Understanding the Barriers and Facilitators to Adherence to Oral Chemotherapy in Hispanic
Youth with Acute Lymphoblastic Leukemia
Wendy Landier, Cynthia Hughes, Evelyn Calvillo, Deborah Brise帽o-Toomey,
Nancy Anderson, and Smita Bhatia
The long-term goal of this project is to develop culturally-relevant, effective interventions to improve
adherence to oral maintenance chemotherapy in a multiethnic cohort of youth with A.L.L. The overall
objective of this two-year proposal is to develop and validate a grounded theory-based model to
explain the reasons for non-adherence to oral maintenance chemotherapy in Hispanic youth with
A.L.L. and to identify culturally-relevant and acceptable interventional strategies to improve adherence
in this group. Participants will be recruited from the population of youth with A.L.L. treated at City of
Hope and their parents/caregivers. The study will be conducted in two phases: (1) The theoretical
model will be developed and potential interventional strategies will be identified during the first year of
the study through interviews conducted with Hispanic youth with A.L.L. and their parents/caregivers,
and with a similar group of Caucasian youth and their parents/caregivers who will serve as the
referent group; followed by (2) Verification of the theoretical model and potential interventional
strategies identified in initial phase of the study via focus groups conducted with the Hispanic cohort
only. The rationale for this project is that its successful completion is expected to lay the foundation
for development of theory-based, culturally relevant, feasible interventions that will effectively improve
adherence to oral maintenance chemotherapy in Hispanic youth with A.L.L. There are three specific
aims: 1) To develop a grounded theory-based model to explain the reasons for non-adherence to oral
maintenance chemotherapy in Hispanic youth with A.L.L.; 2) To identify interventional strategies
(facilitators) aimed at improving adherence to oral maintenance chemotherapy in Hispanic youth with
A.L.L.; and 3) To verify that the grounded theory-based model (identified in Aim #1) and the
interventional strategies to improve adherence (identified in Aim #2) are culturally-relevant, valid, and
acceptable to Hispanic youth with A.L.L. and their parents/caregivers.
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