Funded by a d3center Pilot Grant, an optimized JITAI will provide personalized adherence support that addresses the dyadic unit as an interdependent team. Providing support at the right time, only when it is needed, JITAI can maximize engagement and minimize burden by delivering messages when there is really a benefit.

The dependence of adolescent and young adult patients on family caregivers, which often include a difference in power of authority, along with caregivers’ tendency to want to care and guide their patient through the illness continuum is unlike those seen in other dyadic relationships.

Key challenges are:

• Optimally facilitating positive interactions in a setting that is inherently unbalanced and hierarchical, through a focus on shared goals, reciprocation, and positive emotions
• Leveraging interactions to encourage and empower autonomy and independent agency

This project capitalizes on adolescent and young adult’s near ubiquitous use of technology and enables new directions in examining the link between physical and mental states, and how the young patient and caregiver might affect each other, individually and interdependently.

In the spirit of d3center research, this study moves beyond the “one-size-fits-all” approach, addressing the unique challenges and dynamics of the adolescent and young adult and caregiver dyad. Furthermore, it reflects the success of the Center’s open-source dissemination initiative: the original ADAPTS application is a modification of an app developed and released by Center investigators.