TY - JOUR
T1 - Providing psychological support to parents of childhood cancer survivors
T2 - ‘cascade’ intervention trial results and lessons for the future
AU - Wakefield, Claire E.
AU - Sansom‐daly, Ursula M.
AU - McGill, Brittany C.
AU - Hetherington, Kate
AU - Ellis, Sarah J.
AU - Robertson, Eden G.
AU - Donoghoe, Mark W.
AU - McCarthy, Maria
AU - Kelada, Lauren
AU - Girgis, Afaf
AU - King, Madeleine
AU - Grootenhuis, Martha
AU - Anazodo, Antoinette
AU - Patterson, Pandora
AU - Lowe, Cherie
AU - Dalla‐pozza, Luciano
AU - Miles, Gordon
AU - Cohn, Richard J.
N1 - Funding Information: The Cascade project was funded by Cancer Australia (APP1065428) as well as a Cancer Council New South Wales Program Grant (PG16?02) with the support of the Estate of the Late Harry McPaul. The trial was endorsed by the Australian and New Zealand Children?s Haematology/Oncology Group. Prof Wakefield is supported by the National Health and Medical Research Council of Australia (APP1143767 and APP2008300). Sansom?Daly is supported by the National Health and Medical Research Council of Australia (APP1111800) and an Early Career Fellowship from the Cancer Institute of New South Wales (ID: 14/ECF/1?11, followed by 2020/ECF1163). The Behavioural Sciences Unit is proudly supported by the Kids with Cancer Foundation. Funding Information: Funding: The Cascade project was funded by Cancer Australia (APP1065428) as well as a Cancer Council New South Wales Program Grant (PG16‐02) with the support of the Estate of the Late Harry McPaul. The trial was endorsed by the Australian and New Zealand Children’s Haematology/Oncology Group. Prof Wakefield is supported by the National Health and Medical Research Council of Australia (APP1143767 and APP2008300). Sansom‐Daly is supported by the Funding Information: National Health and Medical Research Council of Australia (APP1111800) and an Early Career Fellowship from the Cancer Institute of New South Wales (ID: 14/ECF/1‐11, followed by 2020/ECF1163). The Behavioural Sciences Unit is proudly supported by the Kids with Cancer Foundation. Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2021/11/1
Y1 - 2021/11/1
N2 - We conducted a three‐armed trial to assess Cascade, a four‐module group videoconferencing cognitive behavior therapy (CBT) intervention for parents of childhood cancer survivors currently aged <18 years. We allocated parents to Cascade, an attention control (peer‐ support group), or a waitlist. The primary outcome was parents’ health‐related quality of life (PedsQL‐Family Impact/EQ‐5D‐5L) six months post‐intervention. Parents also reported their anxiety/depression, parenting self‐agency, fear of recurrence, health service and psychotropic medication use, engagement in productive activities, confidence to use, and actual use of, CBT skills, and their child’s quality of life. Seventy‐six parents opted in; 56 commenced the trial. Cascade achieved good parent engagement and most Cascade parents were satisfied and reported benefits. Some parents expressed concerns about the time burden and the group format. Most outcomes did not differ across trial arms. Cascade parents felt more confident to use more CBT skills than peer-support and waitlisted parents, but this did not lead to more use of CBT. Cascade parents reported lower psychosocial health scores for their child than waitlisted parents. Cascade parents’ health service use, psychotropic medication use, and days engaged in productive activities did not improve, despite some improvements in waitlisted parents. Our trial was difficult to implement, but participants were largely satisfied. Cascade did not improve most outcomes, possibly because many parents were functioning well pre‐enrolment. We used these findings to improve Cascade and will trial the new version in future.
AB - We conducted a three‐armed trial to assess Cascade, a four‐module group videoconferencing cognitive behavior therapy (CBT) intervention for parents of childhood cancer survivors currently aged <18 years. We allocated parents to Cascade, an attention control (peer‐ support group), or a waitlist. The primary outcome was parents’ health‐related quality of life (PedsQL‐Family Impact/EQ‐5D‐5L) six months post‐intervention. Parents also reported their anxiety/depression, parenting self‐agency, fear of recurrence, health service and psychotropic medication use, engagement in productive activities, confidence to use, and actual use of, CBT skills, and their child’s quality of life. Seventy‐six parents opted in; 56 commenced the trial. Cascade achieved good parent engagement and most Cascade parents were satisfied and reported benefits. Some parents expressed concerns about the time burden and the group format. Most outcomes did not differ across trial arms. Cascade parents felt more confident to use more CBT skills than peer-support and waitlisted parents, but this did not lead to more use of CBT. Cascade parents reported lower psychosocial health scores for their child than waitlisted parents. Cascade parents’ health service use, psychotropic medication use, and days engaged in productive activities did not improve, despite some improvements in waitlisted parents. Our trial was difficult to implement, but participants were largely satisfied. Cascade did not improve most outcomes, possibly because many parents were functioning well pre‐enrolment. We used these findings to improve Cascade and will trial the new version in future.
KW - Acceptability
KW - Childhood cancer
KW - Cognitive behavior therapy
KW - Efficacy
KW - Feasibility
KW - Parent
KW - Psychological interventions
KW - Quality of life
KW - Survivorship
KW - Videoconferencing
UR - http://www.scopus.com/inward/record.url?scp=85118660480&partnerID=8YFLogxK
U2 - https://doi.org/10.3390/cancers13225597
DO - https://doi.org/10.3390/cancers13225597
M3 - Article
C2 - 34830752
SN - 2072-6694
VL - 13
JO - Cancers
JF - Cancers
IS - 22
M1 - 5597
ER -