Chemotherapy can damage nervous system structures leading to chemotherapy-induced peripheralneuropathy (CIPN) which impairs quality of life and daily functioning for millions of cancer survivors. Some 30%of recipients live with CIPN chronically beyond completion of chemotherapy. Conventional care is symptomaticincluding antidepressants, anticonvulsants, analgesics, vitamin supplements and topical gels to managesymptoms. While there are no FDA-approved treatments, evidence indicates that specific manual therapytechniques can reduce symptoms of CIPN. There is also evidence that caregivers can learn safe and effectivemanual therapy techniques for use in caregiving through multimedia instruction. However, there currently is nocaregiver education product teaching specific techniques and safety precautions pertaining to CIPN. This project will develop a mobile health (mHealth) app to empower caregivers with knowledge, skills,self-efficacy and motivation to support loved ones with CIPN by use of simple manual techniques based onspecific understanding and safety precautions for CIPN. The project will use a human-centered designapproach in formative research to develop a "minimum viable product (MVP)" for the eventual caregivermHealth app. A user-centered, iterative process with caregiver focus groups will guide development of theMVP which will then be assessed for feasibility through a Think-Aloud protocol. Specific Aims are as follows: Aim 1. Develop initial user-centered app design. We will develop preliminary requirements for coreeducational content to be featured in the app, then refine this with patient focus group feedback. The resultinginitial app design will incorporate principles of ease of navigation, usability, utility, and engagement. Aim 2. Refine app design through an iterative process of qualitative feedback. The initial appdesign will be processed and revised through three rounds of caregiver focus groups for qualitative feedbackand refinement. Qualitative analysis of responses after each round will be conducted, and applied to producerevised versions through round 3, resulting in the MVP prototype. Aim 3. Evaluate usability of a minimum viable product (MVP). Caregivers will experience the MVPprototype through an interactive Think-Aloud session with the design team that is recorded for qualitativeanalysis. This will be followed by debriefing with structured interview questions about design, relevance andintent to use. Quantitative data will assess system usability, and perceived relevance and impact on caregiving.Feasibility criteria will be usability scores and user ratings of perceived value and "intent to use" in caregiving. If Phase I is successful the app will be completed in Phase II followed by a large RCT to assessoutcomes of use for both CIPN sufferers and caregivers. Eventual public health benefits include improvedquality of life and functional well-being for the population of CIPN sufferers, reduced caregiver burden, andreduced economic burden from medical costs and lost productivity associated with CIPN.
Public Health Relevance Statement: Project Narrative
Chemotherapy-induced peripheral neuropathy (CIPN) impairs quality of life and daily functioning
for millions of cancer survivors. While conventional oncology offers no reliable remedy, evidence
indicates manual therapy techniques can benefit CIPN symptoms. Cancer caregiver education
can significantly impact caregiver skills, self-efficacy and well-being, reducing caregiver burden
while benefiting patients. We propose to develop a mobile health (mHealth) app that will
empower caregivers with knowledge, skills, self-efficacy and motivation to provide support to
loved ones with CIPN through use of simple manual techniques at home, based on specific
understanding and safety precautions for CIPN.
Project Terms:
