Just TRAC It! Transitioning Responsibly to Adult Care Using Smart Phone Technology
Condition: Congenital Heart Disease; Heart; Surgery, Heart, Functional Disturbance as Result
MeSH terms: Heart Diseases; Heart Defects, Congenital
Study type: Interventional

Summary: 
      The Just TRAC It! study (Transitioning Responsibly to Adult Care using smart phone
      technology) is a randomized controlled trial designed to evaluate the impact of using smart
      phone technology in combination with the nurse led transition intervention, versus the
      current standard of care (nurse led transition intervention including MyHealth Passport), on
      preparing adolescents with chronic cardiac disease to successfully transition from pediatric
      to adult cardiology care. "Just TRAC it!" is a mobile-health intervention designed to teach
      youth to manage their health using existing functions on their mobile devices. We propose to
      conduct a nurse-led intervention that encourages adolescents to use "Just TRAC it!" while
      addressing the healthcare transition needs of 16-18 year olds.
    

Detailed description: 
      Many adolescents and young adults living with chronic health conditions lack knowledge about
      their medical condition and confidence communicating with health care providers. Despite
      various positions statements on transition by the Canadian Pediatric Society, the American
      Academy of Pediatrics and the American Heart Association, there is limited evidence on the
      impact and effectiveness of transition interventions. Due to the convenience and
      accessibility of technology, adolescents embrace technology-based interventions to aid in
      their disease management and to improve their transition experience. However, there is a
      paucity of evidence-based apps in contrast to countless existing apps that are not
      evidence-based, which act as a barrier to physicians prescribing them. There is a pressing
      need for credible evidence on the effectiveness and value of health apps in improving
      self-management skills in adolescents.

      Instead of redesigning a mobile app, the Just TRAC It! encourages youth to use existing
      functions on their personal phones to track their health information. This information is
      easily retrievable when visiting health care providers and can help youth take ownership in
      managing their own health. This free option, using the technology already on most phones, can
      be used for any patient population or disease category. The use of Just TRAC It! allows youth
      to electronically document all medical information that would previously be printed on their
      MyHealth Passport, but may offer additional functionality in terms of learning to manage
      their health. Further investigation is warranted to evaluate the effectiveness of Just TRAC
      It! on improving patient knowledge, self-management skills, and transition readiness.

      The Stollery Children's Hospital is an international leader in pediatric to adult cardiology
      transition research, with two randomized clinical trials completed (CHAPTER 1 Trial, Mackie
      et al, Heart 2014 and CHAPTER 2 Trial, Mackie et al, BMC Cardiovascular 2016) and a 3rd in
      progress. The Just Trac It! Trial is an extension of our prior work. The results of the
      CHAPTER 1 Trial inform the current standard of care for transition interventions currently
      offered to all 16-18 year olds in our program who have had prior cardiac surgery, and this
      standard of care is the "usual care" (control) group for the Just Trac It! Study.
    

Intervention name(s): Teaching session; Just TRAC It!; MyHealth Passport
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The cardiology nurse (RN) will have an hour long one-on-one teaching session prior to their pediatric cardiology clinic visit. The RN will go over the youth's cardiac history including the chronic heart disease diagnoses, names and dates of cardiac surgical procedures and cardiac catheterizations, and current cardiac medications and doses. She will also discuss transitioning from pediatric to adult care and healthy lifestyle choices.; Just TRAC It! (Transitioning Responsibly to Adult Care) is a mobile health intervention that encourages youth to use existing functions on their personal phones to track their health information. The use of Just TRAC It! allows youth to electronically document all medical information that would previously be printed on their MyHealth Passport, but may offer additional functionality in terms of learning to manage their health.; MyHealth Passport is a customized, wallet-size card that includes the youth's important medical information. The RN will help the youth create a MyHealth Passport online, and print out the card for them.
The same educational intervention will be completed by cardiology nurse using a MyHealth Passport to track their medical information instead of the electronic "Just TRAC It!"
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Patients will be randomized individually in permuted blocks with randomly varying sizes of 2 and 4, and allocation ratio 1:1 for intervention and control groups.
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Transition; Adolescents; Smart phone