The National Palliative Care Research Center

Curing suffering through palliative care research.


Erica Kaye MD, MPH

Assistant Professor

St. Jude Children's Research Hospital

Grant Year
Grant Term
2 years
Grant Type
Kornfeld Scholars Program

Project Description
Understanding Communication to Achieve Trust (U-CHAT): A Prospective Longitudinal Study of Prognostic Communication between Pediatric Oncologists, Children with High-Risk Cancer, and their Parents

High quality communication between pediatric oncologists, patients, and parents is imperative for facilitation of therapeutic alliance and alignment of medical management with goals of care. Historically, communication research in pediatric oncology has been cross-sectional, retrospective, and reliant on survey methodology, and little is known about the specific communication strategies used by pediatric oncologists to share prognostic information or the impact of varying communication techniques on prognostic understanding. This prospective longitudinal study utilizes audio-recording technology to capture serial disease reevaluation discussions occurring in real-time between pediatric oncologists, patients with high-risk cancer, and families, with triangulation of supplemental data including a validated non-verbal communication tool and matched surveys and semi-structured interviews completed by oncologists and patients/parents following recorded conversations. A preliminary pilot conducted in a cohort of solid tumor patients demonstrated high rates of feasibility and acceptability; given pilot success, we propose study expansion to follow a large cohort of high-risk pediatric tumor patients through the end of life. We hypothesize that explicit prognostication will occur infrequently and that provision of clear prognostic information will be associated with increased prognostic awareness and therapeutic alliance. Using mixed methods, we aim to: 1) describe the content, quality, and evolution of prognostic communication across the advancing illness trajectory for pediatric tumor patients; 2) identify associations between specific communication strategies and oncologist-patient/parent concordance related to prognostic awareness; and 3) identify targetable gaps in prognostic communication quality to serve as the basis for development of a clinical intervention pilot in the high-risk pediatric tumor population. This prospective, longitudinal study will increase our understanding of how prognostic information is shared, processed, and understood in the context of high-risk pediatric tumors across the advancing illness course, as well as enable investigation of an intervention to improve prognostic communication for children with high-risk cancer and their families.

Erica C. Kaye, MD, MPH, is an Assistant Professor in the Department of Oncology, Division of Quality of Life and Palliative Medicine, at St. Jude Children’s Research Hospital. Her mixed methods research aims to improve prognostic communication between oncologists, children with high-risk cancer, and their families across the advancing illness trajectory to the end of life. Dr. Kaye received her Bachelor of Arts in English Literature from Yale, her Medical Degree from Harvard, and her Masters in Public Health from Johns Hopkins Bloomberg School of Public Health with a focus on qualitative and mixed methodology training. She completed her pediatrics residency at Boston Children’s Hospital, followed by two subspecialty fellowships in pediatric hematology-oncology and hospice and palliative medicine at St. Jude.

Email: Erica.Kaye@STJUDE.ORG