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Mobile health (mHealth) resources, including apps, are emerging as resources to support children in tracking symptoms and other health-related data. The purpose of this study was to describe symptoms and daily experiences reported by elementary school-age children receiving treatment for cancer using the newly developed Color Me Healthy app.Participants in this descriptive study were children 6-12 years of age, who were receiving cancer treatment at a free-standing children's hospital in the Intermountain West of the United States. Children were requested to use the app for at least five days between clinical visits. Children's app-reported data were extracted from individual user accounts for analysis. Quantitative data were summarized descriptively. Qualitative data were summarized using qualitative content analysis.Nineteen children (6-12 years; median 8 years; 7 females) completed 107 days of app use. All children reported symptoms at least once, and 14 reported at least one day with a symptom of moderate or greater severity. Daily experiences reported through the app reflected children's engagement in usual childhood experiences while also describing life with cancer, including symptoms.Elementary school-age children are capable of self-reporting symptoms using a symptom reporting app, providing preliminary evidence for the potential benefits and clinical relevance of mHealth resources to support health outcomes within this population.Clinicians should anticipate and support ongoing symptom management needs between clinical visits. Children's self-reported data can promote a person-centered approach to symptom assessment and management.

CONTEXT: Cancer and symptom experiences of adolescents and young adults (AYAs) with cancer can be highly variable, creating challenges for clinicians and researchers who seek to optimize AYAs’ health outcomes. Understanding the heuristics AYAs use to designate priority symptoms can provide insight into the meaning they assign to their symptoms and self-management behaviors. OBJECTIVES: This study described the frequency and characteristics of priority symptoms. It qualitatively explored reasons for a symptom’s designation as a priority symptom, perceived causes of priority symptoms, and strategies AYAs use to manage priority symptoms. METHODS: Participants in this single group, longitudinal study reported symptoms using a heuristics-based symptom reporting tool, the Computerized Symptom Capture Tool, at two scheduled visits for chemotherapy. AYAs designated priority symptoms and responded to two short answer questions: What makes this a priority symptom? and What do you do to make it better? RESULTS: Eighty-six AYAs, 15-29 years of age (median 19 years), identified 189 priority symptoms. Priority symptoms were of greater severity (t=3.43; p< .01) and distress (t=4.02; p< .01) compared with non-priority symptoms. Lack of energy, nausea, difficulty sleeping, and pain comprised 39% of priority symptoms. Reasons for priority designation included the impact of the symptom and the attributes of the symptom. Categories of self-management strategies included “Physical Care Strategies,” “Things I take (or not),” and “Psychosocial Care Strategies.” CONCLUSION: Supporting AYAs to identify their priority symptoms may facilitate a more personalized approach to care. Seeking the patient’s perspective regarding priority symptoms could enhance patient-clinician collaboration in symptom management.

BACKGROUND: Children with cancer have difficulty identifying and describing the multiple symptoms they experience during hospitalization and between clinical encounters. Mobile health resources, including apps, are potential solutions to support child-centric symptom reporting. This study evaluated the feasibility and acceptability of a newly developed game-based symptom reporting app for school-age children with cancer. PROCEDURE: Nineteen school-age children (6–12 years of age) receiving treatment for cancer at a COG institution in the Intermountain West of the United States used a game-based symptom reporting app between clinical visits. Feasibility was evaluated through a summary of actual days of app use and interaction with each of the app’s features. Children and their parents participated in interviews regarding the app’s acceptability. RESULTS: Children used the app a median of 4 days (range 1–12) and interacted most frequently with the symptom reporting and the drawing features. Children enjoyed aspects of the app that supported their creativity and provided choices. Parents endorsed the interactive nature of the app and the value of the child providing his/her own report. Both children and parents identified additional opportunities to enhance the child’s user experience. CONCLUSION: Study results support the preliminary feasibility and acceptability of the app. Children’s and parents’ responses supported the developmental relevance of the app and its role in enhancing the child’s autonomy and serving as an outlet for creativity. Future directions include optimizing the child user’s experience and investigating the app’s role as a resource to enhance shared decision making for symptom management.

Launched in June 2016, the Utah Geriatric Education Consortium (UGEC) inter-professional Learning Community was developed by faculty in collaboration with primary care and community partners with a focus on Long Term Care. In 2019, UGEC expanded to include Assisted Living, Home Care and Hospice -5 primary care and 6 community long-term services and supports (LTSS) partners in rural and urban Utah with a primary objective of developing and training existing LTSS healthcare providers and direct care workers on the elements of age-friendly health systems (“4Ms”: mentation, medication, mobility, and what matters) to enhance care and improve outcomes for older adults across the continuum of LTSS. Attendance in the monthly distance learning sessions averages 27.5. Sessions are rated highly and engage nurses, behavioral health workers, administrators, physicians, nursing assistants, occupational and physical therapists. The process, challenges, successes of transitioning to a LTSS ECHO (Extension for Community HealthCare Outcomes) will be discussed.