A Field Test of a Group-delivered Enhancing Connections Program: a Partnership Grant with the Cancer Support Community

团体提供的增强联系计划的现场测试：与癌症支持社区的合作赠款

• 批准号: 9233503
• 负责人: FRANCES Marcus LEWIS
• 金额: $ 7.73万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-01-26 至 2018-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9233503
• 关键词: Academic advising; Active Sites; Affect; Anxiety; Area; Back; Behavioral; Cancer Etiology; Cancer Patient; Child; Child Rearing; Child Support; Clinical; Clinical Trials; Collaborations; Colorectal Cancer; Communities; Competence; Consent; Data; Depressed mood; Diagnosis; Disease; Distress; Education; Eligibility Determination; Emotional; Enrollment; Family; Feasibility Studies; Fright; Goals; Grant; Home environment; Intervention; Language; Leadership; Logistics; Malignant Neoplasms; Malignant neoplasm of prostate; Measures; Medical; Moods; Mothers; National Cancer Institute; Newly Diagnosed; Outcome; Outcome Study; Parenting Education; Parents; Participant; Patients; Persons; Phase; Phase III Clinical Trials; Problem behavior; Program Acceptability; Provider; Quality of life; Questionnaires; Randomized Controlled Trials; Recruitment Activity; Reporting; Research Priority; Sampling; School-Age Population; Services; Site; Social Workers; Standardization; Survivors; Symptoms; Telephone; Testing; Time; Training; Travel; United States; Writing; active method; cancer care; cancer diagnosis; cancer site; cancer type; community organizations; cost; design; dosage; efficacy testing; emotional adjustment; emotional distress; field study; follow-up; improved; leukemia; malignant breast neoplasm; melanoma; negative affect; programs; skills; socioeconomics; standardize measure

An estimated 1.2 million parents of school age children will be newly diagnosed with cancer in the U.S. in 2016. Parental cancer causes substantial behavioral and emotional distress in both the diagnosed parent and child. An estimated 22-33% of the children exceed clinical cut off scores on standardized measures of distress or behavioral-emotional adjustment. Parents, regardless of education and socioeconomic level, are known to struggle with how and what to tell their child about their cancer or how to support the child during the many months of medical treatment. Treatment or disease-related symptoms and parental depressed mood negatively affect the child's physical and emotional access to the parent and the quality of parenting. Despite the magnitude of the problem and numbers affected, there is only 1 cancer parenting education program that has been tested for efficacy, the Enhancing Connections Program. In a 6-state randomized control trial, the program decreased parental depressed mood and anxiety, improved parenting quality, parenting skills and confidence, and enhanced the child's behavioral-emotional adjustment. Child outcomes were significant at 1- year follow up compared to controls. But that program, the Enhancing Connections Program (EC), was tested as an in-person delivered program, constraining its access and availability for parents for whom cost and time constraints or the burden of travel are prohibitive. In order to increase the potential sustainability of the EC Program, the program was formatted for group-delivery. The overall goal of the proposed study is to test the feasibility and short-term impact of the group-delivered EC Program within the largest provider of free group- delivered cancer support services in the United States, the Cancer Support Community, an organization that is a merger of the Wellness Community and Gilda's Club. Phase I will involve training 6 Masters prepared social workers drawn from 3 Beta test sites of the Cancer Support Community in the United States. Phase II will involve implementing the program at these 3 Beta test sites and obtaining detailed data on the feasibility and short-term impact of the program on 33 program participants. A within group (pre-posttest) design will examine short term impact of the program. A total of 33 diagnosed parents with Stage 0-3 cancer will be enrolled, drawn from each Beta site's active recruitment channels. Eligible parents will have a child 5-17 years and read, write and speak English among their languages of choice. After consenting and obtaining baseline measures, study participants will receive 5 fully manualized group-delivered educational counseling sessions at 2- week intervals. Outcomes will be assessed at exit using the same standardized measures as those used to test efficacy of the EC. With a sample of 33 parents, effect sizes will range from medium to large: 0.51-1.16; p values will range from .008 to <.001. Longer term, results will be used to inform a larger implementation grant and clinical trial.

据估计，美国将有 120 万学龄儿童的家长被新诊断出患有癌症。 2016 年。父母患有癌症，给确诊的父母带来严重的行为和情绪困扰 和孩子。据估计，22-33% 的儿童超过了标准化测量的临床截止分数 痛苦或行为情绪调整。父母，无论受教育程度和社会经济水平如何， 众所周知，他们在如何以及向孩子讲述癌症的内容或在治疗期间如何支持孩子等问题上遇到了困难 数月的治疗。治疗或疾病相关症状和父母抑郁情绪 对孩子与父母的身体和情感接触以及养育质量产生负面影响。尽管 就问题的严重程度和受影响的人数而言，只有 1 个癌症育儿教育计划 增强联系计划已经过功效测试。在 6 个州的随机对照试验中， 项目减少了家长的抑郁情绪和焦虑，提高了育儿质量、育儿技巧和 自信，增强孩子的行为情绪调整能力。儿童结局在 1- 与对照相比，一年的随访。但该计划，即增强联系计划 (EC)，已经过测试 作为一个面对面的项目，限制了家长的访问和可用性，因为他们的成本和时间 旅行的限制或负担令人望而却步。为了增加 EC 的潜在可持续性 节目，该节目被格式化为小组传送。拟议研究的总体目标是测试 最大的免费团体提供商内团体交付的 EC 计划的可行性和短期影响 在美国提供癌症支持服务的癌症支持社区是一个组织 健康社区和吉尔达俱乐部的合并。 第一阶段将包括培训 6 名硕士准备的社会工作者，他们来自 3 个 Beta 测试站点。 美国癌症支持社区。第二阶段将涉及在这 3 个地点实施该计划 Beta 测试站点并获取有关该计划的可行性和短期影响的详细数据 33 计划参与者。小组内（事前测试后）设计将检查该计划的短期影响。一个 总共 33 名被诊断患有 0-3 期癌症的父母将被纳入其中，这些父母来自每个 Beta 站点的活跃成员 招聘渠道。符合资格的父母将有一个 5 至 17 岁的孩子，并能读、写和说英语 他们选择的语言。在同意并获得基线测量后，研究参与者将获得 5 每两周一次的完全手动的小组提供的教育咨询课程。结果将是 在出口时使用与测试 EC 功效相同的标准化措施进行评估。与一个 33 位父母的样本，效应大小从中等到大：0.51-1.16； p 值范围为 0.008 至 <.001。从长远来看，结果将用于为更大的实施拨款和临床试验提供信息。