Evaluation of the Healthy Eating and Recovery Together (HEART) digital health intervention to support head and neck cancer caregivers and survivors

Background: Head and neck cancer (HNC) survivors and their caregivers face significant challenges at the end of treatment and interventions are critically needed to support their needs. The Healthy Eating and Recovery Together (HEART) intervention includes a needs assessment and tailored care plan for dyads and an application (App) for caregivers. The objectives of this trial were to evaluate the feasibility, acceptability, and short-term effects of HEART on unmet needs and depression in HNC survivors and caregivers. Methods: In a single arm clinical trial, HNC caregivers and survivors (n=23 dyads) completed baseline surveys followed by an in-person or virtual HEART session; caregivers used the HEART App for 4 weeks and dyads completed a 6-week follow-up survey. Results: HEART feasibility was demonstrated in session completion (100%), content covered (>80%) and App use metrics (mean =20 logins over 4 weeks). The needs assessment triggered an average of 4 referrals per dyad yet acceptance rates were low. HEART acceptability was demonstrated with both dyads and nurses rating the intervention (>75%) and App [mean System Usability Scale (SUS) =75] favorably. Unmet needs remained stable over time in dyads (P>0.05) while depressive symptoms decreased in survivors (P=0.02). Conclusions: Digital health interventions are promising to address HNC survivor and caregiver challenges. HEART demonstrated favorable feasibility and acceptability. With further enhancements to streamline this multi-component intervention and its delivery, timing and participant engagement, HEART merits further study in a larger randomized controlled trial.