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A User-Centered Design Approach to Optimize Medical Regimen Self-Management by Patients and Family Caregivers After Hematopoietic Cell Transplantation (HCT)
Conference poster   Peer reviewed

A User-Centered Design Approach to Optimize Medical Regimen Self-Management by Patients and Family Caregivers After Hematopoietic Cell Transplantation (HCT)

Donna M Posluszny, Dana H Bovbjerg, Arthur M Nezu, Karen L Syrjala, Lindsay Sabik, Susan M. Sereika, Mounzer Agha and Mary Amanda Dew
Annals of behavioral medicine, v 60(Supplement_1), pp S163-S163
01 Apr 2026
DOI: https://doi.org/10.1093/abm/kaag012#page=S163
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https://doi.org/10.1093/abm/kaag012#page=S163View
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Abstract

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Background Allogeneic HCT is a life-altering treatment for patients with hematologic disease. Recipients must have family caregivers to assist them with care post-hospital discharge. Given data showing that nonadherence is common, evidence-based interventions are urgently needed to help patients and their family caregivers manage the challenges of the post-HCT medical regimen together. We created a novel 4-session dyadic problem-solving therapy (DPST), involving both the patient and family caregiver and targeting adherence to the multicomponent medical regimen, all delivered via video conference. To optimize DPST and increase its feasibility, acceptability, efficacy, and eventual dissemination, we implemented a user-centered design approach in intervention development and testing. Method We initially adapted our DPST from traditional PST for application to dyads and medical adherence. It then went through 3 stages of iterative, user-centered processes. Stage 1 consisted of focus group input from patients, family caregivers, and HCT health care professionals. Participants gave feedback on DPST content and procedures. Stage 2 consisted of piloting the refined DPST intervention with dyads and seeking feedback on content and procedures. In Stage 3, we are evaluating the resulting 4-session DPST intervention in a single-site randomized controlled trial for acceptability, feasibility, and potential efficacy. Primary outcomes are adherence to the medical regimen and patient and caregiver perceived task self-efficacy. Results For Stage 1 focus groups, we conducted 3 patient groups (n=12), 3 family caregiver groups (n=12), and 3 health care professional groups (n=14). All types of groups supported the dyadic approach and focus on adherence, and suggested procedural changes (e.g., flexible session timing and scheduling). Stage 2 (n=3 dyads) incorporated recommended changes, and dyads received the modified intervention and suggested further changes (e.g., simplified content wording; a streamlined approach for easier adoption). Stage 3 is underway, with comparison of the finalized DPST intervention to an attention-control study arm. Conclusion User-centered design strategies generated novel feedback, leading to important intervention revisions. An iterative approach to intervention development allowed for direct involvement of stakeholders at sequential stages of work, yielding the potential for greater acceptability and potential utility of the intervention.

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