*Purpose: Nearly 2,000 children undergo solid organ transplant in the US annually. In our previous research with transplant families, parents reported difficulty coping with the complex care at home and decreased quality of life after hospital discharge. We evaluated the feasibility, acceptability and efficacy of a family self-management intervention (myFAMI) that employed an mHealth approach using an app and nurse response as a strategy for improving discharge transition outcomes.

*Methods: In a randomized controlled trial design guided by the Individual and Family Self-Management Theory, we recruited family units (one primary and one secondary family member) of pediatric transplant recipients (standard care n = 23, myFAMI n = 23) at four US transplant centers. The myFAMI app promoted daily communication with the family member initiated by an in-app notification for 30-days after hospital discharge. Family members rated their coping, family self-management at home (medications, follow-up), and child symptom management (fever, pain, vomiting, diarrhea, or other illness). Pre-identified critical responses triggered an alert and subsequent nurse response to the family member within 2 hours. Post-discharge coping (Post Discharge Coping Difficulty Scale), self-efficacy (Self-Efficacy items), and quality of life (PedsQL Family Impact Module^TM) were assessed by telephone at 30-days after discharge. Analysis used descriptive statistics and t-tests.

*Results: 44 of 46 enrolled family units completed study related procedures. Most myFAMI primary (82%, n = 18/22) and secondary family members (67%, n = 8/12) completed the app at least 80% of the time (24/30 days after discharge). 163 trigger alerts were generated by family members and were responded to by the nurse within 2 hours of receipt (100%). myFAMI family members had better outcomes at 30-days than standard care families: less coping difficulty (22 vs 26, p=0.59), improved self-efficacy (9.3 vs 9.0, p=0.08), and improved family quality of life (81.3 vs 75.0, p=0.47).

*Conclusions: The myFAMI intervention was both feasible and acceptable. Findings from this preliminary study are clinically meaningful with effects in the expected direction that support further evaluation in a larger trial. Results advance knowledge and build the science from which to consider the use of myFAMI in post-discharge monitoring for other pediatric chronic illness populations.

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