Reducing Learning and Psychosocial Disparities in Latino Children with Cancer: A Randomized Intervention Trial.

Journal

Journal of the National Cancer Institute
ISSN: 1460-2105
Titre abrégé: J Natl Cancer Inst
Pays: United States
ID NLM: 7503089

Informations de publication

Date de publication:
16 Oct 2024
Historique:
received: 27 06 2024
revised: 18 09 2024
accepted: 09 10 2024
medline: 16 10 2024
pubmed: 16 10 2024
entrez: 16 10 2024
Statut: aheadofprint

Résumé

We developed a high-intensity parenting intervention (HIP) to help parents support the academic success of childhood cancer survivors (CCSs), who often face post-treatment challenges affecting their school-related functioning. This randomized controlled trial (NCT03178617) evaluated HIP's efficacy compared to lower-intensity, single-session, treatment-as-usual services (LIP) in Latino families. Primary outcomes were parenting efficacy and CCSs' school functioning; secondary outcomes included parenting knowledge and measures of CCSs' academic performance, attention, and functioning outside of school. 106 Latino survivors of childhood leukemia and lymphoblastic lymphoma (aged 6-12 years) and their parents were randomly assigned to HIP (n = 54) or LIP (n = 52). Linear mixed-effects models evaluated group differences across baseline, 6-month (T2), and 12-month (T3) assessments. Parenting efficacy and knowledge improved significantly in the HIP arm, resulting in higher scores vs LIP at T2 and T3 (P ≤ .01). No significant between-group differences were found in child school functioning; however, HIP children showed significantly better social functioning and performance on one measure of attention (CPT-3 commissions) at T3 (P < .05). While HIP adherence challenges were observed, with only 33 (61%) completing the intervention, exploratory analyses suggest that benefits were most evident among those who fully engaged. Satisfaction and perceived benefit were greater for HIP vs LIP at both time points (P < .05). Our results suggest the potential value of parent-directed behavioral interventions like HIP for CCSs and their families. Further studies are needed to address participation barriers and enhance engagement to maximize and sustain benefits.

Sections du résumé

BACKGROUND BACKGROUND
We developed a high-intensity parenting intervention (HIP) to help parents support the academic success of childhood cancer survivors (CCSs), who often face post-treatment challenges affecting their school-related functioning. This randomized controlled trial (NCT03178617) evaluated HIP's efficacy compared to lower-intensity, single-session, treatment-as-usual services (LIP) in Latino families. Primary outcomes were parenting efficacy and CCSs' school functioning; secondary outcomes included parenting knowledge and measures of CCSs' academic performance, attention, and functioning outside of school.
METHODS METHODS
106 Latino survivors of childhood leukemia and lymphoblastic lymphoma (aged 6-12 years) and their parents were randomly assigned to HIP (n = 54) or LIP (n = 52). Linear mixed-effects models evaluated group differences across baseline, 6-month (T2), and 12-month (T3) assessments.
RESULTS RESULTS
Parenting efficacy and knowledge improved significantly in the HIP arm, resulting in higher scores vs LIP at T2 and T3 (P ≤ .01). No significant between-group differences were found in child school functioning; however, HIP children showed significantly better social functioning and performance on one measure of attention (CPT-3 commissions) at T3 (P < .05). While HIP adherence challenges were observed, with only 33 (61%) completing the intervention, exploratory analyses suggest that benefits were most evident among those who fully engaged. Satisfaction and perceived benefit were greater for HIP vs LIP at both time points (P < .05).
CONCLUSIONS CONCLUSIONS
Our results suggest the potential value of parent-directed behavioral interventions like HIP for CCSs and their families. Further studies are needed to address participation barriers and enhance engagement to maximize and sustain benefits.

Identifiants

DOI: 10.1093/jnci/djae256 PMID: 39412495
pubmed: 39412495
pii: 7824064
doi: 10.1093/jnci/djae256
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Auteurs

Sunita K Patel (SK)

Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
Department of Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, USA.

Seong-Hyeon Kim (SH)

Department of Clinical Psychology, School of Psychology & Marriage and Family Therapy, Fuller Theological Seminary, Pasadena, CA, USA.

Kathleen Ingman (K)

Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.

Van Huynh (V)

Division of Pediatric Oncology, University of California Irvine College of Medicine, Irvine, CA, USA.
Division of Oncology, Hyundai Cancer Institute, Children's Hospital Orange County, Orange, CA, USA.

Heather Huszti (H)

Department of Pediatric Psychology, Children's Hospital Orange County, Orange, CA, USA.
Department of Psychiatry & Human Behavior, University of California Irvine College of Medicine, Irvine, CA, USA.

Kimberly Kayser (K)

Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Department of Psychiatry and Behavioral Science, Vanderbilt University Medical Center, Nashville, TN, USA.

Grace Mucci (G)

Department of Pediatric Psychology, Children's Hospital Orange County, Orange, CA, USA.
Department of Psychiatry & Human Behavior, University of California Irvine College of Medicine, Irvine, CA, USA.

Melissa Balderrama (M)

Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.

Laura Bava (L)

Cancer and Blood Disease Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.

Abigail Onderwyzer Gold (A)

Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

Alicia Wuth (A)

Department of Pediatric Psychology, Children's Hospital Orange County, Orange, CA, USA.

Nicole Delgado (N)

Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

Alysia Bosworth (A)

Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

Emily Nishimura (E)

Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

Harneet Hara (H)

Division of Oncology, Hyundai Cancer Institute, Children's Hospital Orange County, Orange, CA, USA.
Pediatric Hematology/Oncology, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA.

Anna Pawlowska (A)

Department of Pediatrics, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

Lisa Mueller (L)

Division of Pediatric Hematology and Oncology, Department of Pediatrics, Kaiser Permanente Medical Center, Los Angeles, CA, USA.

F Lennie Wong (FL)

Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.

Classifications MeSH