Twelve-month follow-up of a randomized controlled trial of internet-based guided self-help for parents of children on cancer treatment
Open accessAbstract
BACKGROUND: A substantial proportion of parents of children on cancer treatment report psychological distress such as symptoms of post-traumatic stress (PTSS), depression, and anxiety. During their child's treatment many parents also experience an economic burden. OBJECTIVE: The aim of this study was to evaluate the long-term efficacy of Internet-based guided self-help for parents of children on cancer treatment. METHODS: This study was a parallel randomized controlled trial comparing a 10-week Internet-based guided self-help program, including weekly support from a therapist via encrypted email, with a wait-list control condition. The intervention was based on cognitive behavior therapy (CBT) and focused on psychoeducation and skills to cope with difficult thoughts and feelings. Primary outcome was self-reported PTSS. Secondary outcomes were self-reported symptoms of depression, anxiety, health care consumption, and sick leave during the past month. Outcomes were assessed pre- and postintervention and at 12-month follow-up. Parents of children on cancer treatment were invited by health care personnel at pediatric oncology centers, and parents meeting the modified symptom criteria on the PCL-C were included in the study. Self-report assessments were provided on the Web. RESULTS: A total of 58 parents of children on cancer treatment (median months since diagnosis=3) were included in the study (intervention n=31 and control n=27). A total of 18 participants completed the intervention, and 16 participants in each group participated in the 12-month follow-up. Intention-to-treat analyses revealed significant effects in favor of the intervention on the primary outcome PTSS, with large between-group effect sizes at postassessment (d=0.89; 95% CI 0.35-1.43) and at 12-month follow-up (d=0.78; 95% CI 0.25-1.32). Significant effects in favor of the intervention on the secondary outcomes depression and anxiety were also observed. However, there was no evidence for intervention efficacy on health care consumption or sick leave. CONCLUSIONS: Using the Internet to provide psychological interventions shows promise as an effective mode of delivery for parents reporting an increased level of PTSS and who consider Internet-based interventions as a viable option. Future research should corroborate these findings and also develop and evaluate interventions and policies that may help ameliorate the economic burden that parents may face during their child's treatment for cancer.
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There is wide evidence that psychological interventions maintain results at follow-ups, such as 3 months for a self-help online intervention for suicidal thoughts, 3-6 months for web-based depression interventions, and 12 months for a self-help intervention for parents of children on cancer treatment.
“there is wide evidence of the effectiveness of psychological interventions in terms of maintaining the results on the follow-ups, such as 3 months for a self-help online intervention for suicidal thoughts (Van Spijker et al., 2015)”
From A Self-Applied Multi-Component Psychological Online Intervention Based on UX, for the Prevention of Complicated Grief Disorder in the Mexican Population During the COVID-19 Outbreak: Protocol of a Randomized Clinical Trial (2021) · cites this paper as Cernvall et al., 2017
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Experimental — accuracy not yet measuredApproximately 30% of parents with a need for psychological support are expected to potentially consent to participate.
“Approximately 30% of these (216/720) are expected to potentially consent.11 12 18”
From Study protocol for a feasibility study of an internet-administered, guided, CBT-based, self-help intervention (ENGAGE) for parents of children previously treated for cancer (2018) · cites this paper as [12]
The Results (Recruitment and Baseline Characteristics; page unavailable) report that 747 parents were asked for consent to be contacted again and 553 declined, implying about 26% did not decline. This is broadly consistent with an approximately 30% recruitment estimate, but the paper does not establish that rate specifically for parents needing psychological support or predict that 216 of 720 would consent. (LLM, conf=0.84)
Experimental — accuracy not yet measuredAn internet-administered psychological, self-help intervention is effective in reducing symptoms of anxiety, depression and post-traumatic stress (PTSS) among parents of children recently diagnosed with cancer, with improvements maintained at 1-year follow-up.
“We have shown an internet-administered psychological, self-help intervention to be effective in reducing symptoms of anxiety, depression and post-traumatic stress (PTSS) among parents of children recently diagnosed with cancer,11 with improvements maintained at 1-year follow-up.12”
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Cites
An inventory for measuring clinical anxiety: Psychometric properties.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.893 · Cited by 14,407 · see citing works
Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence
Singer, J. D., & Willett, J. B. (2003) · doi:10.1093/acprof:oso/9780195152968.001.0001 · Cited by 10,647 · see citing works
Power failure: why small sample size undermines the reliability of neuroscience
Button, K. S., Ioannidis, J. P. A., Mokrysz, C., Nosek, B. A., Flint, J., Robinson, E. S. J., & Munafò, M. R. (2013) · Nature Reviews Neuroscience · doi:10.1038/nrn3475 · Cited by 7,641 · cited 1× · see citing works
“As the study was small and underpowered, the risk for inflated effect sizes and type-I errors is also increased [34], which should be kept in mind when interpreting the findings.”
Beck, A. T., Steer, R. A., & Brown, G. (2011) · PsycTESTS Dataset · doi:10.1037/t00742-000 · Cited by 7,535 · see citing works
(1999) · Cited by 5,934 · see citing works
Psychometric properties of the PTSD checklist (PCL)
Blanchard, E. B., Jones-Alexander, J., Buckley, T. C., & Forneris, C. A. (1996) · Behaviour Research and Therapy · doi:10.1016/0005-7967(96)00033-2 · Cited by 3,997 · see citing works
Psychometric properties of the PTSD checklist—civilian version
Ruggiero, K. J., Ben, K. D., Scotti, J. R., & Rabalais, A. E. (2003) · Journal of Traumatic Stress · doi:10.1023/a:1025714729117 · Cited by 1,227 · see citing works
Metacognitive therapy for anxiety and depression
Veeraraghavan, V. (2009) · Anxiety, Stress & Coping · doi:10.1080/10615800902833770 · Cited by 1,165 · see citing works
Feingold, A. (2009) · Psychological Methods · doi:10.1037/a0014699 · Cited by 851 · see citing works
Hedman, E., Ljótsson, B., & Lindefors, N. (2012) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/erp.12.67 · Cited by 672 · see citing works
Are Fathers Involved in Pediatric Psychology Research and Treatment?
Phares, V., Lopez, E., Fields, S. A., Kamboukos, D. M., & Duhig, A. M. (2005) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsi050 · Cited by 414 · see citing works
Bouwmans, C., De Jong, K., Timman, R., Zijlstra-Vlasveld, M., Van der Feltz-Cornelis, C., Tan, S. S., & Hakkaart-van Roijen, L. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-217 · Cited by 401 · see citing works
Psychological interventions for parents of children and adolescents with chronic illness
Eccleston, C., Palermo, T. M., Fisher, E., & Law, E. (2012) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009660.pub2 · Cited by 378 · see citing works
Posttraumatic Stress Symptoms During Treatment in Parents of Children With Cancer
Kazak, A. E., Boeving, C. A., Alderfer, M. A., Hwang, W.-T., & Reilly, A. (2005) · Journal of Clinical Oncology · doi:10.1200/jco.2005.09.110 · Cited by 290 · see citing works
Sahler, O. J. Z., Fairclough, D. L., Phipps, S., Mulhern, R. K., Dolgin, M. J., Noll, R. B., Katz, E. R., Varni, J. W., Copeland, D. R., & Butler, R. W. (2005) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.73.2.272 · Cited by 282 · see citing works
Partial PTSD <i>versus</i> full PTSD: an empirical examination of associated impairment
BRESLAU, N., LUCIA, V. C., & DAVIS, G. C. (2004) · Psychological Medicine · doi:10.1017/s0033291704002594 · Cited by 256 · see citing works
Psychological interventions for parents of children and adolescents with chronic illness
Eccleston, C., Fisher, E., Law, E., Bartlett, J., & Palermo, T. M. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009660.pub3 · Cited by 216 · see citing works
Davison, K. K., Charles, J., Khandpur, N., & Nelson, T. J. (2016) · Maternal and Child Health Journal · doi:10.1007/s10995-016-2157-z · Cited by 207 · see citing works
SAHLER, O. J. Z., VARNI, J. W., FAIRCLOUGH, D. L., BUTLER, R. W., NOLL, R. B., DOLGIN, M. J., PHIPPS, S., COPELAND, D. R., KATZ, E. R., & MULHERN, R. K. (2002) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/00004703-200204000-00003 · Cited by 205 · see citing works
An online family intervention to reduce parental distress following pediatric brain injury.
Wade, S. L., Carey, J., & Wolfe, C. R. (2006) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.74.3.445 · Cited by 199 · see citing works
Sahler, O. J. Z., Dolgin, M. J., Phipps, S., Fairclough, D. L., Askins, M. A., Katz, E. R., Noll, R. B., & Butler, R. W. (2013) · Journal of Clinical Oncology · doi:10.1200/jco.2011.39.1870 · Cited by 195 · see citing works
Salim, A., Mackinnon, A., Christensen, H., & Griffiths, K. (2008) · Psychiatry Research · doi:10.1016/j.psychres.2007.08.005 · Cited by 194 · see citing works
Posttraumatic stress disorder among parents of children on cancer treatment: a longitudinal study
Pöder, U., Ljungman, G., & von Essen, L. (2008) · Psycho-Oncology · doi:10.1002/pon.1263 · Cited by 150 · see citing works
Self-citationPosttraumatic stress symptoms in parents of children with cancer within six months of diagnosis.
Dunn, M. J., Rodriguez, E. M., Barnwell, A. S., Grossenbacher, J. C., Vannatta, K., Gerhardt, C. A., & Compas, B. E. (2012) · Health Psychology · doi:10.1037/a0025545 · Cited by 133 · see citing works
Serious illness in childhood: the different threats of cancer and diabetes from a parent perspective
Boman, K. K., Viksten, J., Kogner, P., & Samuelsson, U. (2004) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2004.05.043 · Cited by 95 · see citing works
Costs of caring for a child with cancer: a questionnaire survey
Eiser, C., & Upton, P. (2006) · Child Care Health and Development · doi:10.1111/j.1365-2214.2006.00710.x · Cited by 93 · see citing works
Impact of childhood cancer on parental employment and sources of income: A Canadian pilot study
Limburg, H., Shaw, A. K., & McBride, M. L. (2007) · Pediatric Blood & Cancer · doi:10.1002/pbc.21448 · Cited by 87 · see citing works
Farmer, R. F., & Chapman, A. (2007) · American Psychological Association eBooks · doi:10.1037/11664-000 · Cited by 80 · see citing works
Cernvall, M., Carlbring, P., Ljungman, L., Ljungman, G., & Essen, L. (2015) · Psycho-Oncology · doi:10.1002/pon.3788 · Cited by 61 · see citing works
Self-citationHovén, E., von Essén, L., & Norberg, A. L. (2013) · Acta Oncologica · doi:10.3109/0284186x.2012.760846 · Cited by 48 · see citing works
Pöder, U., & von Essén, L. (2008) · European Journal of Cancer Care · doi:10.1111/j.1365-2354.2008.00935.x · Cited by 37 · see citing works
Wakefield, C. E., Sansom-Daly, U. M., McGill, B. C., McCarthy, M., Girgis, A., Grootenhuis, M., Barton, B., Patterson, P., Osborn, M., Lowe, C., et al. (2015) · Trials · doi:10.1186/s13063-015-0681-6 · Cited by 35 · see citing works
Wikman, A., Hovén, E., Cernvall, M., Ljungman, G., Ljungman, L., & von Essén, L. (2016) · Acta Oncologica · doi:10.3109/0284186x.2016.1167956 · Cited by 35 · see citing works
Self-citationCernvall, M., Carlbring, P., Ljungman, G., & von Essén, L. (2012) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2012.741095 · Cited by 28 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- [30]Singer JD Willet JB Applied longitudinal data analysis: Modelling change and event occurence 2003 New York, NY Oxford University Press
- [33]Cohen J Statistical power analysis for the behavioral sciences. 2nd edition 1988 Hillsdale, NJ Lawrence Erlbaum Associates
Cited by
Sorted by citations
Ogez, D., Péloquin, K., Bertout, L., Bourque, C.-J., Curnier, D., Drouin, S., Laverdière, C., Marcil, V., Ribeiro, R., Callaci, M., et al. (2019) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-019-09612-8 · Cited by 35 · see citing works
Ljungman, L., Cernvall, M., Ghaderi, A., Ljungman, G., von Essen, L., & Ljótsson, B. (2018) · PeerJ · doi:10.7717/peerj.4570 · Cited by 32 · see citing works
Self-citationWikman, A., Kukkola, L., Börjesson, H., Cernvall, M., Woodford, J., Grönqvist, H., & von Essen, L. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.9457 · Cited by 32 · see citing works
Self-citationWoodford, J., Wikman, A., Cernvall, M., Ljungman, G., Romppala, A., Grönqvist, H., & von Essen, L. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-023708 · Cited by 31 · see citing works
Self-citationEffectiveness trial of an online self-help intervention for sexual problems after cancer
Schover, L. R., Strollo, S., Stein, K., Fallon, E., & Smith, T. (2020) · Journal of Sex & Marital Therapy · doi:10.1080/0092623x.2020.1762813 · Cited by 29 · see citing works
Dominguez-Rodriguez, A., Martínez-Luna, S. C., Hernández Jiménez, M. J., De La Rosa-Gómez, A., Arenas-Landgrave, P., Esquivel Santoveña, E. E., Arzola-Sánchez, C., Alvarez Silva, J., Solis Nicolas, A. M., Colmenero Guadián, A. M., et al. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.644782 · Cited by 18 · see citing works
“, 2015) and a Meta-Analysis of Cowpertwait and Clarke (2013), identified that web-based interventions for depression where the effects are maintained for 3–6 months, and even the results have been observed to maintain in a 12 months follow-up in a selfhelp intervention for parents of children on cancer treatment (Cern…”
BackgroundOgez, D., Péloquin, K., Bertout, L., Bourque, C.-J., Curnier, D., Drouin, S., Laverdière, C., Marcil, V., Aramideh, J., Ribeiro, R., et al. (2021) · Cogent Medicine · doi:10.1080/2331205x.2021.1944476 · Cited by 8 · see citing works
- Authors
- Cernvall, M., Carlbring, P., Wikman, A., Ljungman, L., Ljungman, G., & von Essen, L.
- Affiliations
- Uppsala University (SE)
- Stockholm University (SE)
- Corresponding author
- Cernvall, Martin
- Venue
- Journal of Medical Internet Research
- Publisher
- JMIR Publications Inc.
- Published
- 2017-07-27
- Volume
- 19
- Issue
- 7
- Pages
- e273
- ISSN
- 1438-8871 (ISSN-L)
- PMC
- PMC5553001
- OpenAlex
- W2740282748
- Cited by
- 45
- References
- 34
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 5 · 2023: 5 · 2022: 3 · 2021: 9 · 2020: 3 · 2019: 4 · 2018: 7
- FWCI
- 4.37
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Journal of Medical Internet Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Cancerfonden
- Vetenskapsrådet (K2008-70X-20836-01-3, K2011-70X-20836-04-4)
- Barncancerfonden (PROJ08/010, PRO12/028)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- parents of children with cancer, pediatric oncology, posttraumatic stress symptoms, depression, anxiety, cognitive behavioral therapy, psychoeducation, economic burden, health care utilization, sick leave, long-term efficacy
- MeSH terms
- Adult, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Male, Neoplasms, Parents, Self-Help Groups, Time Factors, Internet
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