Extrafascial out-of-plane continuous interscalene block using the C6 transverse process as a bony landmark -A case series.

Approximately 25% of adolescents and young adults have chronic health conditions []. Many are prescribed daily oral medications. Yet, nonadherence rates commonly exceed 50% [], contributing to poorer health outcomes and, for some conditions, higher mortality risk []. Given prevalent cell phone use among adolescents and young adults [], mobile health (mHealth) interventions represent a promising, scalable approach to supporting medication adherence []. mHealth tools incorporating human support are often more effective than fully automated systems, consistent with the Supportive Accountability Model, which posits that accountability to a supportive human can enhance engagement in health behaviors [,]. Furthermore, integrating human support into mHealth interventions may reduce health disparities [,]. There are several promising interventions consistent with the Supportive Accountability Model. One is E-VOLUTION, a 2-way SMS text messaging intervention offering support from case managers to youth living with HIV []. E-VOLUTION participants who texted most with case managers showed the greatest medical appointment adherence and viral suppression []. Another intervention guided by the Supportive Accountability Model is Cell Phone Support, a phone call intervention offering brief, frequent problem-solving support to help adolescents and young adults overcome adherence barriers. In a randomized controlled trial, Cell Phone Support helped youth living with HIV improve medication adherence and psychosocial outcomes and reduce viral load [,]. Additionally, Teens Taking Charge, an online self-management intervention augmented by calls from coaches, has demonstrated efficacy for reducing pain and improving quality of life among adolescents and young adults with juvenile idiopathic arthritis [] and increasing knowledge, self-efficacy, and transition preparedness among adolescents and young adults with hemophilia []. A pervasive barrier to reaching adolescents and young adults with chronic health conditions (CHC) at scale has been the tendency to design interventions specific to certain diagnoses (eg, HIV and diabetes) [,]. Adherence barriers are similar across conditions [,], and change mechanisms can promote adherence across diagnoses (eg, problem-solving skills [-], habit formation [,], and self-efficacy [-]). Yet, surface-level aspects of intervention design (eg, names, images referencing specific diagnoses, or medications) or study characteristics (eg, researchers enrolling from a population with a single diagnosis and funders limiting investigations to particular diseases) make it challenging to apply mHealth interventions broadly to adolescents and young adults with CHC. There are compelling justifications for focusing mHealth interventions on specific diagnoses, such as targeting the unique aspects of treatment regimens, enhancing community belongingness within a condition, and minimizing sample and outcome measure heterogeneity for scientific control and analytic precision. However, there is a notable gap in mHealth research targeting a behavior (eg, medication adherence) rather than a diagnosis—a strategy that could produce highly scalable interventions applicable to many adolescents and young adults, including those with multiple or rare conditions.