Empowering Minds: A Pilot Study to Assess Feasibility of ADAPT-SCD to Enhance Cognitive Function in Adolescents and Young Adults With Sickle Cell Disease

Background: Executive functioning (EF) deficits are a well-documented complication of sickle cell disease (SCD), yet no standard intervention exists to address this issue. Adapting Daily Activity Performance Through Strategy Training (ADAPT) is a metacognitive strategy training protocol designed to enhance self-assessment and strategic problem-solving, showing potential to mitigate EF deficits in individuals with SCD. Procedure: Adolescents and young adults (AYA) aged 16–25 years with a documented SCD diagnosis were recruited. Baseline assessments of depression, self-awareness, and EF were conducted. Participants completed an adapted version of ADAPT, known as ADAPT-SCD, consisting of 10–14 sessions delivered either in person or via telehealth. Follow-up assessments were conducted immediately post-program and 6 months later. Feasibility was defined as 50% of approached AYA consenting and 10 participants completing at least 10 sessions. Acceptability was determined through participant responses in post-program interviews and surveys. A secondary aim was to examine the changes in EF and depression scores. Results: Feasibility of ADAPT-SCD was partially supported, with 38% (19/50) of approached AYA enrolling, and 10 participants completing the required 10 sessions. Acceptability was supported through positive participant feedback on post-program surveys and interviews. While most changes in EF and depression measures were not clinically significant, the List Sorting Working Memory subtest of the National Institutes of Health Toolbox-Cognitive Battery showed a significant improvement. Conclusions: ADAPT-SCD demonstrated strong acceptability and partial feasibility. However, its impact on EF and depression outcomes warrants further investigation to establish clinical significance and inform future interventions for SCD-related cognitive challenges.