Parent Perspectives after the PRISM-P Randomized Trial: A Mixed-Methods Analysis
Open accessAbstract
Background: Parents experience high distress following their child's diagnosis of cancer. We previously tested two delivery models (group and one-on-one) of the “Promoting Resilience in Stress Management for Parents” (PRISM-P) intervention in a randomized trial: one-on-one delivery improved resilience and benefit finding at three months when compared to usual care (UC). Objective: The objective of this analysis was to evaluate quantitative and qualitative outcomes at six months. Design: In this single-center, phase 2, parallel, 1:1:1 randomized trial conducted December 2016 to December 2018, English-speaking parents with a 2–24 year-old child diagnosed with new cancer were randomly assigned to UC, one-on-one, or group PRISM-P, a brief, skill-based curriculum targeting stress management, goal setting, cognitive reframing, and meaning making. We collected parent-reported outcomes (resilience, benefit finding, and psychological distress) at baseline and three and six months. We applied linear mixed-effects regression models to examine six-month outcomes among all participants and conducted directed content analyses of exit interviews with the first 12 parents to complete each study arm. Results: The 94 participating parents were median aged 35–38 years and predominantly white, college-educated mothers. At six months, there was no statistically significant difference in parent-reported outcomes. Exit interviews ( n = 36) suggested that PRISM-P was highly valued: 100% of interviewed recipients recommended it for other parents. Most suggested more coaching would help them retain skills, and almost all endorsed a combined one-on-one and group program. Conclusions: Although the PRISM-P benefits observed at three months were not sustained for six months, all interviewed parents found it valuable. Additional opportunities to strengthen and sustain resilience resources include longer follow-up, flexible format, and skill reinforcement. Trial Registration: NCT02998086.
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A recent exploration of parents' intervention preferences reported that parents expressed a strong desire for being offered a choice between participating in a group or an individual program, and some parents expressed a strong desire to avoid 'forced' group interaction, with some explicitly stating that they would not attend a group program if that was the only choice.
“A recent exploration of parents’ intervention preferences also reported that parents expressed a strong desire for being offered a choice between participating in a group or an individual program. Some parents in that study expressed a strong desire to avoid ‘forced’ group interaction, with some explicitly stating that they would not attend a group program if that was the only choice [76].”
From Providing psychological support to parents of childhood cancer survivors: ‘cascade’ intervention trial results and lessons for the future (2021) · cites this paper as [76]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIncreasing 'dose' by adding extra modules/boosters or by increasing the amount of experiential practice of key skills has been recommended by other intervention developers.
“Increasing ‘dose’ by adding extra modules/boosters or by increasing the amount of experiential practice of key skills, has been recommended by other intervention developers [76] and might have increased Cascade’s potency; however, time was already the most cited burden of participation.”
From Providing psychological support to parents of childhood cancer survivors: ‘cascade’ intervention trial results and lessons for the future (2021) · cites this paper as [76]
The Discussion recommends ongoing boosters, coaching, and opportunities to practice PRISM-P skills. It does not recommend adding extra modules; the Results report mixed parent views about teaching more than four skills. The cited paper therefore supports the boosters and practice portions, but not the extra-modules portion. (LLM, conf=0.83)
Experimental — accuracy not yet measuredIncreasing dose might have increased Cascade's potency.
“Increasing ‘dose’ by adding extra modules/boosters or by increasing the amount of experiential practice of key skills, has been recommended by other intervention developers [76] and might have increased Cascade’s potency; however, time was already the most cited burden of participation.”
From Providing psychological support to parents of childhood cancer survivors: ‘cascade’ intervention trial results and lessons for the future (2021) · cites this paper as [76]
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Self-citation
- Authors
- Rosenberg, A. R., Zhou, C., Bradford, M. C., Barton, K., Junkins, C. C., Taylor, M., Kross, E. K., Curtis, J. R., Dionne-Odom, J. N., & Yi-Frazier, J. P.
- Affiliations
- University of Washington (US)
- Seattle Children's Research Institute (US)
- University of Alabama at Birmingham (US)
- Palliative Care and Resilience Research Laboratory, Center for Clinical and Translational Research, Epidemiology, and Analytics in Research Program, Seattle Children's Research Institute, Seattle, Washington, USA.
- Corresponding author
- Rosenberg, Abby R.
- ORCID
- Venue
- Journal of Palliative Medicine
- Publisher
- SAGE Publications
- Published
- 2021-09-20
- Volume
- 24
- Issue
- 10
- Pages
- 1505-1515
- ISSN
- 1096-6218 (ISSN-L)
- 1557-7740
- PMC
- PMC9206468
- OpenAlex
- W3136919991
- Cited by
- 9
- References
- 32
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 2
- FWCI
- 1.73
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Palliative Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Cancer Institute (L40 CA170049)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Sociology and Political Science › Family Support in Illness
- Keywords
- parental resilience, benefit finding, psychological distress, childhood cancer, parents of children with cancer, stress management, cognitive reframing, meaning-making, goal setting, group intervention, intervention sustainability, skill retention, exit interviews
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, Counseling, Humans, Neoplasms, Parents, Psychotherapy, Stress, Psychological, Young Adult
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