Development of a Mobile App to Support Head and Neck Cancer Caregiving: Mixed Methods Study

Abstract BackgroundSurvivors with head and neck cancer (HNC) face challenging treatment consequences that can lead to severe disruptions in swallowing and result in weight loss, malnutrition, and feeding tube dependence. Caregivers (family or friends who provide support), ther...

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Main Authors: Katherine Sterba, Evan Graboyes, Jessica Burris, Megan Scallion, Hannah Kinder, Jama Olsen, Benjamin Toll, Kent Armeson, Terry Day, Bhishamjit Chera, Kenneth Ruggiero
Format: Article
Language:English
Published: JMIR Publications 2025-06-01
Series:JMIR Cancer
Online Access:https://cancer.jmir.org/2025/1/e66471
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author Katherine Sterba
Evan Graboyes
Jessica Burris
Megan Scallion
Hannah Kinder
Jama Olsen
Benjamin Toll
Kent Armeson
Terry Day
Bhishamjit Chera
Kenneth Ruggiero
author_facet Katherine Sterba
Evan Graboyes
Jessica Burris
Megan Scallion
Hannah Kinder
Jama Olsen
Benjamin Toll
Kent Armeson
Terry Day
Bhishamjit Chera
Kenneth Ruggiero
author_sort Katherine Sterba
collection DOAJ
description Abstract BackgroundSurvivors with head and neck cancer (HNC) face challenging treatment consequences that can lead to severe disruptions in swallowing and result in weight loss, malnutrition, and feeding tube dependence. Caregivers (family or friends who provide support), therefore, often encounter distressing nutritional caregiving burdens and feel unprepared to provide adequate support at home. ObjectiveThe purpose of this mixed methods study was to develop a mobile support app to support HNC caregiving with an emphasis on nutritional support following treatment. MethodsWe assessed perspectives on nutritional recovery challenges and mobile support app preferences in (1) a national panel of oncology dietitians using a web-based cross-sectional survey and (2) survivors with HNC completing treatment within the past 24 months and their nominated caregivers using dyadic semistructured interviews. Descriptive statistics for survey data were synthesized with thematic analysis of interview data to characterize nutrition-related perceptions and intervention preferences; results were integrated, and themes were translated to high-priority main menu domains and subdomains for a mobile app for caregivers. ResultsSurveys were completed by dietitians (n=116, 100%; female n=87, 50%, with >10 years practice experience). Interviews included survivors with HNC (n=15; 12/15, 80% male, and 6/15, 40% with oropharynx cancer) and their caregivers (n=13; 11/13, 85% female, and 10/13, 77% spouses). Dietitians, survivors, and caregivers perceived that the majority of nutritional concerns assessed (eg, swallowing, feeding tube management, weight maintenance, and caregiver distress about nutrition) were very or extremely important to caregiving in the 6 months following treatment conclusion. The caregiving tasks rated highest in importance by dietitians included tracking nutritional concerns (n=113, 97%), working together as a team on nutritional concerns (n=104, 90%), and making care decisions (n=102, 88%). Five themes emerged from dyadic interviews, including types of nutritional challenges faced, that competing symptoms were difficult to separate from nutritional challenges, the emotional challenges related to nutrition and recovery, the diverse set of medical and support tasks taken on by caregivers, and information and resource needs in caregivers. Qualitative interview and survey themes guided the content of the Healthy Eating and Recovery Together (HEART) app with an intake tracker and sections for nutrition recovery support, other competing caregiving tips, peer support, and caregiver self-care. ConclusionsResults pinpointed optimal content for a mobile app for caregivers of individuals with HNC and support the acceptability of implementing the HEART app following HNC treatment.
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spelling doaj-art-5512c7b2c5d8453682d44a7e24841ffb2025-08-20T02:35:56ZengJMIR PublicationsJMIR Cancer2369-19992025-06-0111e66471e6647110.2196/66471Development of a Mobile App to Support Head and Neck Cancer Caregiving: Mixed Methods StudyKatherine Sterbahttp://orcid.org/0000-0001-9780-8695Evan Graboyeshttp://orcid.org/0000-0003-3766-468XJessica Burrishttp://orcid.org/0000-0002-9170-0701Megan Scallionhttp://orcid.org/0009-0007-0614-4098Hannah Kinderhttp://orcid.org/0009-0007-9121-6665Jama Olsenhttp://orcid.org/0009-0001-8690-9527Benjamin Tollhttp://orcid.org/0000-0001-7978-8416Kent Armesonhttp://orcid.org/0000-0003-3758-6693Terry Dayhttp://orcid.org/0000-0003-1431-4214Bhishamjit Cherahttp://orcid.org/0009-0003-2816-3557Kenneth Ruggierohttp://orcid.org/0000-0001-8504-6988 Abstract BackgroundSurvivors with head and neck cancer (HNC) face challenging treatment consequences that can lead to severe disruptions in swallowing and result in weight loss, malnutrition, and feeding tube dependence. Caregivers (family or friends who provide support), therefore, often encounter distressing nutritional caregiving burdens and feel unprepared to provide adequate support at home. ObjectiveThe purpose of this mixed methods study was to develop a mobile support app to support HNC caregiving with an emphasis on nutritional support following treatment. MethodsWe assessed perspectives on nutritional recovery challenges and mobile support app preferences in (1) a national panel of oncology dietitians using a web-based cross-sectional survey and (2) survivors with HNC completing treatment within the past 24 months and their nominated caregivers using dyadic semistructured interviews. Descriptive statistics for survey data were synthesized with thematic analysis of interview data to characterize nutrition-related perceptions and intervention preferences; results were integrated, and themes were translated to high-priority main menu domains and subdomains for a mobile app for caregivers. ResultsSurveys were completed by dietitians (n=116, 100%; female n=87, 50%, with >10 years practice experience). Interviews included survivors with HNC (n=15; 12/15, 80% male, and 6/15, 40% with oropharynx cancer) and their caregivers (n=13; 11/13, 85% female, and 10/13, 77% spouses). Dietitians, survivors, and caregivers perceived that the majority of nutritional concerns assessed (eg, swallowing, feeding tube management, weight maintenance, and caregiver distress about nutrition) were very or extremely important to caregiving in the 6 months following treatment conclusion. The caregiving tasks rated highest in importance by dietitians included tracking nutritional concerns (n=113, 97%), working together as a team on nutritional concerns (n=104, 90%), and making care decisions (n=102, 88%). Five themes emerged from dyadic interviews, including types of nutritional challenges faced, that competing symptoms were difficult to separate from nutritional challenges, the emotional challenges related to nutrition and recovery, the diverse set of medical and support tasks taken on by caregivers, and information and resource needs in caregivers. Qualitative interview and survey themes guided the content of the Healthy Eating and Recovery Together (HEART) app with an intake tracker and sections for nutrition recovery support, other competing caregiving tips, peer support, and caregiver self-care. ConclusionsResults pinpointed optimal content for a mobile app for caregivers of individuals with HNC and support the acceptability of implementing the HEART app following HNC treatment.https://cancer.jmir.org/2025/1/e66471
spellingShingle Katherine Sterba
Evan Graboyes
Jessica Burris
Megan Scallion
Hannah Kinder
Jama Olsen
Benjamin Toll
Kent Armeson
Terry Day
Bhishamjit Chera
Kenneth Ruggiero
Development of a Mobile App to Support Head and Neck Cancer Caregiving: Mixed Methods Study
JMIR Cancer
title Development of a Mobile App to Support Head and Neck Cancer Caregiving: Mixed Methods Study
title_full Development of a Mobile App to Support Head and Neck Cancer Caregiving: Mixed Methods Study
title_fullStr Development of a Mobile App to Support Head and Neck Cancer Caregiving: Mixed Methods Study
title_full_unstemmed Development of a Mobile App to Support Head and Neck Cancer Caregiving: Mixed Methods Study
title_short Development of a Mobile App to Support Head and Neck Cancer Caregiving: Mixed Methods Study
title_sort development of a mobile app to support head and neck cancer caregiving mixed methods study
url https://cancer.jmir.org/2025/1/e66471
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