The purpose of this Academic Research Enhancement Award proposal is to conduct a small-scale, health- related research project on text messages to improve adherence to oral chemotherapy agents. Michigan State University College of Nursing (MSU-CON) has not been a major recipient of National Institute of Health grant funding. As a result, the overall objectiveof this proposal is to strengthen the research environment in the College of Nursing so that it can develop into a significant health-related scientific research enterprise. This project would involv undergraduate and graduate students and, thus, generate student interest in research as a career. The importance of the research planned for this proposal is as follows. More than 50 oral chemotherapy agents in pill form are currently on the market, with projections that in 3 years, 25% of cancer treatments will be delivered in pill form. There are many associated benefits of oral agents, such as convenience, avoidance of clinic visits, and reduced impact on daily activities. For oral agents to achieve a - therapeutically effective level for cancer treatmet, patients must strictly adhere to the regimen. Adherence to oral cancer agents is often less than 80%, which may be inadequate for treating the cancer. To further complicate this, nearly 75% of those with cancer also have comorbid conditions with self-care management responsibilities, which may create barriers to oral agent adherence. To date, empirical research in the area of improving adherence to oral agents is underdeveloped. The goal of this research is to improve adherence to oral chemotherapy agents through a technology-based strategy: tailored short message service (SMS) text messages. This 10 week, two group, prospective randomized controlled trial will enroll 75 patients (50 in the intervention group and 25 in the control group) from three cancer centers to examine the feasibility, acceptability, and satisfaction with a three week, tailored, text message intervention for oral agent adherence. Descriptive statistics, generalized linear modeling, and generalized estimating equations will be used for analysis. In this proposal, preliminary data will be collected to examine efficacy of the text message intervention to promote adherence to oral agents. Data will then be used to further inform the development of an intervention to improve adherence to oral agents for an R01 application to conduct a larger randomized trial to test this innovative intervention. This study can have a transformative impact on oral agent adherence by developing a technology-based strategy to promote adherence among the increasing number of cancer patients who receive their cancer treatment in pill form. This type of novel intervention also has the potential to transform and impact many other ill populations that require adherence to a medication regimen. Furthermore, this proposal involves numerous nursing students, allowing them to be fully functioning members of a team and engaging them in the research process. This application will strengthen the research environment at MSU- CON so that it can develop into a significant health-related scientific research enterprise.

Public Health Relevance

Nearly 50 oral chemotherapy agents are on the market, with projections that, in three years, 25% of cancer treatments will be delivered in pill form. Adherence to oral agents is sub-optimal among cancer patients and, thus, can compromise the effectiveness of the cancer treatment. The goal of this AREA grant is to engage nursing students in research as a career opportunity while conducting research to improve adherence to oral cancer agents by using an innovative text message intervention that assists patients in maintaining a therapeutically effective dose of their chemotherapy.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Academic Research Enhancement Awards (AREA) (R15)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-HDM-R (90))
Program Officer
O'Mara, Ann M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Michigan State University
Schools of Nursing
East Lansing
United States
Zip Code
Spoelstra, Sandra L; Sikorskii, Alla; Given, Charles W et al. (2016) Adult Cancer Patient Recruitment and Enrollment into Cell Phone Text Message Trials. Telemed J E Health 22:836-842
Spoelstra, Sandra L; Given, Charles W; Sikorskii, Alla et al. (2016) Proof of Concept of a Mobile Health Short Message Service Text Message Intervention That Promotes Adherence to Oral Anticancer Agent Medications: A Randomized Controlled Trial. Telemed J E Health 22:497-506
Spoelstra, Sandra L; Given, Charles W; Sikorskii, Alla et al. (2015) A randomized controlled trial of the feasibility and preliminary efficacy of a texting intervention on medication adherence in adults prescribed oral anti-cancer agents: study protocol. J Adv Nurs 71:2965-76
DeKoekkoek, Tracy; Given, Barbara; Given, Charles W et al. (2015) mHealth SMS text messaging interventions and to promote medication adherence: an integrative review. J Clin Nurs 24:2722-35
Harper, Amy L; Meckes Jr, David G; Marsh, Jacob A et al. (2010) Interaction domains of the UL16 and UL21 tegument proteins of herpes simplex virus. J Virol 84:2963-71