Acceptability and feasibility of salivary stress research with adolescents and young adults with sickle cell disease

Objectives Sickle cell disease (SCD) primarily impacts Black and African Americans who often face social-ecological stressors that can influence biological stress responses. Saliva is a widely used assessment of stress biomarkers; however, few studies have utilized this methodology in SCD. This study aimed to determine the acceptability and feasibility of at-home saliva collection and examine social-ecological and disease-related correlates of participation. Methods A cohort of adolescents and young adults (AYA) with SCD (ages 16-25) enrolled in a survey study had the opportunity to opt into a 1-day, 4-sample, at-home saliva collection. Acceptability was assessed via survey, and feasibility was assessed via saliva enrollment rate and factors contributing to enrollment and adherence with the protocol. Investigated social-ecological correlates included demographics, surveys of stressors and health-related skills, and census tract-level neighborhood factors. Disease-related factors were obtained from the electronic medical record. Results Forty-nine AYA (M _age = 19.6, 40.8% female) completed acceptability surveys with 70% reporting being “Likely” or “Very Likely” to provide saliva samples for research. Three quarters of AYA who completed surveys opted into the saliva collection (75.5%; n = 37). In total, 89.2% (n = 33) collected and returned at least 2 samples to the study team. AYA with higher neighborhood poverty, more hospitalizations in the year prior to enrollment, and lower self-management skills were less likely to opt into saliva collection. Conclusion At-home saliva collection is acceptable and feasible among AYA with SCD, yet there is a need for tailored support strategies to enhance participation in salivary research.