Grant Number:	1R34CA301428-01A1 Interpret this number
Primary Investigator:	Kunin-Batson, Alicia
Organization:	University Of Minnesota
Project Title:	Adapting a Caregiver-Directed Mhealth Intervention to Support Positive Health Behaviors in Children Treated for Acute Lymphoblastic Leukemia
Fiscal Year:	2026

PROJECT SUMMARY/ABSTRACT Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. Although survival rates exceed 90%, treatment success has come with a cost. Adult survivors of childhood ALL are 7 times more likely to die of cardiac causes and almost twice as likely to develop type 2 diabetes than the general population, making early intervention strategies for chronic disease prevention a high priority. Both during and after cancer therapy, children treated for ALL are at risk for fatigue, excessive weight gain, and maladaptive health behavior changes across multiple domains (reduced physical activity, poor dietary quality, increased screen time usage, inadequate sleep) that are driven by physiological (chemotherapy-induced) changes and social (home/environmental) factors. Given the young age at diagnosis of most children with ALL (2-9 years) and the known impact of cancer on the family, health behavior interventions that focus on parenting strategies and modifications to the home environment are important. Further, such interventions must address multiple health behaviors to maximize the benefit to cardiometabolic health. Unfortunately, few empirically supported health behavior change interventions exist for children with ALL. Many of these are time and resource intensive (e.g., face-to-face sessions, trained interventionists) and reach only a subset of patients who have already developed cardiometabolic conditions (i.e., obesity). Additionally, health behavior interventions are typically not offered until after cancer treatment is over, missing an important opportunity to prevent the development of cardiometabolic conditions that emerge while children are on treatment and persist into survivorship. Mobile phone-delivered (mHealth) programs are a potential avenue to overcome resource, reach, and timing barriers to increase the accessibility of health behavior interventions for children with ALL but have not yet been designed to meet their needs. The primary goal of the proposed study is to leverage key stakeholders to adapt and test the feasibility of a parent-targeted, mHealth intervention (MINISTOP 2.0) to support healthy lifestyle habits among 2-9-year-old children with ALL undergoing maintenance chemotherapy in the U.S. MINISTOP 2.0 was developed for use in general pediatrics and is rooted in social cognitive theory and behavior change techniques. In line with Phases 1b and 2b of the Obesity-Related Behavioral Intervention Trials (ORBIT) framework, we will leverage key stakeholder feedback (multidisciplinary cancer care experts, parents/guardians [“caregivers”] of ALL patients, institutional parent/family and health advisory boards) to adapt MINISTOP 2.0 and test the feasibility of the adapted intervention (ADAPT-ALL) among n=30 caregivers in a randomized controlled pilot trial over a 6-month intervention period. Data will inform a future large scale randomized controlled trial to evaluate the efficacy of ADAPT-ALL in comparison to a survivor education control condition on children’s health behaviors, body mass index trajectories, and cardiometabolic health outcomes. Overall, this research is expected to have public health benefits for children with ALL in the U.S. by improving health behaviors to reduce cardiometabolic risk.





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