Leveraging an academic-industry partnership to develop a cancer-specific mobile meditation app

Project: Research project

Project Details


Leveraging an academic-industry partnership to develop a cancer-specific mobile meditation app Leveraging an academic-industry partnership to develop a cancer-specific mobile meditation app Chronic symptom burden among cancer patients/survivors is debilitating and costly. Long term, accessible, and effective solutions for ongoing symptom management in ~15.5 million US cancer patients/survivors are sorely needed as chronic symptom burden costs the healthcare system an estimated $125 billion every year. Cancer patients suffer from a wide range of symptoms affecting quality of life that persist into survivorship and can last more than a decade. Our feasibility studies, and 100 letters of support, show that cancer patients/survivors want and are willing to participate in complementary strategies to minimize their symptom burden. The benefits of meditation (i.e., mindfulness-based therapies) for alleviating fatigue, anxiety, depression, and sleep disturbance in cancer is well demonstrated. In-person meditation, usually delivered at a cancer center may improve symptoms, but such programs are expensive and difficult to sustain. Some patients struggle to attend even short-term programs due to distance, scheduling, and symptom burden. While technological solutions hold promise as accessible, flexible, low-cost and scalable approaches, long-term engagement with commercial mobile applications (i.e., apps) is very low. Current meditation apps are limited in their engagement, acceptability, and applicability to cancer patients/survivors unique experiences and needs. Despite over 150 mobile apps marketed for cancer, NONE include user supported, evidence-based strategies to increase engagement in meditation. To improve the long-term uptake and impact of mHealth in patient populations, the Center for eHealth Research and Disease Management recommends stakeholder feedback in the early design phase to develop interventions targeted for end users. To date, there has been a dearth of evidence-based apps because: (1) NO commercially designed meditation apps have been evaluated for feasibility or efficacy in cancer patients/surivors and (2) NO researcher-designed meditation apps have made it to commercialization. In contrast, behavioral scientists at ASU, cancer providers at Mays Cancer Center, and developers at Calm are partnering to create a standalone meditation app integrating evidence-based techniques for long-term cancer patient/survivor needs. Calm is a consumer-based meditation app accessible across smartphone platforms (Android and iOS) with 75 million downloads and 2 million subscribers. In 2018, Calm was the top downloaded health and fitness app. We propose to leverage the Calm platform designed for the general population, to develop a standalone cancer-specific meditation app that reflects the unique physical, psychological, cognitive and social needs of cancer patients/survivors by engaging patients and providers in the design and feasibility evaluation stages. There is currently an unmet need for commercially available, tailored, evidence-based meditation apps specifically designed for cancer patients/survivors. We have identified six specific adaptations needed to accommodate the clinical manifestations of cancer patients/survivors including: 1) non-body and non-breath focused meditations, 2) positions and practice that do not induce fatigue, 3) context specific meditations e.g. during chemo, 4) self-tracking of symptoms, 5) content on grief, trauma etc, specific to meditation practice, and 6) patient supports specific to ongoing meditation practice. Without such adaptations, and ultimately efficacy testing, patients will not experience the full benefits of meditation nor engage with the app long term, providers will not prescribe the app to cancer patients, and the app may not be eligible for long term, cancer-specific insurance reimbursement. Using the IDEAS (Integrate, Design, Assess, and Share) framework we will conduct the following aims: Specific Aim 1: Using two focus groups, we will INTEGRATE our formative work, the social cognitive theory, and perspectives from our experienced-user advisory committee (N=20) who will use the current Calm platform to identify design content and features for a standalone cancer-specific app prototype leveraging the commercial infrastructure of the Calm platform. Our advisory committee will consist of both cancer patients/survivors (n=10; 5 of each) and health care providers (n=10). Specific Aim 2: DESIGN a meditation app prototype tailored to cancer patients/survivors unique needs including content related to cancer-related experiences, emotions, symptoms, physical and psychological needs, cancer-specific symptom self monitoring, social support and sense of belonging within the app and through Facebook. Specific Aim 3: ASSESS (i.e., beta-test) the prototypes form and function with cancer patients/survivors (N=30). We will use Bowens feasibility model to determine via surveys and interviews: (a) acceptability (satisfaction, perceived appropriateness, perceived positive/negative effects); (b) demand (use of the app, interest or intention to use); (c) practicality (how it makes them feel, ease of use); (d) adaptation (suggestions for modifications to improve performance for cancer patients/survivors); and (e) integration (how can the app be integrated into the cancer system) Feasibility benchmarks: >80% of cancer patients/survivors will accept the prototype, demand the prototype for themselves and other cancer patients/survivors, and find it practical. Data from Aim 3 will guide refinement of the prototype to be tested in a fully powered RCT to establish long term engagement (Phase 2). This work will result in an evidence based, cancer-specific meditation app through a commercial platform that can be scaled and sold at discounted costs to clinic providers and directly to patients (SHARE; Phase 3).
Effective start/end date3/1/216/30/22


  • HHS: National Institutes of Health (NIH): $155,543.00


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