PRISM for Parents of Children With Cancer Promoting Resilience in Stress Management (PRISM) Intervention for Parents of Children With Cancer

Parenting a child with cancer is highly distressing. Both during and after cancer therapy,
parents may suffer from poor mental health, risky health behaviors, and financial hardship,
all of which may impact patients, siblings, and the family unit. Positive psychological
resources can mitigate negative outcomes. In this regard, resilience is particularly
important, describing an individual's ability to maintain psychological and/or physical
well-being in the face of stress.

The investigators have previously described the "Promoting Resilience in Stress Management"
(PRISM) intervention for adolescent and young adult patients with cancer. This brief, 1:1
intervention targets four "resilience resources" over approximately 3 months: skills in
stress-management/mindfulness, goal-setting, cognitive restructuring, and meaning-making.
Notably, every parent whose child received the PRISM requested a similar intervention for
him- or herself. Hence, the investigators adapted two versions of the intervention for
parents (the "PRISM-P"). First, using the same 1:1 format, they piloted the PRISM-P amongst
12 parents of children with cancer. Feedback was highly positive; however, many parents
requested additional group-based social support. Second, they conducted a half-day symposium
and administered small-group adaptations of the PRISM-P to 70 parents of children with
serious illness. Feedback was again positive; however, the opportunity to develop individual
skills was limited.

This application proposes a pilot Randomized Clinical Trial (RCT) to evaluate and compare
these 2 formats of the PRISM-P with usual care, in order to determine optimal methodologies
and preferences for future, larger studies. Consecutive eligible parents of children with
newly diagnosed cancer will be randomly assigned to one of the 3 options (N=75 total, n=25
per arm). Secondary aims will assess parent-reported stress, burden of care, hope, goals,
optimism, benefit-finding, psychological distress, and health behaviors, and ongoing
perceptions of usefulness, feasibility, and preference.

Inclusion Criteria: Parents of children who:

- Are aged 2-24 years

- Have been diagnosed with new malignancy between 1-10 weeks prior

- Are scheduled to receive cancer-directed therapy at Seattle Children's Hospital

- Has provided written informed consent (child aged 18 years and older), written assent
(child aged 13-17 years), verbal assent (child aged 7-12 years).

- Able to speak and read English language

- Cognitively able to participate in interactive interviews

Exclusion Criteria:

- Parent is < 18 years of age

- Parent is cognitively or physically unable to participate in interactive interview

- Parent is unable to speak and read English language

- Parent or child participated on prior PRISM intervention study