The health and well-being of these youth is directly impacted by the degree to which they adhere to their treatment regimen. However, treatment regimens for chronic illness can be highly complex, making adherence problematic, particularly when combined with deficits in memory and executive functioning concomitant with many chronic illnesses. Adherence also tends to deteriorate over time; the youth's motivation or commitment to treatment may decline as symptoms improve or negative side effects occur. With low adherence comes worsening symptoms and significantly greater risk for serious medical complications and mortality in young adulthood. The costs associated with low adherence, such as the need for additional care, are also substantial both for the patient and society. While a number of factors have been found to impact treatment adherence, risk for non-adherence-across varied forms of chronic illness-is markedly elevated when the youth lacks disease- and treatment-related knowledge and when parents provide little supervision for carrying out regimen tasks. With nearly 90% of youth with chronic illness expected to survive and therefore transition from pediatric care into adult-focused healthcare systems, it is critically important to empower youth to take ownership of their own healthcare. To do so, tools there is a need to provide accessible, affordable tools that can effectively increase patients' skills and knowledge for managing their illness and support on-going adherence to their treatment regimen. The purpose of this project is to test the efficacy of Planet K, a mobile and web-based technology infrastructure specifically designed to (a) enhance youths' chronic kidney disease- and treatment-related knowledge through interactive and game-based educational materials; (b) support adherence to the treatment regimen through customized task prompts via mobile and web-based delivery; and (c) promote patient-provider communication through real-world data collection and feedback loops. Investigators will examine the effectiveness of the Planet K mobile app and website in improving treatment adherence, disease-related knowledge, transition readiness, condition management, and the psychological correlates of these variables in adolescents and young adults with chronic kidney disease (CKD). All participants will complete study measures at pre- and post-assessment time points. In total, participants will take part in this study for approximately 2 months from pre- to post-assessment. Families will be recruited to participate in either the treatment condition or the control group. Families in the treatment condition will receive the Planet K app and access to the associated website for the full duration of the study (4 months) between pre-test and post-test. Families in the control group will not receive access to the app and website but instead will be asked to complete a series of online questionnaires at each of the two data collection time points (pre-test, post-test). Investigators hypothesize that greater use (i.e., dosage) and prolonged use of Planet K will: increase disease-related knowledge, treatment adherence, self-efficacy for management of CKD, current CKD self-management behaviors, perceived severity of CKD, readiness to transition to independent self-care, and perceived benefits of CKD treatment, while also decreasing perceived barriers to CKD treatment. Moreover, investigators believe that improvement of these outcomes through use of Planet K will result in more positive mental health outcomes for participants, including lower depression and higher reported quality of life. Investigators expect that those in the treatment condition will have better outcomes than those in the control group on all of these measures at both midpoint and post-assessment time points. Finally, investigators expect all participants to report high usability, quality, and value of the Planet K mobile app and website and to positively rate their experience with Planet K.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
68
Planet K is a mobile and web-based technology infrastructure specifically designed to (a) enhance youths' chronic kidney disease- and treatment-related knowledge through interactive and game-based educational materials; (b) support adherence to the treatment regimen through customized task prompts via mobile and web-based delivery; and (c) promote patient-provider communication through real-world data collection and feedback loops.
3-C Institute for Social Development
Durham, North Carolina, United States
Knowledge of CKD
Both parents and adolescent participants will complete a consultant-created 25 item questionnaire to assess their knowledge of CKD.
Time frame: Collected at two time points: pre-test and 2 months later at study completion to measure change
End Stage Renal Disease-Adherence Questionnaire (ESRD-AQ)
Both adolescent and parent participants will complete a modified version of the End Stage Renal Disease-Adherence Questionnaire (ESRD-AQ; Kim, Y., Evangelista, L.S., Phillips, L.R., Pavlish, C., \& Kopple, J.D., 2010). This 28-item measure assesses the extent to which youth adhere to the treatment plan put forth by their healthcare provider, including regular visits to the doctor, taking medications as prescribed, and following dietary recommendations. The parent version contains 22 items and the youth version contains 25 items.
Time frame: Collected at two time points: pre-test and 2 months later at study completion to measure change
Perceived Treatment Benefits
Both adolescents and their parents will report on their perceptions of the benefits and barriers of adherence to the condition treatment regimen. This measure was adapted from the Beliefs about Dietary Compliance scale (BDCS; Bennett et al, 2001) and contains 9 items on both the parent and youth versions.
Time frame: Collected at two time points: pre-test and 2 months later at study completion to measure change
STARx Transition Readiness Questionnaire
This 18-item measure assesses the extent to which youth are ready to transition to independent care and manage their health-related needs independently. Items assess adolescents' independence in scheduling doctor's appointments, remembering to take medication, finding answers to health-related questions, knowledge of their condition, and how easy/difficult these tasks are for the youth.
Time frame: Collected at two time points: pre-test and 2 months later at study completion to measure change
Chronic Kidney Disease Self-Efficacy Instrument
Adolescents will complete the 25-item Chronic Kidney Disease Self-Efficacy Instrument (CKD-SE; Lin, C., Wu, C., Anderson, R., et al., 2012). This measure assesses patients' self-confidence in managing their condition, including self-confidence in (a) managing the disease autonomously, (b) integrating treatment requirements to fit new situations or social activities, (c) finding solutions to CKD-related problems, and (d) finding social support when needing help.
Time frame: Collected at two time points: pre-test and 2 months later at study completion to measure change
Self-Management:Self-Efficacy for Managing Chronic Disease Scale
Self-Efficacy for Managing Chronic Disease scale (Ritter \& Lorig, 2015), a 6-item measure assessing confidence in self-management ability.
Time frame: Collected at two time points: pre-test and 2 months later at study completion to measure change
Self-Management: Partners in Health Scale
Partners in Health scale (Cordova et al. 2013), an eleven item measure assessing ability to observe and manage symptoms.
Time frame: Collected at two time points: pre-test and 2 months later at study completion to measure change
Quality of Life
Adolescents will complete a subset of 19 items from the Kidney Disease and Quality of Life-Short Form (KDQOL-SF; Hays et al., 1997). Items were modified to be more general and applicable to any medical condition. These items comprise subscales that assess patients' symptoms, burden of condition in interfering with life, cognitive functioning, social support, and difficulty sleeping.
Time frame: Collected at two time points: pre-test and 2 months later at study completion to measure change
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