A Field Test of a Group-delivered Enhancing Connections Program: a Partnership Grant with the Cancer Support Community

据估计，美国将有120万学龄儿童的父母被新诊断为癌症。 在2016年。双亲癌症在确诊的双亲中都会造成严重的行为和情感痛苦 还有孩子。据估计，22%-33%的儿童超过了标准化测量的临床分界值 痛苦或行为-情绪调整。父母，无论受教育程度和社会经济水平如何， 众所周知，他们在如何以及用什么告诉孩子他们的癌症或如何在 几个月的医疗救治。治疗或疾病相关症状与父母抑郁情绪 对孩子与父母的身体和情感接触以及育儿质量产生负面影响。尽管 从问题的严重性和受影响的人数来看，只有1个癌症育儿教育项目 已经进行了有效性测试，即增强联系计划。在一项包含6个州的随机对照试验中， 该计划降低了父母的抑郁情绪和焦虑，提高了育儿质量，提高了育儿技能， 自信，并增强了孩子的行为-情绪适应能力。儿童结局在1-1岁显著 与对照组相比，进行了一年的随访。但这项名为加强联系计划(EC)的计划已经过测试 作为面对面交付的计划，限制了家长的访问和可用性，因为家长需要花费大量时间 旅行的限制或负担是令人望而却步的。为了增加欧共体的潜在可持续性 计划，该计划的格式是为了团体递送。拟议研究的总体目标是测试 集团提供的电子商务计划在最大的免费集团内的可行性和短期影响- 在美国提供癌症支持服务的癌症支持社区，一个 健康社区和吉尔达俱乐部的合并。 第一阶段将包括培训6名准备好硕士学位的社工，这些社工来自本会的3个测试地点 美国癌症支持社区。第二阶段将涉及在这三个地点实施该计划 Beta测试点，并获得关于该计划的可行性和短期影响的详细数据 计划参与者。小组内(前后测试)设计将检查该计划的短期影响。一个 共有33名被诊断患有0-3期癌症的父母将被登记，从每个Beta网站的活跃人员中抽取 招聘渠道。符合条件的父母将有一个5-17岁的孩子，并能读写说英语 他们选择的语言。在同意并获得基线测量后，研究参与者将获得5 完全人性化的团体提供的教育咨询课程，每隔2周。结果将是 在退出时使用与欧盟有效性测试相同的标准化措施进行评估。使用一个 由33个父项组成的样本，效果大小从中到大：0.51-1.16；p值从.008到 &lt；.001。从长远来看，结果将用于更大规模的实施拨款和临床试验。

An estimated 1.2 million parents of school age children will be newly diagnosed with cancer in the U.S. in 2016. Parental cancer causes substantial behavioral and emotional distress in both the diagnosed parent and child. An estimated 22-33% of the children exceed clinical cut off scores on standardized measures of distress or behavioral-emotional adjustment. Parents, regardless of education and socioeconomic level, are known to struggle with how and what to tell their child about their cancer or how to support the child during the many months of medical treatment. Treatment or disease-related symptoms and parental depressed mood negatively affect the child's physical and emotional access to the parent and the quality of parenting. Despite the magnitude of the problem and numbers affected, there is only 1 cancer parenting education program that has been tested for efficacy, the Enhancing Connections Program. In a 6-state randomized control trial, the program decreased parental depressed mood and anxiety, improved parenting quality, parenting skills and confidence, and enhanced the child's behavioral-emotional adjustment. Child outcomes were significant at 1- year follow up compared to controls. But that program, the Enhancing Connections Program (EC), was tested as an in-person delivered program, constraining its access and availability for parents for whom cost and time constraints or the burden of travel are prohibitive. In order to increase the potential sustainability of the EC Program, the program was formatted for group-delivery. The overall goal of the proposed study is to test the feasibility and short-term impact of the group-delivered EC Program within the largest provider of free group- delivered cancer support services in the United States, the Cancer Support Community, an organization that is a merger of the Wellness Community and Gilda's Club. Phase I will involve training 6 Masters prepared social workers drawn from 3 Beta test sites of the Cancer Support Community in the United States. Phase II will involve implementing the program at these 3 Beta test sites and obtaining detailed data on the feasibility and short-term impact of the program on 33 program participants. A within group (pre-posttest) design will examine short term impact of the program. A total of 33 diagnosed parents with Stage 0-3 cancer will be enrolled, drawn from each Beta site's active recruitment channels. Eligible parents will have a child 5-17 years and read, write and speak English among their languages of choice. After consenting and obtaining baseline measures, study participants will receive 5 fully manualized group-delivered educational counseling sessions at 2- week intervals. Outcomes will be assessed at exit using the same standardized measures as those used to test efficacy of the EC. With a sample of 33 parents, effect sizes will range from medium to large: 0.51-1.16; p values will range from .008 to <.001. Longer term, results will be used to inform a larger implementation grant and clinical trial.