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Cited by 125Childhood Cancer Survivors' Quality of LifeFamily Support in IllnessResilience and Mental Health

Effect of the Promoting Resilience in Stress Management Intervention for Parents of Children With Cancer (PRISM-P): A Randomized Clinical Trial

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Rosenberg, Abby R., Bradford, Miranda C., Junkins, Courtney C., Taylor, Mallory, Zhou, Chuan, Sherr, Nicole, Kross, Erin, Curtis, J. Randall +1 more·2019·JAMA Network Open
DOI 10.1001/jamanetworkopen.2019.11578PMC PMC6751761
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Abstract

Importance: Parents of children with serious illness, such as cancer, experience high stress and distress. Few parent-specific psychosocial interventions have been evaluated in randomized trials. Objective: To determine if individual- or group-based delivery of a novel intervention called Promoting Resilience in Stress Management for Parents (PRISM-P) improves parent-reported resilience compared with usual care. Design, Setting, and Participants: This parallel, phase 2 randomized clinical trial with enrollment from December 2016 through December 2018 and 3-month follow-up was conducted at Seattle Children's Hospital. English-speaking parents or guardians of children who were 2 to 24 years old, who had received a diagnosis of a new malignant neoplasm 1 to 10 weeks prior to enrollment, and who were receiving cancer-directed therapy at Seattle Children's Hospital were included. Parents were randomized 1:1:1 to the one-on-one or group PRISM-P intervention or to usual care. Data were analyzed in 2019 (primary analyses from January to March 2019; final analyses in July 2019). Interventions: The PRISM-P is a manualized, brief intervention targeting 4 skills: stress management, goal setting, cognitive reframing, and meaning making. For one-on-one delivery, skills were taught privately and in person for 30 to 60 minutes approximately every other week. For group delivery, the same skills were taught in a single session with at least 2 parents present. Main Outcomes and Measures: Participants completed patient-reported outcome surveys at enrollment and at 3 months. Linear regression modeling evaluated associations in the intention-to-treat population between each delivery format and the primary outcome (Connor-Davidson Resilience Scale scores, ranging from 0 to 40, with higher scores reflecting greater resilience) and secondary outcomes (benefit finding, social support, health-related quality of life, stress, and distress) at 3 months. Results: In total, 94 parents enrolled, were randomized to 1 of the 3 groups, and completed baseline surveys (32 parents in one-on-one sessions, 32 in group sessions, and 30 in usual care). Their median (interquartile range) ages were 35 to 38 (31-44) years across the 3 groups, and they were predominantly white, college-educated mothers. Their children had median (interquartile range) ages of 5 to 8 (3-14) years; slightly more than half of the children were boys, and the most common cancer type was leukemia or lymphoma. One-on-one PRISM-P delivery was significantly associated with improvement compared with usual care in parent-reported outcomes for resilience (β, 2.3; 95% CI, 0.1-4.6; P = .04) and for benefit finding (β, 0.5; 95% CI, 0.2-0.8; P = .001). No significant associations were detected between either platform and other parent-reported outcomes. Conclusions and Relevance: When delivered individually, PRISM-P was associated with improved parent-reported resilience and benefit finding. This scalable psychosocial intervention may help parents cope and find meaning after their child receives a diagnosis of a serious illness. Trial Registration: ClinicalTrials.gov identifier: NCT02998086.

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  • Psychological interventions can be effective for parents of children with cancer and other serious illnesses, yielding small-moderate improvements in QOL, anxiety, and other outcomes.

    “Psychological interventions can be effective for parents of children with cancer and other serious illnesses [22,23], yielding small–moderate improvements in QOL, anxiety, and other outcomes [23,24,25,26,27,28,29].”

    From Providing psychological support to parents of childhood cancer survivors: ‘cascade’ intervention trial results and lessons for the future (2021) · cites this paper as [28]

    The Discussion reports that one-on-one PRISM-P improved resilience and benefit finding in parents of children newly diagnosed with cancer, supporting the claim that a psychological intervention can help these parents. It also reports no significant improvement in health-related quality of life or distress; the trial did not establish anxiety improvements, small–moderate effects across the listed outcomes, or effectiveness for parents of children with other serious illnesses. The indexed passages provide section labels but no page numbers. (LLM, conf=0.89)

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  • It may have been more feasible to improve other outcomes that map more closely to the content of Cascade, such as perceived peer-support, emotion regulation, or resilience.

    “Nonetheless, it may have been more feasible to improve other outcomes that map more closely to the content of Cascade, such as perceived peer-support, emotion regulation, or resilience [27,28].”

    From Providing psychological support to parents of childhood cancer survivors: ‘cascade’ intervention trial results and lessons for the future (2021) · cites this paper as [28]

    The Results (One-on-One PRISM-P Delivery Compared With UC; page not provided) report improved resilience after a resilience-focused intervention, supporting resilience as an outcome aligned with intervention content. The paper does not evaluate Cascade or show that perceived peer support or emotion regulation would be more feasible to improve. (LLM, conf=0.85)

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Authors
Rosenberg, A. R., Bradford, M. C., Junkins, C. C., Taylor, M., Zhou, C., Sherr, N., Kross, E., Curtis, J. R., & Yi-Frazier, J. P.
Affiliations
  • University of Washington (US)
  • Seattle Children's Research Institute (US)
  • Center for Clinical and Translational Research, Seattle Children’s Research Institute, Seattle, Washington
Corresponding author
Rosenberg, Abby R.
ORCID
Venue
JAMA Network Open
Publisher
American Medical Association (AMA)
Published
2019-09-18
Volume
2
Issue
9
Pages
e1911578
ISSN
2574-3805 (ISSN-L)
DOI
10.1001/jamanetworkopen.2019.11578
PMC
PMC6751761
OpenAlex
W2974400907
Cited by
125
References
64
Citations by year
2026: 10 · 2025: 21 · 2024: 29 · 2023: 24 · 2022: 13 · 2021: 22 · 2020: 5 · 2019: 1
FWCI
10.66
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JAMA Network Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • American Thoracic Society
  • American Lung Association
  • University of Washington
  • National Palliative Care Research Center
  • National Institutes of Health
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
  • Social Sciences › Sociology and Political Science › Family Support in Illness
  • Social Sciences › Psychology › Clinical Psychology › Resilience and Mental Health
Keywords
parental resilience, parents of children with cancer, childhood cancer, stress management, psychosocial interventions, group intervention, individual interventions, cognitive reframing, meaning-making, goal setting, benefit finding, social support, health-related quality of life, distress, intervention delivery format, seriously ill children, parent support programs, cancer-directed therapy, pediatric oncology nursing, nurse-led intervention
MeSH terms
Adaptation, Psychological, Adolescent, Adult, Child, Child, Hospitalized, Child, Preschool, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasms, Parents, Social Support, Stress, Psychological, United States, Program Evaluation, Health Care Surveys, Resilience, Psychological, Young Adult

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