Project Description
Promoting Resilience in Stress Management (PRISM): A Novel Supportive Intervention for Parents of Children with Cancer
Parenting a child with cancer is highly distressing. Both during and after cancer therapy, parents
may suffer from poor mental health, risky health behaviors, and financial
hardship, all of which may impact patients, siblings, and the family unit. Positive psychological resources can
mitigate negative outcomes. In this
regard, resilience is particularly important, describing an individual’s
ability to maintain psychological and/or physical well-being in the face of
stress.
We have previously described the “Promoting Resilience in
Stress Management” (PRISM) intervention for adolescent and young adult patients
with cancer. This brief, 1:1
intervention targets four “resilience resources” over approximately 3 months:
skills in stress-management/mindfulness, goal-setting, cognitive restructuring,
and meaning-making. Notably, every
parent whose child received the PRISM requested a similar intervention for him-
or herself. Hence, we adapted two
versions of the intervention for parents (the “PRISM-P”). First, using the same 1:1 format, we piloted
the PRISM-P amongst 12 parents of children with cancer. Feedback was highly positive; however, many
parents requested additional group-based social support. Second, we conducted a half-day symposium and
administered small-group adaptations of the PRISM-P to 70 parents of children
with serious illness. Feedback was again
positive; however, the opportunity to develop individual skills was limited.
This application proposes a pilot Randomized Clinical Trial
(RCT) to evaluate and compare 3 formats of the PRISM-P in order to determine
optimal methodologies and preferences for future, larger studies: Individual
(1:1) vs. group-based vs. combined. We
hypothesize that the combined-format will be associated with higher parent-reported
resilience 6 months following enrollment.
Consecutive eligible parents of children with newly diagnosed cancer
will be randomly assigned to one of the 3 formats (N=75 total, n=25 per arm). Secondary aims will assess parent-reported
stress, burden of care, hope, goals, optimism, benefit-finding, psychological
distress, and health behaviors, and ongoing perceptions of usefulness,
feasibility, and preference.
Bio
Abby R. Rosenberg, MD, MS, is an Assistant Professor of
Pediatrics in the Division of Hematology/Oncology at the University of
Washington and Seattle Children’s Hospital. She is the director of the
“Palliative Care and Resilience” research program at Seattle Children’s
Research Institute and the chair of the Palliative Care subcommittee of the
Children’s Oncology Group. Dr. Rosenberg’s clinical and
investigative work has focused primarily on the intersection of the medical,
psychosocial, and bioethical issues involved in the care of adolescents and
young adults (AYAs) with advanced cancer. Specifically, she and her team
have developed a platform for studying and promoting resilience in this patient
population. Ongoing projects include a randomized trial to test a novel,
resilience-promoting intervention, as well as evaluations of end-of-life
communication practices among AYAs with cancer. Dr. Rosenberg is honored
to be a recipient of the 2016 Pilot/Exploratory Support Award where she will
expand the application of her resilience intervention to parents of children
with cancer.
Email: abby.rosenberg@seattlechildrens.org