ACT-ALL: Reducing Guardians’ Abandonment of Children’s Treatment for Acute Lymphoblastic Leukemia in Tanzania: Development and Evaluation of an SMS Intervention

Time period:

1 January 2026 – 31 December 2029

Project leader:

Louise von Essen

Project member:

Carina King, Robert Moshiro, Malale Tungu, Holly Sugg, David Richards, Joanne Woodford

Funder:

Swedish Research Council

Type of award:

Project grant

Total funding:

5,400,000 SEK

Purpose: To reduce guardians’ abandonment of children’s maintenance therapy (MT) for Acute Lymphoblastic Leukemia (ALL) in Tanzania with an SMS intervention. Aims: To explore barriers and facilitators concerning guardians’ adherence to children’s MT, and needs and preferences regarding an SMS intervention (Study I); examine number of children starting ALL, rates of adherence to and abandonment of MT, and associated risk factors (II); co-design an intervention and methods and procedures for a pragmatic superiority randomized controlled trial (RCT) (III); evaluate the intervention plus usual care (UC) vs UC to reduce abandonment and cost-effectiveness at 12 month follow-up; explore relationships between intervention implementation, mechanisms, context, and outcome variation, and implementation barriers and facilitators (IV). Research implemented 2026-2029 from Muhimbili National Hospital. To enhance real-world impact, guardians of children treated for ALL and children treated for ALL contribute. Study I: qualitative; guardians, children, and healthcare professionals (HCPs) participate in Focus Group Discussions; Study II: prospective cohort study; Study III: co-design; guardians, children, HCPs, and technology experts participate in Workshops; Study IV: pragmatic superiority RCT (N=116) with internal pilot and mixed-methods process evaluation. Research can increase survival rates for childhood ALL and contribute to healthcare and research capacity building in Tanzania.