A new research initiative led by Victoria Marshall, PhD, RN at the University of South Florida (USF) College of Nursing aims to transform the way older adults manage cancer treatment—thanks to significant funding from the Florida Department of Health.
A prototype icon of Marshall's mHealth program
The state grant, providing more than $213,000, will allow Marshall and her multidisciplinary team to fully develop and finalize a web-based program specifically designed for adults aged 65 and older who are prescribed oral anti-cancer medications. This technology will bridge critical gaps in cancer care by addressing adherence, education, and symptom management for a population often left out of digital health innovations.
While mobile health (mHealth) apps are commonplace, few have been designed with older adults in mind. Marshall’s previous research, funded by the National Cancer Institute, collected data on the targeted audience and confirmed that older adults are not only using technology, but doing so for health-related purposes at surprisingly high rates.
“We found that older adults are using technology,” she said, “Surprisingly, they’re using smartphones the most which is not what I thought I would find. Almost 68% of them are using smartphones for only health related purposes.”
Rather than focusing on evaluating the medications themselves, the web-based program serves as a powerful educational and self-management tool. Key features will include:
An example of personalized medication calendars from Marshall's prototype of the GOAL Health program
- Personalized medication calendars and reminders, including support for complex dosing schedules like treatment cycling and rest periods.
- Evidence-based symptom management toolkits, previously tested in clinical trials and now being digitized for the first time.
- Drug-specific education materials written at a 6th-grade reading level to help patients better understand side effects, interactions, and proper usage.
The platform will also integrate information about food and drug interactions, which is particularly important for older patients managing multiple medications for coexisting conditions.
The Florida Department of Health grant is funding the interactive development phase of the project, taking it from a clickable prototype to a fully functional, user-ready platform. Marshall says the prototype build of the program was funded by the Dean’s Grant through the USF College of Nursing.
Once finalized, a group of older adults will test the system using a "think aloud" method, where their interactions and feedback will help refine the design before broader clinical trials.
“This funding is absolutely essential,” said Marshall, “It allows us to complete the buildout of the program and test its usability with real patients before moving on to a full-scale randomized control trial.”
Marshall, a nurse with two decades of experience and a background in chronic disease management, has built a robust interdisciplinary team. In addition to her web developers to build the program, it includes experts from the USF College of Medicine, USF Department of Computer Science and Engineering, and Moffitt Cancer Center—ensuring that both clinical and technological perspectives are baked into the platform's development.
However, Marshall gives special credit to Usha Menon, PhD, RN, FAAN, FSBM, senior associate vice president of USF Health and dean of the College of Nursing, who pushed Marshall to apply for this grant.
The final product will support 28 of the most commonly prescribed FDA-approved oral anti-cancer medications, covering a substantial portion of what’s currently available to patients nationwide.
While the current grant supports a one-year development phase, the research team is already planning the next steps: a large-scale randomized control trial involving at least 300 patients. That phase will assess outcomes like medication adherence, symptom severity, daily life interference, and patient satisfaction with the information provided.
"Allowing them to have a resource that's online and usable on multiple devices can help them manage their oral anti-cancer medication, symptoms, and side effects at home with evidence based measures," Marshall said. "It can really inform them about their medication, how it's working, and why it was prescribed."