Northwestern Investigator Alexandra Psihogios, PhD, Awarded Prestigious NCI R37 to Test Social Media Strategy for Cancer Medication Adherence

November 13, 2025

A new National Cancer Institute (NCI) R37 MERIT Award will support an innovative clinical trial led by Alexandra Psihogios, PhD, at Northwestern University Feinberg School of Medicine Department of Medical Social Sciences (MSS) and Ann and Robert H. Lurie Children’s Hospital of Chicago. This innovative multi-site study will test whether social media influencers can improve adherence to oral chemotherapy among adolescents and young adults (AYAs) with leukemia. "We are so proud of Psihogios for receiving an NCI R37 MERIT award. It is one of the most prestigious recognitions in cancer research, reserved for those investigators whose research is truly exceptional and impactful," said MSS department chair Rinad Beidas, PhD.

AYA survivors often transition from intensive inpatient treatment to monthly clinic visits while continuing low-dose oral chemotherapy for two to three years. Although adherence is vital, a landmark Children’s Oncology Group study demonstrated that taking less than 95 percent of prescribed doses for six months increases relapse risk nearly three-fold. Rates of adherence drop most sharply during adolescence as young people regain independence, feel healthier, and resume normal life.

Psihogios and her team have developed a digital intervention that meets young people where they already spend time: social media. Working with a community advisory board of cancer survivors who are also established influencers on platforms such as TikTok, the investigators created relatable, peer-driven videos that deliver health education, normalize barriers to medication-taking, and reinforce the importance of adherence.

“Influencers shape young people’s purchasing decisions every day. This project asks whether they can also motivate life-saving health behaviors,” Psihogios said.

The five-year award will advance three major aims:

Optimize message tailoring. A best-worst scaling experiment will determine which types of posts are most persuasive, including the impact of tone, identity match between viewer and influencer, and content style.
Evaluate in a randomized clinical trial. Participants will receive either the tailored influencer-based intervention or an education-only control. Electronic medication monitoring caps will objectively track adherence for six months, along with changes in knowledge, perceived norms, and other mechanisms.
Plan for national dissemination. Qualitative interviews with survivors and organizational partners will inform strategies to implement and scale the approach across cancer organizations and digital platforms.

The Influencer Advisory Board, made up of vetted advocates who have cultivated large public followings through their cancer experiences, has collaborated on the intervention’s design for more than two years and will remain engaged throughout implementation.

Psihogios described the team as eager to launch early study activities and begin enrollment across collaborating clinical sites.

“Adolescents and young adults have already survived the hardest part of leukemia treatment,” Psihogios said. “This work is about ensuring that what they have overcome continues to count, by helping them finish their therapy as safely and successfully as possible.”